Main use Active ingredient Manufacturer
Managing complications of cancer involving the bones Zoledronic acid Novartis

How does it work?
Zometa infusion contains the active ingredient zoledronic acid,which is a type of medicine called a bisphosphonate. Bisphosphonates aremedicines that reduce the turnover of bone.

Bone is not a static structure. It is continually shaped,reformed and rebuilt by cells called osteoblasts and osteoclasts. These cellscontinously deposit and remove calcium and phophorous, stored in a proteinnetwork that makes up the structure of the bone. Old bone is broken down by theosteoclasts and new bone is formed by the osteoblasts.

Biphosphonates work by binding very tightly to the bone tissueand preventing the calcium being removed by the osteoclasts. This stops theosteoclasts from breaking down the bone.

Cancers involving the bone, for example breast or prostatecancer that has spread to the bone, or bone marrow cancer (multiple myeloma),can cause excessive bone breakdown. This causes areas of bone weakness that canlead to bone pain and fractures. Zoledronic acid can be used in thesesituations to bind to the bone and prevent it being broken down.

Zoledronic acid also has some anti-cancer effect on thecancerous cells in the bone, which helps reduce the growth of the cancer in thebones. This can help prevent the cancer from pressing on nerves, particularlyin the spine, and reduce the need for surgery or radiotherapy on thebones.

When the osteoclasts remove calcium from the bones, the calciumthen seeps into the blood. The excessive breakdown of bone that occurs whencancer spreads to the bones can therefore lead to high levels of calcium in theblood. This can cause symptoms such as nausea, tiredness and confusion. Aszoledronic acid prevents the calcium being removed from the bone, it can beused to treat high levels of calcium in the blood that are a result of cancer.

As the medicine slows bone turnover and so prevents calciumbeing reabsorbed from the bones into the blood, it can cause the amount ofcalcium in your blood to fall too low. Your doctor may therefore ask you totakecalcium andvitamin D supplements to prevent this. (Vitamin D isneeded by the body to help it absorb calcium.)

What is it used for?
Preventing bone complications (such as fractures, bone complications requiring radiotherapy or surgery, compression of nerves in the spine, or high blood calcium levels) in people with advanced cancer involving the bones, for example breast cancer or prostate cancer that has spread to the bones, or bone marrow cancer (multiple myeloma).
Reducing high levels of calcium in the blood (hypercalcaemia) caused by tumours.
How is it given?
Zometa infusion isgiven via a drip into a vein (intravenous infusion) over at least 15 minutes.
For preventing bone complications of cancer, the drip is given every three to four weeks.
Zometa infusion is given as a single dose to lower high bloodcalcium levels that are the result of tumours.
Warning!
You will need to have regular blood tests while you are having treatment with this medicine, in order to check your kidney function and the level of calcium and other minerals in your blood. This is particularly important if you have any existing problems with your kidneys, or you are also taking diuretic medicines or other medicines that can affect the kidneys.
It is important that you drink enough fluid both before and after your infusion to prevent dehydration. However, it i