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Due to the risk of clinical significant deterioration in renal function, which may progress to renal failure, single doses of Zoledronic acid should not exceed 4mg and the duration of infusion should be no less than 15 minutes.
Because safety and pharmacokinetic data are limited in patients with severe renal impairment (Serum creatine > 4.5 mg/ml). Zoledronic acid treatment is not recommended in patients its bone metastases with severe renal impairment. Concomitant use of potentially nephrotoxic drugs (Aspirin, NSAIDs, diuretics, ACE inhibitors) may increase the potential for renal impairment. Zoledronic acid should not be mixed with calcium containing I.V. infusion.
