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Zometa: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on Jan 3, 2023.

1. How it works

  • Zometa is a brand (trade) name for zoledronic acid. Zoledronic acid strengthens bones and may be used for the treatment or prevention of osteoporosis. It works by inhibiting osteoclasts which are responsible for breaking down and reabsorbing bone (by a process known as bone resorption). It also inhibits increased osteoclastic activity and the release of calcium by the skeleton induced by tumors.
  • Zometa belongs to a group of medicines known as bisphosphonates.

2. Upsides

  • Zometa is used for the treatment of high calcium levels (hypercalcemia) associated with cancer. It is given as a single IV dose of 4mg and retreatment may be considered after 7 days if serum calcium levels do not return to normal.
  • Zometa may be used to treat patients with multiple myeloma or bone metastases from solid tumors in addition to standard chemotherapy regimens.
  • Zometa is administered every three to four weeks when used for the treatment of osteolytic bone lesions of multiple myeloma or osteolytic bone metastases of solid tumors.
  • Zometa is available as a generic under the name zoledronic acid.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Fever, nausea, constipation, anemia, and shortness of breath are the most frequently reported side effects. Low blood pressure, abdominal pain, and vomiting may also occur.
  • A lowering in the levels of certain electrolytes such as phosphate, potassium, and magnesium may occur.
  • Some people report insomnia, anxiety or confusion, coughing, and skeletal pain with Zometa.
  • May not be suitable for some people including those with kidney disease, pre-existing esophageal or gastrointestinal conditions, low blood calcium levels (hypocalcemia), or dental disease. Patients who are being given Zometa for high calcium levels associated with cancer should be adequately hydrated before administration. Rare reports of bronchoconstriction (a narrowing of the airways) have been reported in aspirin-sensitive patients given Zometa.
  • There are concerns about the long-term safety of bisphosphonates (such as Zometa) as long-term use has been associated with atypical femur fractures, osteonecrosis of the jaw, and esophageal cancer. The risk of osteonecrosis of the jaw is greater in those who have received chemotherapy, radiation, or steroids.
  • Rarely may cause other side effects including uveitis (eye inflammation) and other adverse effects. Severe and occasionally incapacitating bone joint or muscle pain has also been reported. Zometa should be discontinued if this occurs.
  • May interact with some other medicines such as aminoglycosides or calcitonin (may have an additive calcium-lowering effect), loop diuretics (an additive sodium-lowering effect) as well as other drugs that may also adversely affect the kidneys. Zometa should never be given at the same time as other bisphosphonates, such as Reclast.
  • Zometa must be administered over no faster than 15 minutes because shorter infusion times have been associated with an increased risk of renal toxicity which may progress to kidney failure.
  • Zometa is only available as an injection for administration by a healthcare provider.
  • Avoid in pregnancy. Bisphosphonates, such as Zometa, can cause fetal harm in animals, such as renal pelvis ureter syndrome and interference with natural delivery. Animal data suggest that the uptake of bisphosphonates into fetal bone is greater than into maternal bone. There are no data on fetal risk and pregnancy in humans. It is unknown if Zometa is excreted into human milk and use should be avoided.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

  • Zometa is only available as an injection for administration by a healthcare provider and is indicated for the treatment of hypercalcemia associated with cancer, osteolytic bone lesions of multiple myeloma, or osteolytic bone metastases of solid tumors. It must be administered over no less than 15 minutes.

5. Tips

  • Immediately before having your Zometa injection, you should drink two full glasses of water.
  • You may need to take supplementary calcium or vitamin D if your dietary intake is inadequate. Your doctor will advise you about this.
  • Tell your doctor if you have ever had kidney problems in the past before taking Zometa.
  • Make sure you get your laboratory tests done as instructed that test for creatinine while you are being administered Zometa.
  • Make sure you have a dental check-up before you start Zometa. Talk to both your dentist and doctor if you require dental surgery or tooth extraction and you have been administered Zometa. Keep good oral hygiene, get regular dental check-ups, and report any oral symptoms such as tooth pain, jaw pain, loose teeth, or mouth ulcers to your doctor while you are being administered Zometa.
  • Tell your doctor if you experience any thigh or groin pain, muscle cramps or twitches, severe or debilitating muscle pain, eye inflammation, or any other adverse effects of concern while you are being administered Zometa. Common side effects include nausea, tiredness, bone pain, constipation, fever, shortness of breath, and anemia.
  • Do not take any other medications with Zometa without first talking with your doctor. Never take other bisphosphonates (such as Reclast) while taking Zometa.
  • Tell your doctor if you are sensitive to aspirin before you are administered Zometa. Report any feelings of breathlessness to your doctor if they occur while taking Zometa.
  • Do not take Zometa while pregnant or breastfeeding. If you inadvertently become pregnant while being administered Zometa, tell your doctor immediately.

6. Response and effectiveness

  • Studies have shown that Zometa is more effective than pamidronate at normalizing calcium levels associated with moderate-to-severe hypercalcemia of malignancy, and also has a faster onset of action and longer time to relapse.
  • Experts recommend Zometa be given initially as a 4mg dose, with the 8mg dose reserved for people requiring retreatment.

7. Interactions

Medicines that interact with Zometa may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with Zometa. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Zometa include:

  • aminoglycoside antibiotics, such as amikacin, gentamicin, kanamycin, neomycin, paromomycin, or tobramycin
  • angiogenesis inhibitors, such as bevacizumab or everolimus
  • aspirin
  • calcitonin
  • deferasirox
  • diuretics, such as bumetanide, ethacrynic acid, or furosemide
  • digoxin
  • chemotherapy agents for cancer
  • NSAIDs, such as ibuprofen, diclofenac, and naproxen
  • oral steroids, such as dexamethasone, prednisone and methylprednisone
  • proton pump inhibitors, such as omeprazole
  • thalidomide.

Note that this list is not all-inclusive and includes only common medications that may interact with Zometa. You should refer to the prescribing information for Zometa for a complete list of interactions.


Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Zometa only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2023 Revision date: January 3, 2023.