Zoledronate

Zoledronate is given by intravenous infusion or 'drip'. The medicine is injected into a vein in your arm as a drip so it goes in slowly over 15 to 30 minutes. A Zoledronate infusion can be given to you by your GP or nurse or you may be referred to a specialist or clinic. 

You will usually only need to get a zoledronate infusion every 12 to 18 months.

After a few years on zoledronate, your doctor will review your treatment, to check if you still need the medicine.

It's important to prepare before your infusion, read more about how to prepare for it below. 

Tests and monitoring

Your doctor will arrange for you have a blood test 1 week before the infusion.

• This is to check your calcium and vitamin D levels.
• If they are very low, your doctor may delay your treatment until your levels have improved.
• If you're not already taking vitamin D tablets, your doctor will ask you to take calciferol (vitamin D) tablets before your infusion.
• You may also have a blood test to make sure your kidneys are working well.

Getting your medication

In most cases your doctor will give you a prescription for the medication. You'll need to take the prescription to a pharmacy, pick up the medication before your appointment and remember to take it with you on the day of your infusion.

Cost

While the zoledronate medication is free, you may need to pay for having the infusion. You may also have to pay a prescription charge when collecting the medicine from the pharmacy.

Dental treatment and take care with dental hygiene

If you need any dental treatment, you should have it done before your infusion. If you haven't had a recent dental check, consider having one and talking to your dentist about the infusion. But if you aren't having any problems with your teeth, this isn't essential.

Problems with your jaw

Zoledronate can cause a problem with the jaw called osteonecrosis of the jaw, which are ulcers in gums or tooth sockets. It rarely happens in people being treated for osteoporosis. It's more likely in people being treated for cancer who take higher doses of zoledronate. 

To reduce the risk of this problem, it is best to:

• Take good care of your teeth and mouth (such as brushing your teeth twice a day and regular flossing between your teeth).
• Have regular dental check-ups.
• Let your dentist know that you're having zoledronate treatment.
• Talk to your doctor or dentist if you have any loose teeth, tooth pain, or swelling or numbness in your jaw.

Hydration

It's important that you are well hydrated on the day of the infusion as it is given by drip into a vein in your arm. Read more about staying hydrated below. 

You can eat and drink as normal.

Drink plenty of fluids to avoid dehydration

It's important that you're well hydrated before and after having the infusion. Your doctor or nurse will advise how much water you need to drink – this is usually at least 1 or 2 large glassfuls before and after treatment.

Medicines to avoid on the day of the infusion

You shouldn't take any anti-inflammatory medication (like aspirin or ibuprofen) or diuretic medication (like furosemide or bendroflumethiazide) on the day of your appointment. If you aren't sure about what you're taking, and what to do, ask your doctor.

Risk of a reaction during the infusion

For some people, zoledronate can cause a reaction (called an infusion reaction) while it's being given so you’ll be carefully monitored during the infusion and for a time afterwards. Reactions are usually more common with your first infusion. You may be prescribed paracetamol and an anti-allergy tablet on the day of your infusion.

Tell your nurse if you have any of these symptoms during your infusion:

• fever
• chills
• flushing
• skin rash
• itching
• dizziness
• headache
• trouble breathing.

Like all medicines zoledronate can cause side effects, although not everyone gets them.