Medical expert of the article
New publications
Preparations
Zoldria
Last reviewed: 03.07.2025

All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.

Zoledronic acid is a solution of zoledronic acid monohydrate combined with additional elements.
Indications Zoldria
It is used for hypercalcemia that develops against the background of a neoplasm of a malignant nature.
It is also prescribed to prevent the development of negative signs in the area of bone tissue in people with malignant tumors or lesions affecting the bones (vertebral compression, pathological fractures, as well as complications after radiation therapy procedures or surgeries).
Release form
The substance is released in the form of powder for infusion liquid, in 4 mg vials. There is 1 vial in a box.
Pharmacodynamics
Zoledronic acid is a bisphosphonate that exhibits potent inhibitory effects on osteoclastic bone resorption.
The selective effect of bisphosphonates on bone tissue is associated with their strong affinity for mineralized bone tissue. The use of the drug leads to the development of an active effect on their structure and improves their mineralization.
In addition to slowing down the resorption processes, zoledronic acid has a direct antitumor effect on cultured myeloma cells, as well as breast carcinoma. This effect develops due to slowing down cell proliferation and apoptosis induction processes - the drug has an anti-metastatic effect.
Pharmacokinetics
Data concerning the pharmacokinetic parameters of the drug in bone metastases were obtained after the administration of 5- and 15-minute infusions (single or repeated) with a dosage of 2, 4, as well as 8 and 16 mg of the substance to 64 patients. It should be taken into account that the pharmacokinetics of the drug does not depend on the size of its dosage.
From the start of the infusion procedure, there is a rapid increase in plasma values of the drug. The peak value is noted at the end of the procedure, after which a rapid decrease in concentration is recorded to 10% of Cmax after 4 hours, and also <1% of Cmax after 24 hours, followed by a prolonged period of low values, not exceeding 0.1% of Cmax until the 2nd infusion, performed on the 28th day.
The intravenously administered drug is excreted via the kidneys in 3 phases: first, there is a rapid 2-stage excretion from the systemic circulation with an α-half-life of 0.24 hours and a β-half-life of 1.87 hours, followed by a prolonged phase with a terminal γ-half-life of 146 hours. No accumulation of the drug in the blood plasma was recorded with repeated infusions at intervals of 28 days.
Zoledronic acid does not participate in metabolic processes and is excreted unchanged through the kidneys. During the first 24 hours, 39±16% of the drug portion is found in the urine. The remainder of the substance is synthesized with bone tissue, after which it is released back from them with subsequent renal excretion.
The total clearance rate is 5.04±2.5 l/h, regardless of the dosage of Zoldria, as well as the patient's age, gender, race and weight. Prolonging the infusion time from 5 to 15 minutes reduces the level of the active substance at the end of the procedure by 30%, but does not affect the plasma AUC values.
Dosing and administration
Use in osteoporosis developing during postmenopause, male osteoporosis, and also for the treatment and prevention of osteoporosis caused by GCS and the prevention of recurrent fractures in the hip area: 1 infusion of 5 mg of the substance is administered intravenously.
In Paget's disease, a single intravenous infusion of 5 mg of the drug is prescribed. The duration of the infusion is at least 15 minutes. People with this disease need to ensure adequate calcium and calciferol intake in daily portions for 10 days after using Zoldria.
Use Zoldria during pregnancy
Since there is no experience of using Zoldria in pregnant women, it should not be used during this period.
There is also no data on whether the drug is excreted in breast milk, which is why it is prohibited to prescribe it to nursing women.
Contraindications
Main contraindications:
- severe intolerance to the active element of the drug and any additional components contained in its composition, or other bisphosphonates;
- severe form of renal failure;
- hypocalcemia.
Side effects Zoldria
The use of the drug may provoke the following side effects:
- disorders affecting the hematopoietic system: leukopenia or thrombocytopenia, as well as anemia. Pancytopenia occurs rarely;
- digestive disorders: vomiting, anorexia, dry mouth, nausea, constipation, stomatitis, diarrhea or abdominal pain;
- problems with the functioning of the central and peripheral nervous systems: taste disorders, anxiety, headaches, tremors, hyperesthesia or hypoesthesia, as well as sleep disorders and dizziness. Occasionally, a feeling of confusion develops;
- symptoms arising from the musculoskeletal system: myalgia, pain in the bone area and arthralgia. Sometimes muscle cramps appear;
- respiratory disorders: sometimes cough or dyspnea appears;
- problems with the cardiovascular system: sometimes the blood pressure level decreases or increases. Bradycardia occasionally occurs;
- disorders affecting urinary function: sometimes hematuria, acute renal failure or proteinuria appear;
- lesions of the subcutaneous layers and epidermis: rashes (including macular or erythematous), itching and hyperhidrosis;
- manifestations from the visual organs: weakening of visual acuity or conjunctivitis. Occasionally, episcleritis or uveitis develops;
- signs of allergy: symptoms of hypersensitivity. Quincke's edema occasionally develops;
- local manifestations: irritation, pain and swelling at the site of drug application;
- laboratory test data: increased blood urea and creatinine levels, development of hypocalcemia, hypophosphatemia or hypomagnesemia. Rarely, hypernatremia or -kalemia occurs;
- other: the appearance of chills, a feeling of malaise or severe fatigue, fever, flushing of the face, and in addition to this, the development of a flu-like condition, asthenia, pain in the sternum and peripheral edema, as well as weight gain.
[ 1 ]
Overdose
In cases of intoxication causing clinically noticeable hypocalcemia, the patient's condition can be compensated by additional oral calcium intake or calcium gluconate infusion.
Interactions with other drugs
Great caution should be exercised when combining bisphosphonates with aminoglycosides because they may lead to additive effects, resulting in serum calcium levels remaining low for longer than necessary.
The drug should also be combined with loop diuretics with caution, because their additive effect may cause hypocalcemia.
With precautions, Zoldria is also combined with other potentially nephrotoxic drugs. It is also necessary to take into account the possibility of hypomagnesemia during the course of therapy.
Osteonecrosis of the jaw has been reported in combination with drugs that have antiangiogenic activity.
[ 2 ]
Storage conditions
Zoldria should be kept in a place closed to small children. Temperature values should not exceed 25°C.
The drug dissolved in 5 ml of injection water is then diluted with sterile saline or 5% glucose solution - this substance has a shelf life of 24 hours (when kept at a temperature of 2-8° C).
Shelf life
Zoldria can be used within 36 hours from the date of release of the therapeutic drug.
Application for children
The drug cannot be used in pediatrics.
Analogues
Analogues of the drug are Aclasta, Zometa, Deztron with Zoledronic acid-Vista, as well as Metakos and Zoledronic acid-Pharmex.
Attention!
To simplify the perception of information, this instruction for use of the drug "Zoldria" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.