Zoledronic acid (Zometa)

Zoledronic acid is a type of bisphosphonate drug. Doctors use it to treat cancers affecting the bone, most commonly

• Myeloma
• Secondary breast cancer
• Secondary prostate cancer

You may also have zoledronic acid to treat high levels of calcium in the blood (hypercalcaemia), which can occur with secondary bone cancer.

Zoledronic acid is a clear liquid that goes into your vein as a drip (infusion). You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath or a PICC line. These lines give the drug into a major vein in your chest. They stay in throughout your course of treatment.

The drip usually lasts for about 15 minutes, but you may have it over a longer period.

You may have zoledronic acid in one of two ways

• As a single treatment to reduce calcium levels in your blood
• Every 3 to 4 weeks as a treatment to prevent or reduce bone damage – you may need to take calcium and vitamin D supplements if you are having it regularly

We have listed the possible side effects of zoledronic acid below. There is general information about bisphosphonates in the cancer treatment section. There is general information about cancer drug side effects in this section.

More than 10 in every 100 people have one or more of these.

• Flu like symptoms, including a fever, chills and headache affect about 1 in 10 (10%) people
• Low levels of calcium in your blood (hypocalcaemia), causing changes in sensation such as tingling or burning in your lips and tongue – you will have blood tests to check the levels of calcium and other minerals such as potassium, phosphate and magnesium
• Zoledronic acid may have a harmful effect on a developing baby – you should not become pregnant or father a child whilst taking it, so talk to your doctor or nurse about contraception before you start treatment if there is any possibility that you or your partner could become pregnant

Between 1 and 10 in every 100 people have one or more of these.

• Feeling or being sick – this usually only lasts for a few days and can be controlled with anti sickness medicines
• Loss of appetite
• Bone pain – this may be worse when you first start treatment and you may need stronger painkillers until it improves
• Stomach pain occurs in just under 1 in 10 people (10%)
• Anaemia (a drop in the number of red blood cells)
• Red and sore eyes (conjunctivitis) – you may need eye drops to soothe your eyes
• Difficulty in sleeping
• Mood changes – you may feel anxious or agitated while you are having this drug
• Kidney changes – your doctor will take blood tests regularly to check how well your kidneys are working
• Redness and pain at the injection site
• Changes in blood pressure – during treatment, your blood pressure may be lower or higher than usual so your nurse or doctor will check this regularly
• Changes to your bowels – you may be constipated or have diarrhoea
• Tiredness, drowsiness and dizziness

Fewer than 1 in 100 people have these.

• Breathlessness and a cough
• Osteonecrosis of the jaw can be a side effect of taking bisphosphonates for longer than a year – have a dental check up before you start treatment and tell your dentist that you are having zoledronic acid

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.