PATIENT INFORMATION SHEET - ZOLEDRONATE (ACLASTA)

Zoledronate (also known as zoledronic acid or Aclasta) is the most potent medicine in the
bisphosphonate class currently available. Bisphosphonates work by preventing resorption
of bone by inhibiting the function of bone-dissolving cells called osteoclasts.
Bisphosphonates are commonly used in the treatment of osteoporosis and aget!s
disease" and are also used for preventing some forms of cancer from spreading in bone.
Zoledronate is given by an intravenous infusion (into a vein in the arm via a #drip$) over
about %&-'( minutes and can be given each %)-)* months as needed for treatment of
osteoporosis. +reatment of aget!s disease involves even less fre,uent infusions.
Zoledronate increases the bone density in patients with osteoporosis" to about the same
e-tent as other medicines such as alendronate (.osama-)" and is effective at reducing
fracture rates" by '&-/(0. 1t also reduces bone pain in aget!s disease. 1t is licensed in
2ew Zealand for treatment of osteoporosis and aget!s disease. 3ther than flu-like
symptoms after the first infusion" side effects from zoledronate treatment are uncommon"
and are in general no different from placebo-treated patients in randomised trials. 1t should
be remembered that ma4or fractures can be very serious" so this should be balanced
against the small risk of ill effects from treatments. +reatment is usually accompanied by
some calcium tablets and 5or vitamin 6 tablets given at the time of the infusion" to keep
blood calcium levels normal.
7ide effects with zoledronate include8
%. About '(0 of individuals may e-perience a flu-like feeling after their first treatment"
which usually last )*-/) hours" but which can occasionally go on for longer"
sometimes with associated muscle or 4oint aching. +his usually responds well to
regular paracetamol or an anti-inflammatory such as 2urofen or diclofenac. +he
chance of this side-effect occurring after second or third zoledronate infusions is
much lower (about '-*0).
). 1ndividuals with important pre-e-isting kidney damage can sometimes e-perience
deterioration in their kidney function after the administration of zoledronate. 1t is
normal practice not to use zoledronate in people whose kidneys are not functioning
well.
'. 9ery rarely" drugs in the bisphosphonate class can cause eye inflammation" which
responds to appropriate treatment.

:nproven side effects with zoledronate include8
%. 3steonecrosis of the 4aw (ulceration in tooth sockets or the gums" observed in a
small number of cancer patients receiving high-dose treatment but not increased in
those treated for osteoporosis or aget!s disease).
). Atrial fibrillation (an abnormal heart rhythm noted by one group of overseas
investigations but not seen in any other clinical trials).
'. :pper leg fractures (reported rarely throughout the world and not yet proven to be
related to bisphosphonate therapy" but the possibility e-ists. 1f the association
becomes proven" present calculations show that about '(( fractures are prevented
for each such fracture occurring).
1f you have any other ,uestions about this medicine" or your bone condition" you should
feel free to ask the doctors or nurses at your local infusion clinic.
August 2012
Auckland Bone Density