The basics
Zoledronic acid (brand name-Zometa) is an FDA-approved treatment for bone diseases (such as multiple myeloma, Paget’s disease, osteoporosis etc.) in patients who have cancer. It is used in cancer chemotherapy and will slow or stop the spread of cancer.
Zoledronic acid is in a class of medications called bisphosphonates. It works by slowing bone breakdown, increasing bone density (thickness), and decreasing the amount of calcium released from the bones into the blood.
Let us walk you through the key things you need to know about zoledronic acid.
Zoledronic acid also comes in a different formulation under the brand name Reclast. This is used for non-cancer conditions.
How should I take zoledronic acid (Zometa)?

Zoledronic acid is injected into a vein over at least 15 minutes by a healthcare provider in a medical facility.
You should talk to your doctor from time to time about whether you still need to be treated with this medication. Be sure to drink at least 2 glasses of water or another liquid within a few hours before you receive zoledronic acid.
Your doctor may prescribe or recommend a calcium supplement and a multivitamin containing vitamin D to take during your treatment. You should take these supplements as directed by your doctor. You can help them by tracking your side effects in Ankr.
What are the side effects of zoledronic acid (Zometa)?
Common side effects
- itching, redness, pain, or swelling in the place where you received your injection
- red, swollen, itchy, or teary eyes or swelling around the eyes
- constipation
- nausea
- vomiting
- diarrhea
- stomach pain
- loss of appetite
- weight loss
- heartburn
- hoarseness
- mouth sores
- difficulty falling asleep or staying asleep
- fever, chills, cough, and other signs of infection
- white patches in the mouth
- numbness or tingling around the mouth or in fingers or toes
- hair loss
- rash
- hives
- itching
Serious side effects
- excessive worry
- agitation
- depression
- swelling, redness, irritation, burning, or itching of the vagina
- white vaginal discharge
- swelling of the eyes, face, lips, tongue, throat, hands, arms, feet, ankles, or lower legs
- difficulty breathing or swallowing
- upper chest pain
- irregular heart beat
- muscle spasms, twitches, or cramps
- unusual bruising or bleeding
- painful or swollen gums
- loosening of the teeth
- numbness or heavy feeling in the jaw
- sore in the mouth or the jaw that does not heal
- dull, aching pain in your hips, groin, or thighs leadong to bone break
Zoledronic acid may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online or by phone (1-800-332-1088).
Use the free Ankr platform or Ankr app to track your symptoms.
What special precautions should I follow?
Before receiving zoledronic acid (zometa)
- tell your doctor about your allergies
- tell your doctor about other intakes
- tell your doctor if you have or have ever had any other disease, symptom, or treatment
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. You should use a reliable method of birth control to prevent pregnancy while you are receiving zoledronic acid.
While you are on zoledronic acid (Zometa)
- If you become pregnant while receiving zoledronic acid, call your doctor. Zoledronic acid may harm the fetus.
- Call your doctor right away if you experience severe pain at any time during your treatment with zoledronic acid injection.
- You should know that zoledronic acid may cause osteonecrosis of the jaw (ONJ, a serious condition of the jaw bone), especially if you have dental surgery or treatment while you are using the medication.
I forgot a dose. What should I do?
If you miss an appointment to receive a zoledronic acid infusion, call your doctor as soon as possible.
In case of an emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.
Symptoms of overdose may include
- fever
- weakness
- sudden tightening of muscles or muscle cramps
- fast, pounding, or irregular heart beat
- dizziness
- uncontrollable eye movements
- double vision
- depression
- difficulty walking
- uncontrollable shaking of a part of your body
- seizures
- confusion
- shortness of breath
- pain, burning, numbness or tingling in the hands or feet
- difficulty speaking
- difficulty swallowing
- decreased urination
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
Brand names
- Zometa®
- Reclast®
Last Revised – 06/27.2023, FDA updated-11/15/2011, SG
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