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Anticipated interaction to be considered: Caution is advised when bisphosphonates like Zoledronic Acid Monohydrate are administered with aminoglycosides and loop diuretics, since both agents may have an additive effect, resulting in a lower serum of calcium level for longer periods than required (see Precautions).
Caution is indicated when Zoledronic Acid Monohydrate is used with other potentially nephrotoxic drugs (see Adverse Reactions).
Observed interactions to be considered: Caution is advised when Zoledronic Acid Monohydrate is administered with anti-angiogenic drugs as an increase in incidence of ONJ have been observed in patients treated concomitantly with these drugs.
Absence of interactions: Zoledronic Acid Monohydrate has been administered concomitantly with commonly used anticancer agents, diuretics (except for loop diuretics, see Anticipated interaction to be considered as previously mentioned), antibiotics and analgesics without clinically apparent interactions occurring. No dose adjustment for Zoledronic Acid Monohydrate 4 mg is needed when co-administered with Thalidomide.
Zoledronic Acid Monohydrate 4 mg given as a 15 minutes infusion was administrated either alone or with Thalidomide (100 mg once daily on days 1-14 and 200 mg once daily on days 15-28). Co-administration of Thalidomide with Zoledronic Acid Monohydrate did not significantly change the pharmacokinetics of Zoledronic Acid Monohydrate or creatinine clearance.
