Prevention of skeletal-related events (pathological fractures, spinal compression, radiation or surgery to bone, or tumour-induced hypercalcaemia) in adult patients w/ advanced bone malignancies. Treatment of adult patients w/ tumour-induced hypercalcaemia.
Prevention of skeletal-related events in patient w/ advanced bone malignancies Adult & elderly Recommended dose: 4 mg IV infusion for not <15 min every 3-4 wk. Dilute the conc w/ 100 mL NaCl 0.9% or glucose soln 5%. Patient should also take oral Ca supplement 500 mg & vit D 400 IU daily. Hydrate patient prior to & following administration of Zometa. Renal impairment CrCl >60 mL/min 4 mg; 50-60 mL/min 3.5 mg; 40-49 mL/min 3.3 mg; 30-39 mL/min 3 mg. Treatment of tumour-induced hypercalcaemia Adult & elderly 4 mg single dose.
Assess patients prior to administration to ensure adequate hydration. Avoid overhydration in patients at risk of cardiac failure. Monitor serum levels of Ca, phosphate & Mg after initiation of treatment. Monitor renal function carefully in patients w/ untreated hypercalcemia. Patients w/ tumor-induced hypercalcemia w/ evidence of renal function deterioration. Assess serum creatinine levels prior to each dose of Zometa. Withhold use if renal deterioration during treatment occurs. Concomitant use w/ drug that could affect renal function & drugs known to cause hypocalcemia. Osteonecrosis of the jaw or the external auditory canal. Discontinue if atypical femur fracture is suspected. Measure serum Ca & correct hypocalcemia prior to therapy. Adequately supplement w/ Ca & vit D. May affect ability to drive or operate machinery. Not recommended in patients w/ severe renal impairment. Severe hepatic impairment. Not to be used during pregnancy. Childn 1-17 yr.
Lower serum Ca level w/ aminoglycosides, calcitonin or loop diuretics. Possibility of hypomagnesaemia w/ potential nephrotoxic agents. Increased risk of renal dysfunction w/ thalidomide. Increased incidence of osteonecrosis of the jaw w/ anti-angiogenic agents.
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