Zoledronic Acid
Zoledronic acid is a potent bisphosphonate used to treat conditions involving excessive bone loss and high blood calcium levels. It strengthens bones and reduces the risk of fractures by inhibiting osteoclasts, the cells responsible for breaking down bone tissue. This medication is used for osteoporosis, Paget's disease, hypercalcemia of malignancy, and to prevent bone complications in patients with cancer that has spread to the bones.
A bisphosphonate that strengthens bones by blocking bone-resorbing cells, used for osteoporosis, bone metastases, and hypercalcemia.
Key facts at a glance
- ATC
- M05BA08
- RxNorm
- 77655
- Generic
- Zoledronic Acid
- Class
- atc-m05
- Brands
- Reclast
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
7 groupspregnancy
all trimestersavoid use
do not use during pregnancy due to potential risk of fetal harm and skeletal abnormalities
discontinue prior to conception if possible
Use of this medication in this population requires careful consideration of risks and benefits.
lactation
breastfeedingavoid use
discontinue breastfeeding or avoid drug, decision should be made considering importance of drug to mother
monitor infant for hypocalcemia
Use of this medication in this population requires careful consideration of risks and benefits.
geriatric
elderlyno adjustment needed
use standard dosing, monitor renal function regularly
定期监测肾功能和血钙水平
pediatric_age
children adolescentsnot recommended
not indicated for use in pediatric patients, safety and efficacy not established
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
renal_impairment
severeavoid if CrCl <35 mL/min
do not use in patients with severe renal impairment (CrCl <35 mL/min), contraindicated
assess renal function before each dose
Use of this medication in this population requires careful consideration of risks and benefits.
renal_impairment
moderatereduce dose to 4 mg if CrCl 35-50 mL/min
for osteoporosis treatment, consider reduced dose in patients with CrCl 35-50 mL/min
Use with caution and monitor for adverse effects.
hepatic_impairment
mild moderateno adjustment needed
no dosage adjustment required, limited pharmacokinetic data but drug not hepatically metabolized
standard monitoring
Statistics and clinical data
FDA approval year
First FDA approval for Zoledronic Acid
Drug class
Pharmacological classification of Zoledronic Acid
Primary indications
Therapeutic indications for Zoledronic Acid (Reclast)
Administration route
Route of administration for Zoledronic Acid
Treatment and prevention of osteoporosis in postmenopausal women and men; Paget's disease of bone; hypercalcemia of malignancy; and prevention of skeletal-related events in patients with bone metastases from solid tumors and multiple myeloma.
Zoledronic acid binds to bone mineral and is taken up by osteoclasts (bone-resorbing cells), where it inhibits their activity and induces apoptosis, thereby reducing bone resorption and increasing bone mineral density.
Administered as an intravenous infusion (typically once yearly for osteoporosis, more frequently for cancer indications). May cause flu-like symptoms, hypocalcemia, and rare but serious jaw necrosis (ONJ). Adequate hydration, calcium, and vitamin D supplementation are important. Requires monitoring of renal function and is contraindicated in severe renal impairment.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy