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Zoledronic acid

Aclasta, Zerlinda, Zometa

Zoledronic acid is given by intravenous infusion in a hospital setting.

You will be asked to drink several glasses of water during treatment to make sure that you are not dehydrated.

Your doctor may recommend that you see your dentist before receiving this treatment.

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About zoledronic acid

Type of medicine


Used for

Osteoporosis; Paget's disease of bone; bone problems associated with some cancers

Also called

Aclasta®; Zerlinda®; Zometa®

Available as


Zoledronic acid, a bisphosphonate, is prescribed for the treatment of a number of different problems which affect bones. It is prescribed as a treatment for osteoporosis, and it is also used to prevent bone damage in people with Paget's disease of bone. It is also given as a treatment for people with some cancers in order to reduce bone damage and blood calcium levels.

Osteoporosis is a bone disease which causes bones to become brittle and fragile, making them prone to breaks and fractures. During our lifetime, old bone tissue is constantly being broken down and replaced by new bone. As we get older, our bone begins to lose density because old bone is lost faster than new bone can replace it. Zoledronic acid slows down the rate at which old bone is lost and this leads to an overall increase in bone density.

In Paget's disease of bone, zoledronic acid works on bones to make them stronger and help prevent bone thickening. This helps ease symptoms such as pain, bone damage and fracture.

In some cancers there can be an excessive breakdown of bone. As this happens, calcium is lost from the bone and seeps into the blood, leading to higher than normal levels of calcium in the blood. This is called hypercalcaemia. Zoledronic acid binds to bone and reduces the rate at which it is broken down. This helps to strengthen bones and prevents the loss of calcium. This in turn reduces the high levels of calcium in the blood.

Before having zoledronic acid

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start treatment it is important that your doctor knows:

  • If you are pregnant or breastfeeding. Zoledronic acid is not suitable for women who could become pregnant.

  • If you are due to have any dental treatment in the near future, or if you have not recently had a dental check-up.

  • If you have a heart condition.

  • If you have any problems with the way your kidneys work, or with the way your liver works.

  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

  • If you have ever had an allergic reaction to a medicine.

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How you will be given zoledronic acid

  • Before you start the treatment, ask to read the manufacturer's printed information leaflet from inside the pack. It will give you more information about zoledronic acid and will provide you with a full list of the side-effects which you may experience from having it.

  • Zoledronic acid will be given to you in a hospital clinic. It will be administered by intravenous infusion - this means that it is injected slowly (over 15 minutes or so) into one of your veins.

  • The number of doses you will be given will depend upon the reason why it has been prescribed for you. Many people require only a single dose, although repeat doses can be required for people with osteoporosis and in some cancers.

Getting the most from your treatment

  • It is important that you do not become dehydrated during treatment with zoledronic acid. Your doctor will advise how much water you need to drink - this is usually one or two large glassfuls before and after treatment.

  • If you have osteoporosis or Paget's disease of bone, it may be necessary for you to take supplements of calcium and vitamin D alongside this treatment. If so, your doctor will prescribe these for you.

  • Good dental hygiene is important during treatment with this medicine - this means that you must brush your teeth regularly and have regular dental check-ups. You should also make sure that your dentist is aware that you have had zoledronic acid, as some dental treatments may not be recommended for you.

  • Remember to keep your regular appointments with your doctor so that your progress can be monitored. You may need to have blood tests following this treatment.

  • You should avoid becoming pregnant whilst you are being treated with zoledronic acid. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner.

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Can zoledronic acid cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with zoledronic acid. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common side-effects (these affect fewer than 1 in 10 people)

What can I do if I experience this?

Conjunctivitis, feeling dizzy

Take care, especially if using tools or machines

Feeling sick (nausea) or being sick (vomiting), gastrointestinal upset

Stick to simple foods and drink plenty of water to replace any lost fluids

Headache, high temperature (fever), aches and pains, flu-like symptoms

Ask your doctor or pharmacist to recommend a suitable painkiller, and take plenty of rest and fluids

Changes in heart rhythm and changes to some blood test results

Your doctor will monitor for these

Swelling or pain at the infusion site

This should soon pass

Less common, but possibly serious, side-effects

What should I do if I experience this?

Pain in your thigh, hip, or groin

Speak with your doctor as soon as possible - these can be signs of a thighbone fracture

A loose tooth, or jaw pain with swelling or numbness

Speak with your doctor as soon as possible - these can be signs of a problem called osteonecrosis of the jaw

Ear pain, discharge from an ear, ear infection

These could be signs of a problem called osteonecrosis of the ear. Speak with your doctor straightaway

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.

Important information about all medicines

Important information about all medicines

If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.

If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.

Always read the printed information leaflet that comes with your medicine.

If you have any questions about this medicine ask your pharmacist.

Report side effects to a medicine or vaccine

If you experience side effects, you can report them online through the Yellow Card website.

Further reading and references

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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