Side effects include bone pain, nausea, constipation, fatigue, confusion, hallucination, anemia, muscle pain, vomiting, weakness, anorexia, fever, dyspnea, eye irritation, hypocalcemia, headache, diarrhea, bone pain and hypophosphatemia.
Administration is mostly associated with fever (44.2%). Occasionally patients experience a flu like syndrome consisting of fever, chills, bone pain and/or arthralgia (10%) and myalgia.
Gastrointestinal reactions such as nausea/vomiting (29%/14%) and anorexia (9%) have been reported following administration. Injection site reactions such as erythema, redness or swelling were observed infrequently and resolved in most cases without treatment within 24-48 hrs.
Azotemia (2%) has been reported during therapy with zoledronic acid, serum creatinine should be monitored.
Electrolyte imbalances may occur during treatment with zoledronic acid. Hypocalcaemia (1.2%), hypomagnesemia (10%) and hypophosphatemia (52%) have been reported. Monitor serum calcium, phosphate and magnesium during therapy, short term supplementation of these electrolytes may be necessary.