Zoledronic Acid Treatment
What is Zoledronic Acid?
- Zoledronic acid (also known as Reclast) is a medication used to strengthen bones and reduce fracture risk in conditions such as osteoporosis, osteopenia and certain cancers affecting the bones.
- It belongs to a group of medicines called bisphosphonates, which slow down the cells that break down bone.
- Most commonly is given as 12-50 min infusion once a year for 3 to 5 years.
- Most people tolerate Zoledronic Acid well, and it helps preserve bone strength for years to come.
What to Do Before Your Infusion
- Stay well-hydrated – drink at least 2 glasses of water before and after your infusion.
- Take acetaminophen (Tylenol) – take a dose before your infusion, then another every 6 hours for the next 24 hours as needed to ease fever, muscle aches, or flu-like symptoms.
- Tell your provider if you are already being treated with Zometa, Prolia, or Xgeva.
- Maintain good oral health — a dental exam before starting Zoledronic acid can help reduce rare jaw issues.
- If you’re planning an invasive dental procedure (like a tooth extraction, implant or root canal), it’s usually best to postpone your infusion until about 2 months after the procedure or once healing is complete.
Possible Side Effects (Most Are Mild and Temporary)
- Common—but short-lived
- Flu-like symptoms: fever, muscle aches, headache, fatigue.
- Less common (but important to know)
- Jaw bone problems (osteonecrosis of the jaw, ONJ): Extremely rare.
- Risk with osteoporosis doses is about 1 to 10 in 10,000 people (0.01%–0.1%). Risk is higher in cancer patients on higher, more frequent doses.
- Low blood calcium: rare, usually mild (may feel like tingling or cramps).
- Kidney effects: very rare – staying hydrated lowers risk.
- Jaw bone problems (osteonecrosis of the jaw, ONJ): Extremely rare.
Dental & Jaw Health Tips
- Osteonecrosis of the jaw is very rare, especially with once-yearly osteoporosis treatment.
- Keep up good oral hygiene and regular dental visits.
- Avoiding invasive dental work shortly before or after your infusion helps significantly decrease the risk.