Zoledronic acid
Say it: zoh-leh-DRON-ik AS-id · Brand names: Zometa, Reclast
Zoledronic acid is a medicine given in a vein that helps keep bones strong and lowers high calcium from cancer.
What it is
Your body is always breaking down old bone and building new bone. Zoledronic acid is a type of medicine called a bisphosphonate. It sticks to bone and slows the cells that break it down, which helps protect bones and lower calcium in the blood.
Often used for
- preventing fractures and other bone problems from cancer that has spread to the bone
- multiple myeloma
- high calcium caused by cancer
- thin bones (osteoporosis)
- Paget disease of bone
How you get it
It is given as a drip into a vein over at least 15 minutes. For cancer in the bone it is often given every 3 to 4 weeks, and sometimes less often. For high calcium it may be given once. Your schedule may be different.
Common side effects and what helps
- Flu-like feeling with fever, chills, and aches for a few days, most often after the first dose. Ask your team what you can take.
- Bone, joint, or muscle pain. Tell your team if it is strong.
- Nausea. Eat small meals and ask about nausea medicine.
- Feeling tired. Rest when you need to.
- Constipation or diarrhea. Drink plenty of fluids.
- Feeling short of breath. Tell your team if it is new.
Call your care team right away if you have
- Peeing much less than usual, or swelling in your legs
- Muscle cramps, twitching, or tingling in the fingers, toes, or around the mouth. These can be signs of low calcium.
- Jaw pain, swelling, loose teeth, or a sore in the mouth that does not heal
- New pain in the thigh, hip, or groin
- Very bad bone, joint, or muscle pain
- Wheezing or trouble breathing
Before you start, tell your team
- If you have kidney problems
- If you have dental problems or plan to have teeth pulled or dental implants
- If you have asthma that gets worse with aspirin
- All medicines you take, including other bone medicines and water pills
- If you are pregnant, may become pregnant, or are breastfeeding. It can harm an unborn baby.
Good to know
- It can harm the kidneys. You will have a blood test to check your kidneys before each dose.
- Drink plenty of fluids before each dose, unless your team tells you otherwise.
- A rare but serious jaw bone problem can happen. See a dentist before starting and keep good dental care.
- It can lower your calcium. Your team may ask you to take calcium and vitamin D.
- Rarely, unusual thigh bone fractures can happen.
Questions to ask
- Should I see a dentist before I start?
- Do I need calcium and vitamin D?
- How often will I get this, and for how long?
- How will you check my kidneys?
Side effect guides
Sources
Quick answers
- What is Zoledronic acid?
- Zoledronic acid is a medicine given in a vein that helps keep bones strong and lowers high calcium from cancer. Brand names: Zometa, Reclast.
- What is Zoledronic acid used for?
- preventing fractures and other bone problems from cancer that has spread to the bone; multiple myeloma; high calcium caused by cancer; thin bones (osteoporosis); Paget disease of bone.
- How is Zoledronic acid given?
- It is given as a drip into a vein over at least 15 minutes. For cancer in the bone it is often given every 3 to 4 weeks, and sometimes less often. For high calcium it may be given once. Your schedule may be different.
- What are the common side effects of Zoledronic acid?
- Flu-like feeling with fever, chills, and aches for a few days, most often after the first dose. Bone, joint, or muscle pain. Nausea. Feeling tired. Constipation or diarrhea. Feeling short of breath.
- When should I call my care team while taking Zoledronic acid?
- Peeing much less than usual, or swelling in your legs; Muscle cramps, twitching, or tingling in the fingers, toes, or around the mouth. These can be signs of low calcium; Jaw pain, swelling, loose teeth, or a sore in the mouth that does not heal; New pain in the thigh, hip, or groin; Very bad bone, joint, or muscle pain; Wheezing or trouble breathing.
Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.