Zeclast^®

Zeclast®

Generic Name: Zoledronic Acid
Dosage Form: Injectable solution containing 5 mg of zoledronic acid in 100 mL
Drug Class: Bisphosphonates
Indications: Used for the prevention and treatment of osteoporosis and Paget’s disease of bone.

Zeclast®

Zeclast® (Zoledronic Acid) is a bisphosphonate that inhibits osteoclast-mediated bone resorption, reduces bone cell breakdown, lowers blood calcium and phosphate levels, and increases their excretion from the bloodstream.

Indications

• Osteoporosis
• Paget’s disease of bone

Dosage Form

• Injectable solution: 5 mg zoledronic acid in 100 mL

Advantages

• Ready-to-use vial (no preparation needed)
• Annual injection for bone disorders
• Injection every two years for the prevention of postmenopausal osteoporosis
• Short intravenous administration without hospitalization

Preparation

• Zeclast® is a ready-to-use solution and does not require dilution.
• Do not inject simultaneously with solutions containing calcium or divalent cations (e.g., Ringer’s lactate).
• Each vial is for single use only; discard any unused portion.
• Do not mix or administer with other medications simultaneously.
• If refrigerated, allow the solution to reach room temperature before injection.
• The solution should be clear; do not use if precipitate forms or color changes.

Administration

• Administer only via intravenous infusion.
• Minimum infusion time: 15 minutes.
• Ensure the patient is adequately hydrated before infusion.
• Flush the IV line with at least 10 mL of normal saline after infusion.

Monitoring During Treatment

• Serum creatinine and creatinine clearance before each infusion
• Dental check-up before starting therapy
• Signs of femoral fractures
• Musculoskeletal pain
• Eye inflammation
• Pregnancy status
• Patient hydration
• Biochemical bone markers
• Serum calcium, phosphorus, magnesium, and vitamin D levels
• Bone density measurement
• Annual height and weight check
• Chronic back pain assessment
• Serum alkaline phosphatase and pain evaluation in Paget’s disease

Contraindications

• Hypersensitivity to zoledronic acid, other bisphosphonates (e.g., alendronate), or any component
• Acute renal failure or creatinine clearance <35 mL/min
• Hypocalcemia
• Pregnancy or breastfeeding

Warnings and Precautions

• Ensure adequate intake of calcium and vitamin D during therapy if dietary intake is insufficient.
• Report severe bone, joint, or muscle pain.
• Avoid invasive dental procedures during treatment when possible.
• Bisphosphonates may increase the risk of osteonecrosis of the jaw (ONJ) in patients with: alcohol/tobacco use, anemia, cancer, corticosteroid therapy, diabetes, long-term bisphosphonate therapy, high-dose IV bisphosphonates, autoimmune disorders, oral surgery/trauma, poor oral hygiene, or head/neck radiotherapy. Inform your doctor if any of these apply.
• Use with caution in patients with aspirin-sensitive asthma.
• Maintain adequate hydration but avoid excessive fluids, especially in heart failure patients.
• Report any signs of kidney problems: decreased urine output, changes in urination, hematuria, or rapid weight gain.

Use During Pregnancy and Breastfeeding

• Zoledronic acid is not recommended during pregnancy or breastfeeding.

Side Effects

Possible side effects (not everyone experiences these):

• Dizziness, fatigue, weakness
• Gastrointestinal issues: abdominal pain, nausea, vomiting, loss of appetite, constipation, diarrhea
• Swelling of lower limbs
• Headache
• Flu-like symptoms
• Bone pain
• Urinary tract infection
• Cough and shortness of breath

Drug Interactions

• Consult your doctor or pharmacist before taking zoledronic acid with other medications or supplements.

Packaging

• Each package contains 1 vial of Zeclast®.

Storage

• Store below 30°C, away from light and moisture.
• Keep in the original packaging until use.
• Keep out of reach of children.
• Do not use after the expiration date.

References

1. Zoledronic Acid: Drug information, UpToDate 2025
2. Medicines.org.uk – Zoledronic Acid