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ZOLEDRONIC ACID: It is a bisphosponic acid that is an inhibitor of osteoclastic bone resorption.

Indications: Hypercalcemia of malignancy multiple myeloma. Bone metastaes form solid tumors.

Dosage and administration: Administration: 4mg is dliuted in 100ml of sterle 0.9% Nacl or 5% dextrose injection for intravenous infusion over no less athan 15 minutes.

Hypercalcemia of mallgnancy/tumor induced hypercalcemla (lbumin-corrected serum calcium> 12mg/dl) : 4mg as a single dose. If required repeat the inital dose after minium of 7days interval

Multimyleona and metastic bone lesion form solid tumor : 4mg every 3 to 4 weeks. Duration of treatment for prostatic cancer is 15 months, for other solid tumor is 9 months

Contra-indications: Hypersensitivity. Severe renal impairment.

Special Precautions: Monitor serum creatinine valcium eletroytes, phosphate magnsium and hematocrit/heamoglobin. Adeguately rehydrate the patient before treatment. Hepatic insuficiency Astham (aspriin sensitive)
Pediatric: Safety and efficacy is not established
Pregnancy: Not recommended.
Lactation: Safety is not established.
Elderly: Safe but monitor renal function.

Side effects: Common: Pancytopenia, confusion nausea, flue-like syndorme fatigue, arthligia bradycadia, cretinie, level, elevation, fever thist, hypercalcemia, taste preversion.

Uncommon: Thrombocytopenia, conjunctivitis vomiting, skeletal, pain, chest pain, hypophosphataemia, hypomagensaemia, headache, puruitus, rahs.

Rare: Local reaction at infusion site.
Very rare: Acute renal failure

Drug Interactions: Increased risk of hypocalcemia when used in combination with loop diuretics. Risk of renal dysfunction may be increased when used in combination with thalidomide.