Zoledronic acid

About zoledronic acid

Zoledronic acid is a medication we use to treat osteoporosis. Osteoporosis is a condition that weakens bones and increases the risk of fractures.

Zoledronic acid helps to strengthen bones by slowing down the process that causes bone loss.

We often recommend zoledronic acid to patients who have had a recent bone fracture.

How we give it

We usually give patients zoledronic acid as an intravenous infusion. This means we inject it into your vein. The infusion lasts about 15 minutes and we monitor you for any reactions while it is underway.

We usually give the infusion once a year. We do this for 3 years, and up to a maximum of 6 years. (Sometimes we give patients a one-off infusion.)

After 3 years, we review your bone density and decide if you need further yearly infusions. 

Preparing for your infusion

Zoledronic acid can affect your kidneys. We always check your kidney function before your infusion.

Benefits and side effects

The benefits and possible side effects are as follows.

Benefits

Zoledronic acid helps to make your bones stronger. If you fall over during the first year of treatment, it reduces your risk of fractures by 30%.

Side effects

Common

• Flu-like symptoms, headache, joint or muscle pain for 3 to 5 days after the infusion. We recommend you take paracetamol for a day or two afterwards, to minimise potential side effects.

Serious 

• Low blood calcium levels (hypocalcaemia). This side effect is rare. We ensure your calcium and vitamin D levels are normal before your infusion, by starting you on supplements if you need them. We also recommend you continue them long-term, to maintain bone strength.
• ONJ (osteonecrosis of the jaw). This means healing in the mouth is delayed (for example after major dental surgery). We advise you maintain good oral (mouth) hygiene and have regular dental check-ups every 6 to 12 months. 
• Atypical fracture. This is a type of thigh bone fracture that can occur after many years of treatment. This side effect is extremely rare (1 in 1,000).

More information

For more guidance, visit the Royal Osteoporosis Society information on zoledronic acid.