ZOLEDRONIC ACID

 (Zometa)

Standard Prescription

Zoledronic Acid __ mg IV (__ mg/kg/dose)

Dosages

Osteogenesis imperfecta and other forms of osteoporosis:
<2 years:
Usual dose: 0.025 mg/kg/dose IV; maximum 2 mg; repeat every 3 months. Reduced dose (1 st cycle): 0.0125 mg/kg/dose IV, maximum 1 mg

>= 2 yrs:
Usual dose: 0.05 mg/kg/dose IV, maximum 4 mg; repeat every 6 months.
Reduced dose (1st cycle): 0.025 mg/kg/dose IV, maximum 2 mg
Reduced dose (spinal aBMD Z-score >0): 0.025 mg/kg/dose IV, maximum 2 mg; repeat every 12 months.
Reduced dose (spinal aBMD Z-score -2 to 0): 0.025 mg/kg IV, maximum 2 mg; repeat every 6 months.

Mechanism of Action


Forms Supplied

injection: 4 mg/5 mL vial

Comments

May cause fever, flu-like symptoms (chills, malaise, rigor, fatigue, flushing, nausea), more common with 1st and 2nd doses; may treat with acetaminophen or ibuprofen. Nausea and vomiting may be treated or prevented with ondansetron.

Hypocalcemia may be seen, especially with high doses and with 1 st doses. Ensure patient is Vitamin D-replete and has sufficient dietary calcium.

For 1st cycle only: give 50% of dosage to minimize side-effects.

References

217, 218

Last Edited

2022-04-25 06:47:08