The Zombie

Zometa slows down the process of bone resorption and corrects the metabolic processes of bone tissue.

Indications The Zombie

It is applied in case of such violations:

• secondary lesion of bone tissue (metastases) in tumors of a widespread nature (carcinoma of the prostate or breast);
• multiple myeloma ;
• hypercalcemia with a tumor nature or hyperparathyroidism;
• prevention of the appearance of fractures of a pathological nature;
• prevention of compression of the spinal trunk;
• during surgical procedures related to bones;
• prevention of osteoporosis during therapy for breast carcinoma using agents that slow down the aromatase activity.

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Release form

The substance is released in the form of an infusion fluid, inside a 4 mg / 0.1 L bottle, and also as a concentrate in 4 mg / 5 ml vial.

Pharmacodynamics

Zoledronic acid is a bisphosphonate with high therapeutic efficacy. It inhibits bone resorption, affecting osteoclasts that destroy bone tissue.

Selective effects on bone tissue are associated with significant affinity for them. Osteoclasts absorb bisphosphonates exclusively in the areas of bone change, and then the effect on bone tissue is slowed down, and the process of their destruction stops. But some details of the principle of the influence of drugs have not yet been finally determined.

The drug has a powerful antiresorption effect. Use in women with osteoporosis associated with postmenopause resulted in a significant decrease in the likelihood of vertebral fractures and their recurrence. During therapy in patients with Paget's disease, there is a reliable and long-term therapeutic response, stabilization of alkaline phosphatase parameters and bone metabolism values. In people with similar pathologies, the drug does not affect the state of a healthy bone, helps to preserve its architectonics, and does not destroy mineralization.

At the same time, the drug, inhibiting cell proliferation, causes an antitumor effect in the case of myeloma or a breast tumor. It has antimetastatic activity, which is why it can be used for bone metastases, as well as for their prevention. Slowing bone resorption significantly reduces pain.

In the case of carcinomas with bone metastases, the drug prevents fractures as well as spinal compression, reduces hypercalcemia associated with the tumor, and excretion of Ca along with urine. Frequently, the need for radiation therapy is also weakened.

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Pharmacokinetics

Bisphosphonates have poor absorption inside the gastrointestinal tract, which makes it more advisable to use medicinal fluids for intravenous injection. Infusion increases the performance inside the serum and they reach the maximum at its end. After 4 hours there is a decrease in values by 10%, and then another 1% after the next 24 hours. Intlasma protein synthesis equals 50%.

The drug is excreted through the kidneys in several phases; the final half-life is 146 hours. In the case of repeated injections (after a 28-day period), drug accumulation does not occur. For the first day, approximately 40 ± 16% of the portion is recorded inside the urine. The residue is deposited inside the bone tissue, after which it is released into the circulatory system at low speed. The substance does not participate in metabolic processes, being excreted through the kidneys in an unchanged state (less than 3% is excreted through the faeces).

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Dosing and administration

Drug concentrate (4 mg / 5 ml) is dissolved in a dextrose solution or NaCl (0.1 L). Use the finished substance should be immediately. The infusion procedure lasts 15 minutes. The finished liquid can be stored for 24 hours at a temperature of 2-8 ° C. It is forbidden to mix the drug with other means, and its introduction must be carried out through a separate infusion system.

In the case of bone metastases in tumors of a widespread nature and myelomas, 4 mg of the drug is used 1-fold over a 3-4-week period.

To prevent osteoporosis with pathological fractures due to breast carcinoma during therapy with the use of aromatase inhibitors during postmenopause, you need to use 4 mg of drugs 1 time per six months.

It is necessary to take into account that during therapy it is necessary to regularly monitor the blood values of urea, creatinine and minerals. Creatinine values are checked before each injection.

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Use The Zombie during pregnancy

It is forbidden to appoint pregnant or lactating women.

Contraindications

Main contraindications:

• strong sensitivity to bisphosphonates, as well as zoledronic acid;
• severe renal failure (CC values ≤ 30 ml / minute).

Caution is necessary when used in patients with disorders of the kidneys, insufficiency of the hepatic function, as well as with aspirin-type BA.

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Side effects The Zombie

Often, when using the medication, such side effects are noted:

• flu-like syndrome and fever, as well as headaches;
• anemia;
• conjunctivitis;
• loss of appetite, vomiting with nausea;
• pain in the joints with bones;
• renal dysfunction;
• hypocalcemia or hypophosphatemia, as well as an increase in the values of urea with creatinine.

Occasionally, these symptoms appear:

• feeling of confusion or anxiety, dizziness, sleep disturbance and tremor;
• pancyto or leukopenia;
• uveitis or visual impairment;
• stomatitis, constipation, abdominal pain, diarrhea and dryness affecting the oral mucosa;
• cough or dyspnea;
• rash and itching;
• cramps affecting the muscles;
• decrease or increase in blood pressure, as well as bradycardia;
• proteinuria or hematuria, and in addition to this ARF;
• swelling, asthenia and weight gain;
• Hypokalemia or Magnesia, as well as hypernatremia.

The urticaria, anaphylaxis, bronchial spasm, drowsiness and atrial fibrillation were reported individually.

Overdose

In acute Zomet poisoning, there is a disorder in the kidneys (even acute renal failure may appear), and in addition, the electrolyte structure of the blood changes (calcium with phosphates and magnesium).

In the case of the development of clinically significant hypocalcemia, infusions should be performed with the administration of calcium gluconate.

Interactions with other drugs

The combination of the drug with aminoglycosides increases the likelihood of hypocalcemia.

It is forbidden to combine medicine with agents that have a nephrotoxic effect.

Combining drugs with thalidomide increases the likelihood of developing disorders of renal activity and acute renal failure in people with multiple myeloma.

Zometa has no chemical compatibility with Ringer's solution.

[12], [13]

Storage conditions

Zometa should be maintained at temperature values not exceeding 30 ° C.

Shelf life

Zometa can be used in the range of a 3-year period from the date of manufacture of the drug.

[14]

Application for children

Do not use Zometa in pediatrics.

Analogs

Analogues of the substance are Rezoskan, Zoledrax, Blaztera and Zoledronic-Rus 4, and in addition Zolerix, Aklast, Veroclast with Zoledronic acid, Resorb with Rezoklastin FS and Zoledronate-Teva.

[15]

Reviews

Zometa is often commented on with mention of the negative symptoms she causes. Bisphosphonates used intravenously at the first injection resulted in muscle pain, an increase in temperature, flu-like signs and a general state of indisposition, but with new injections they did not occur.

The reviews also mention a single development of maxillary osteonecrosis with recent tooth extractions in individuals who received high portions of bisphosphonates via infusion injections.