Daily Medication Pearl: Zoledronic Acid (Zometa)


Zoledronic acid (Zometa) is indicated for the treatment of hypercalcemia that may occur with cancer.

Medication Pearl of the Day: Zoledronic Acid (Zometa)

Indication: Zoledronic acid (Zometa) is a bisphosphonate indicated for the treatment of hypercalcemia that may occur with cancer; for patients with multiple myeloma and patients with documented bone metastases from solid tumors, in conjunction with standard antineoplastic therapy. Prostate cancer should have progressed after treatment with at least 1 hormonal therapy.


  • Dosing: 4 mg as a single-use intravenous infusion over no less than 15 minutes, 4 mg as retreatment after a minimum of 7 days.
  • Dosage forms: 4 mg/100 mL single-use ready-to-use bottles, 4 mg/5 mL single-use vial of concentrate.
  • Adverse events: The most common adverse events (greater than 25%) were nausea, fatigue, anemia, bone pain, constipation, fever, vomiting, and dyspnea.
  • Mechanism of action: In vitro, zoledronic acid inhibits osteoclastic activity and induces osteoclast apoptosis. Zoledronic acid also blocks the osteoclastic resorption of mineralized bone and cartilage through its binding to bone. Zoledronic acid inhibits increased osteoclastic activity and skeletal calcium release induced by various stimulatory factors released by tumors.

Source: ZOMETA (zoledronic acid) Injection Label (fda.gov)

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