Overview

Zoledronic acid is a bisphosphate and is commonly used to treat weak or thinning bones.

It can also be used to help prevent breast cancer from returning. It is effective for women who have been successfully treated (with surgery, radiotherapy or chemotherapy) for early breast cancer.

It can also reduce the risk of breast cancer spreading to the bones and other parts of the body. It has been found to be effective for post-menopausal women, and reduces the risk of dying from breast cancer.

The benefit of zoledronic acid is similar to chemotherapy, which your doctor might have discussed with you.

Taking zoledronic acid

Zoledronic acid is given by a drip (infusion) into a vein through a thin tube (cannula).

It is usually given in the outpatient department at the hospital. The infusion takes at least 15 minutes, and is given every 6 months for 3 years.

Common side effects

Some people have very few side effects, while others might have more. These are the most commons side effects, but speak to your doctor or nurse if you have any that are not listed here.

Increased pain

Some people have pain for a short time after they have had their zoledronic acid injection. If this happens, your doctor can prescribe painkillers for you.

Flu-like symptoms

You might have flu-like symptoms for 24 to 48 hours, such as:

• a high temperature
• chills
• pain in your muscles or joints

Let your doctor know if these side effects are difficult to manage. You might need to take mild painkillers, such as paracetamol.

Less common side effects

Effect on the kidneys

Zoledronic acid can sometimes affect how your kidneys work. This does not usually cause any symptoms, and the effects are generally mild. Your doctor will check how well your kidneys are working during your treatment by doing blood tests before each treatment.

Red or sore eyes

You might get red or sore eyes for a few days after your treatment. Your doctor can prescribe eye drops to help ease this.

Anaemia

Anaemia means you have a low red-blood-cell count. Symptoms of anaemia include feeling very tired and breathless. Your doctor can check if you are anaemic by doing a blood test.

Headaches

This is not common, but it is important to let your doctor know if you are getting headaches. They will advise you about what medicines to take.

It is also important to drink plenty of fluids immediately before and for a few days after your zoledronic acid treatment.

Feeling sick (nausea) and being sick (vomiting)

If this happens, your doctor can prescribe anti-sickness (anti-emetic) medicines to prevent or greatly reduce the sickness.

Jaw problems (osteonecrosis)

Osteonecrosis is a rare but serious side effect of zoledronic acid treatment. This is when healthy bone tissue in the jaw becomes damaged and dies. Gum disease, problems with your dentures and some dental treatments, such as having a tooth removed, can increase the risk of this.

Symptoms of osteonecrosis can include:

• pain, swelling, and redness of the gums
• loose teeth
• a feeling of numbness or heaviness in your jaw

You should have a full dental check-up before you start having zoledronic acid treatment, and tell your dentist that you are having this treatment. It is also very important to have routine dental check-ups before and while having zoledronic acid treatment.

It’s also important to look after your teeth by brushing them regularly. If you have any of the symptoms of osteonecrosis, tell your cancer specialist and dentist immediately.

Vitamin supplements

You might be asked to take calcium and vitamin D supplements while having treatment with zoledronic acid. Your doctor will let you know if you need to.

Non-cancer admission

If you are admitted to hospital for a reason not related to cancer, it is important to tell the doctors and nurses looking after you that you are having treatment with zoledronic acid. You should tell them the name of your cancer specialist so that they can ask for advice.

Emergency contacts

It’s important to know who you should contact if you have any problems or difficult side effects once you have left hospital. Write them down and share them with family and friends, too.

Support and further information

Macmillan have more information about taking zoledronic acid, including more about the side effects and possible dental issues.