Monograph Details
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Neoplasms
> Miscellaneous oncology agents
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ZOMETA |
| Manufacturer |
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Novartis Pharmaceuticals Corp |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Bisphosphonate. |
| Generic Name |
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Zoledronic acid 4 mg/vial; conc soln for IV infusion after dilution. |
| Indications |
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Hypercalcemia of malignancy. Adjunct in multiple myeloma and bone metastases of solid tumors. |
| Children |
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Not recommended. |
| Adults |
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Give by IV infusion over at least 15 minutes. Hypercalcemia of malignancy (albumin-corrected serum calcium ≥12 mg/dL): max 4 mg; allow at least 7 days before retreating. Multiple myeloma or bone metastases: CrCl >60mL/min: 4 mg; CrCl 50–60mL/min: 3.5mg; CrCl 40–49mL/min: 3.3mg; CrCl 30–39mL/min: 3mg; CrCl <30mL/min: see literature; all: every 3–4 weeks (give oral multivitamin supplement with calcium 500 mg + Vit. D 400 IU daily). |
| Contraindications |
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Pregnancy (Cat.D). |
| Precautions |
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Not recommended for use in patients with with bone metastases and severe renal impairment. Renal or hepatic insufficiency. Check serum creatinine before each dose: withhold until serum creatinine is within 10% of baseline if serum creatinine increases by 0.5 mg/dL from a normal pre-treatment level, or by 1 mg/dL from an abnormal pre-treatment level, within 2 weeks of next dose. Assure adequate hydration when treating hypercalcemia of malignancy. Closely monitor electrolytes (esp. calcium, magnesium, phosphate), CBC/differential, hematocrit, hemoglobin. Aspirin-sensitive asthma. Avoid dental surgery (do preventative dental work before therapy). Elderly. Nursing mothers: not recommended. |
| Interactions |
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Additive hypocalcemic effect with aminoglycosides, loop diuretics. Caution with other nephrotoxic drugs (eg, thalidomide). |
| Adverse Reactions |
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Fever, flu-like syndrome, GI upset, anemia, dyspnea, electrolyte disturbances, musculoskeletal pain (may be severe), hypotension, CNS effects, rigors, headache, paresthesia, renal toxicity; rare: jaw osteonecrosis. |
| How Supplied |
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Vials—1 |
| Additional Resources |
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• Related Prescribing Note |
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