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No clinically apparent interactions occurred when Zoledronic acid was administered concomitantly with commonly used anticancer drugs, diuretics, antibiotics and analgesics. Zoledronic acid had shown no appreciable binding in vitro to plasma protein and to human P450 enzymes, indicating a low likelihood of pharmacokinetic drug interactions. However, no formal clinical interaction studies have been performed.
Caution is advised when bisphosphonates are administered with amino glycoside, since these agents may have an additive effect to lower serum calcium level for prolonged periods. This has not been reported in Zoledronic acid clinical trials. Caution is advised when Zoledronic acid is used with potentially nephrotoxic drugs. (Renal functions are monitored). In multiple myeloma patients, the risk of renal dysfunction may be increased when Zoledronic acid is used in combination with thalidomide.
