Osteolytic, osteoblastic & mixed bone metastases of solid tumours & osteolytic lesions of multiple myeloma in conjunction w/ standard antineoplastic therapy. Hypercalcaemia of malignancy (HCM).
Adequately hydrate patients w/ mild to moderate renal impairment prior to administration. Avoid overhydration in patients at risk of cardiac failure. Carefully monitor albumin-corrected serum levels of Ca, phosphate, Mg & serum creatinine after initiating therapy. Consider monitoring renal function of untreated hypercalcaemia patients. Do not administer concomitantly w/ other zoledronic acid-containing medications, & w/ other bisphosphonates. Bronchoconstriction in acetylsalicylic acid sensitive asthmatic patients. Osteonecrosis of the jaw (ONJ); avoid invasive dental procedures if possible. Osteonecrosis of other anatomical sites including hip, femur & external auditory canal. Atypical subtrochanteric & diaphyseal femoral fractures, primarily in patients receiving long-term osteoporosis treatment. Potential severe & occasional incapacitating bone, joint &/or muscle pain. Co-administration w/ other hypocalcaemia-causing drugs. Measure serum Ca & correct hypocalcaemia prior to initiating therapy. Adequate supplementation Ca & vit D. Not recommended for patients w/ severe renal impairment prior to initiation of therapy. Severe hepatic insufficiency. Women of childbearing potential.
May have additive effect w/ aminoglycosides, calcitonin, loop diuretics. Concomitant use w/ other potentially nephrotoxic drugs. Increased incidence of ONJ w/ anti-angiogenic drugs.
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