What is Zometa^® (zoledronic acid)? 

Question: My doctor is recommending that I go on zoledronic acid because I have prostate cancer in my bones. What is it?

Answer: Zoledronic acid is a drug in the class of pharmaceuticals called bisphosphonates. They work by decreasing the break down of bone.

What are Zometa's uses in patients with prostate cancer?

Question: I have metastatic prostate cancer to my bones and heard that zoledronic acid might be helpful. When is it used?

Answer: Zoledronic acid is used in men with metastatic prostate cancer in bone. It helps reduce the incidence of skeletal-related events. These are pathologic fractures, spinal cord compression, the need for surgery or radiation to affected bones, the development of high calcium levels in the blood, or a change of systemic therapy because of bone pain. Some states have approved its use for anyone receiving a LHRH-A therapy who has osteoporosis.

How often is Zometa^® (zoledronic acid) given? 

Question: I have metastatic prostate cancer in my bones. I've been told in my support group that I should take zoledronic acid. How is it given and how often should I take it?

Answer: In patients with prostate cancer in the bone, it is given intravenously for 15 minutes every 3 to 4 weeks. Patients who have osteoporosis and are on a LHRH-A therapy receive it every 3 months.

What are the side effects of Zometa^® (zoledronic acid)? 

Question: I am about to begin receiving zoledronic acid to help with bone pain and to strengthen my bones. What are its side effects?

Answer: About 25 percent of patients can get a flulike illness after the first infusion (fever, bone, and muscle aches). Kidney function can be adversely affected by this drug.

There have been a number of cases of death of bone in the jaw (osteonecrosis of the jaw) that have implicated zoledronic acid as a possible cause. Low blood calcium levels can occur as a result of the administration of this drug, but can be prevented by taking calcium and vitamin supplements.

How can the side effects of Zometa^® (zoledronic acid) be prevented? 

Question: I am about to begin zoledronic acid to help with bone pain and to strengthen my bones. Is there anything I can do to prevent any side effects?

Answer: Premedications, such as Tylenol or nonsteroidal antiinflammatory drugs, can be given before the first administration of zoledronic acid to prevent the flulike syndrome. Kidney function tests need to be checked before each administration of zoledronic acid so that the dose can be modified or withheld if there is decreased kidney function.

Careful attention to dental hygiene and a prezoledronic acid dental examination should be done. Dental extractions and dental procedures should be avoided when on this drug. If it is necessary to do a dental procedure, zoledronic acid should be held for a period of time before and after the procedure.

Calcium levels should be intermittently checked while on zoledronic acid.


Are there any other indications for Zometa^® (zoledronic acid) beside for patients with prostate cancer in their bones? 

Question: I don't have prostate cancer in my bones at this time. However, I had a bone density scan that showed osteoporosis and I'm about to begin hormonal therapy. Will zoledronic acid benefit me?

Answer: Recently it has been shown that zoledronic acid given once every 3 months can help prevent further bone loss in patients on LHRH-A agonists, such as Lupron^® (leuprolide), Zoladex^® (goserelin), etc., who have osteoporosis.

Can bone loss be prevented while on androgen deprivation therapy? 

Question: I was told I have osteoporosis. What can I do to help build bone and prevent further bone loss?

Answer: Increased activity, especially light and repetitive weight lifting exercises, may be helpful.

A diet rich in calcium and Vitamin D, and using Vitamin D, (400 to 800 international units per day) and calcium supplements, (1,000 to 1,500 milligrams per day) is helpful.

Zometa^® (zoledronic acid) has been very useful in preventing further bone loss and helps to build bone.

Are there any new treatments for metastatic prostate cancer?

Question: I heard there was recently a new drug approved for metastatic prostate cancer?

Answer: Yes, this new drug is a vaccine made from your own immune cells, called Sipuleucel (Provenge^®). It was recently approved by the FDA for the treatment of asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer. A Phase III clinical trial demonstrated that patients on this drug lived an average of 4.1months longer and had a 22.5% reduction in the risk of death compared with the men in the control group. You should discuss with your doctor if this a treatment option for you.