Case Evaluation

Zometa: Zometa Overview

What is Zometa?

Zometa (zoledronic acid) is used to treat hypercalcemia (excess calcium in the blood) that may occur with some types of cancer. It is also used to treat Paget's disease and multiple myeloma (tumors formed by the cells of the bone marrow), as well as to treat bone metastasis (spread of cancer).

Zoledronic acid (sometimes called zoledronate) is in a group of medicines called bisphosphonates. Zometa is an intravenous bisphosphonate drug made by Novartis Pharmaceuticals Corporation, and was approved by the U.S. Food and Drug Administration (FDA) in 2001 for treating hypercalcemia, and in 2002 for treatment of bone metastasis. Zoledronic acid (sometimes called zoledronate) is in a group of medicines called bisphosphonates

Zometa and Osteonecrosis of the Jaw

In September 2004, Novartis Pharmaceuticals and the FDA notified dental healthcare professionals of revisions to prescribing information to describe the occurrence of osteonecrosis of the jaw (ONJ) observed in cancer patients receiving treatment with intravenous bisphosphonates (such as Zometa). ONJ is a medical condition in which the jawbone partially crumbles and dies. ONJ may cause severe pain, loose teeth, exposed bone, loss of function, and disfigurement.

The revised prescribing information recommends that cancer patients receive a dental examination prior to starting bisphosphonate treatment, and that they avoid invasive dental procedures while on these medications.

Taking Zometa

Because Zometa is administered intravenously, it should only be administered by or under the supervision of your doctor or healthcare professional. Follow your healthcare professional's orders regarding Zometa dosing.

It is important that your healthcare professional check your progress at regular visits after you start taking Zometa, even if your condition improves. Tell your healthcare professional right away if you experience any of the following symptoms while taking Zometa:

  • agitation
  • blood in urine
  • coma
  • confusion
  • decreased urine output
  • depression
  • dizziness
  • headache
  • irritability
  • lethargy
  • muscle twitching
  • nausea
  • rapid weight gain
  • seizures
  • stupor
  • swelling of face, ankles, or hands
  • unusual tiredness or weakness

These could be signs of serious kidney problems.

What should I discuss with my healthcare provider before receiving Zometa?

You should not receive Zometa if you are allergic to zoledronic acid or similar medicine such as alendronate (Fosamax), etidronate (Didronel), ibandronate (Boniva), pamidronate (Aredia), risedronate (Actonel), or tiludronate (Skelid), or if you:

  • have low levels of calcium in your blood; or
  • if you are pregnant or breast-feeding.

Zometa and Reclast are two different brands of zoledronic acid. You should not be treated with Reclast if you are already receiving Zometa. Before receiving a Reclast injection, tell your doctor if you are already being treated with Zometa.

Before receiving Zometa, tell your doctor if you have:

  • asthma, or a sulfite allergy;
  • a thyroid or parathyroid disorder;
  • malabsorption syndrome (an inability to absorb food and nutrients properly);
  • a history of surgical removal of part of your intestine;
  • bone cancer; or
  • kidney disease.

If you have any of these conditions, you may not be able to receive Zometa, or you may need a dosage adjustment or special tests during treatment.

Your doctor may recommend you have a dental exam for preventive tooth and gum care before you start your treatment with Zometa. This is especially important if you have cancer, if you are undergoing chemotherapy or using steroids, or if you have poor dental health.

Some people using medicines similar to Zometa have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms of this condition may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums.

You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and dental surgery or pre-existing dental problems.

FDA pregnancy category D. Zometa can cause harm to an unborn baby. Do not receive Zometa without telling your doctor if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. Zometa can pass into breast milk and may harm a nursing baby. Do not receive Zometa without telling your doctor if you are breast-feeding a baby.

Are There Any Interactions With Drugs or Foods?

Zometa and certain other medicines can interact with each other. Tell your healthcare professional about all the medicines you take - including prescription and non-prescription medicines.

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