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What Is Zometa?

Zometa® (zoledronic acid) is a medication known as a bisphosphonate that prevents bone damage in multiple myeloma patients. Our body closely controls cells that build bone (osteoblasts) and cells that break down bone (osteoclasts). For myeloma patients, signals sent by myeloma cells can disturb cell control by stimulating osteoclasts, leading to excess bone breakdown. Myeloma patients may experience various bone problems, including weak bones, lytic lesions (destruction of an area of bone), and fractures or breaks in the bone. 

Experts from the International Myeloma Working Group recommend Zometa as the preferred targeted treatment in patients with newly diagnosed myeloma, whether or not they are diagnosed with bone disease.1

In addition to preventing bone damage, research suggests that Zometa may also have an antimyeloma effect. In the Myeloma IX trial of studying bisphosphonate and thalidomide-based therapy in 1,970 patients, Zometa improved progression-free survival by about two months and reduced mortality by about 5.5 months compared to clodronic acid.2,3

Who Is a Candidate for Zometa? 

Zometa may be recommended for myeloma patients, even if you do not have current bone disease. Zometa is the preferred bone-targeted treatment in patients with newly diagnosed myeloma, except in certain circumstances, such as patients with impaired kidney function.4  If you have kidney impairment, your doctor may offer another medication, such as Xgeva® (denosumab). 

Hypocalcemia or low calcium levels in your blood must be corrected before starting treatment with Zometa. Your doctor will do a blood test to measure your calcium levels before starting treatment. Depending on the results, your doctor may recommend taking calcium and vitamin D supplements. Calcium and vitamin D are often given as pills to take at home.  

You may not be eligible to take Zometa if you are pregnant, as Zometa can cause harm to a developing unborn baby.

There are other reasons you may not be a candidate for Zometa. Please see the package insert for more information and discuss Zometa with your doctor.

How Is Zometa Given?

The typical dose of Zometa is 4 mg, given by infusion every 3-4 weeks. The infusion typically lasts 15 minutes or longer. Patients with impaired kidney function may receive a lower dose of Zometa or alternative medication.

Monthly infusions for 12 months is the typical duration of treatment with Zometa. Afterward, your doctor may reduce the frequency or stop Zometa altogether.

Important Safety Information

Zometa may cause severe reactions in some people. When studied in newly diagnosed myeloma patients, the most common side effects were: 

  • gastrointestinal effects (such as diarrhea, nausea, constipation, loss of appetite),
  • back pain,
  • fatigue, 
  • fever, 
  • low levels of red blood cells (anemia), 
  • low levels of platelets (thrombocytopenia), 
  • low levels of a type of immune cell called neutrophils (neutropenia),
  • low levels of potassium (hypokalemia), 
  • low levels of phosphorus (hypophosphatemia), 
  • and low levels of calcium (hypocalcemia). 

The most common serious side effects were pneumonia and sepsis (a life-threatening infection)5.

Like other bone-targeting medications, Zometa may cause osteonecrosis of the jaw (ONJ). Therefore, you must complete a dental exam before starting Zometa. ONJ may cause you to feel:

  • pain, 
  • numbness, 
  • unusual drainage, 
  • or swelling from your jaw, mouth, or teeth. 

If you experience any of these symptoms while taking Zometa, it is important to contact your doctor

For a complete list of side effects, please see the Zometa package insert or check out the additional resources below.

Additional Information

The European Public Assessment Report on Zometa

FDA Package Insert: Zometa

Denosumab versus zoledronic acid in bone disease treatment of newly diagnosed multiple myeloma: an international, double-blind, double-dummy, randomized, controlled, phase 3 study
 

Footnotes
  1. Stenger, “Updated Recommendations on the Treatment of Multiple Myeloma–Related Bone Disease From the Bone Working Group of the International Myeloma Working Group - The ASCO Post.”
  2. Raje et al., “Denosumab versus Zoledronic Acid in Bone Disease Treatment of Newly Diagnosed Multiple Myeloma.”
  3. Morgan et al., “Long-Term Follow-up of MRC Myeloma IX Trial.”
  4. Stenger, “Updated Recommendations on the Treatment of Multiple Myeloma–Related Bone Disease From the Bone Working Group of the International Myeloma Working Group - The ASCO Post.”
  5. Raje et al., “Denosumab versus Zoledronic Acid in Bone Disease Treatment of Newly Diagnosed Multiple Myeloma.”

 


The International Myeloma Foundation medical and editorial content team

Comprised of leading medical researchers, hematologists, oncologists, oncology-certified nurses, medical editors, and medical journalists, our team has extensive knowledge of the multiple myeloma treatment and care landscape. Additionally, Dr. Brian G.M. Durie reviews and approves all medical content on this website. 

Last Medical Content Review: April 8, 2024

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