Zoledronic acid.
BACKGROUND
Both bone metastases and fragility fractures due to bone loss result in considerable morbidity affecting quality of life and independence as well as placing complex demands on healthcare resources. Zoledronic acid is a widely used intravenous bisphosphonate that reduces this skeletal morbidity in both benign and malignant conditions.


METHODS
The incidence, clinical importance and prevention strategies to minimize side effects associated with the use of zoledronic acid are discussed with a particular focus on use in oncology where intensive monthly scheduling is required. This potentially increases the risk for adverse events over the 6-12 monthly administration used to treat benign bone diseases.


RESULTS
A detailed understanding of the generally favorable safety profile of zoledronic acid, but particularly the potential for renal dysfunction and osteonecrosis of the jaw.


CONCLUSIONS
When compared to many other therapies, especially in the cancer setting, the severity of adverse events related to zoledronic acid is generally mild and, with the exception of the acute phase response causing transient fever, myalgia and bone pain, side effects are infrequent. Thus, the benefits of treatment with zoledronic acid within its licensed indications almost always outweigh the risks.
University of Sheffield, Weston Park Hospital, Academic Unit of Clinical Oncology, Sheffield, UK. r.e.coleman@sheffield.ac.uk
Robert
R
Coleman
Roger
R
Burkinshaw
Matthew
M
Winter
Helen
H
Neville-Webbe
Jim
J
Lester
Emma
E
Woodward
Janet
J
Brown
D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001847:Bone Diseases / Q000188:drug therapy; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use*; D064420:Drug-Related Side Effects and Adverse Reactions; D050723:Fractures, Bone / Q000188:drug therapy; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects* / Q000627:therapeutic use*; D000077211:Zoledronic Acid
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid