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Indications & Uses
Adronic is indicated for:
Pharmacology
Zoledronic acid is a nitrogen-containing bisphosphonate, and it works mainly on bone. It stops osteoclasts from breaking bone down (this is called bone resorption). Bisphosphonates bind strongly to mineralized bone, and after an intravenous dose zoledronic acid moves quickly into the bone. Inside the osteoclast, its main molecular target is the enzyme farnesyl pyrophosphate synthase, though other mechanisms are not ruled out.
In clinical studies of tumour-induced hypercalcemia, zoledronic acid lowered serum calcium and reduced the amount of calcium passed in the urine. Besides blocking bone resorption, it also has anti-tumour, anti-angiogenic and anti-pain activity. It has cytostatic and pro-apoptotic effects on tumour cells too, and it shows a synergistic cytostatic effect with other anti-cancer drugs.
When doses were repeated every 28 days, the active substance did not build up in plasma. Zoledronic acid is not metabolized. The kidney excretes it unchanged.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Hypercalcemia of malignancy
The maximum recommended dose of Zoledronic Acid for hypercalcemia of malignancy (serum calcium 12 mg/dl or 3.0 mmol/l) is 4 mg. This 4 mg dose must be given as a single-dose intravenous infusion. If a patient has mild-to-moderate renal impairment, the dose of Zoledronic Acid doesn't need to be adjusted. Re-treatment may be considered if serum calcium does not return to normal after the first treatment. At least 7 days should pass before re-treatment, so the initial dose has time to give its full response.
Multiple myeloma and bone metastases of solid tumors
For patients with multiple myeloma and metastatic bone lesions from solid tumors, the recommended dose of Zoledronic Acid is 4 mg infused every 3 to 4 weeks. These patients should also be given an oral calcium supplement of 500 mg and 400 IU of Vitamin-D daily.
Side Effects
Zoledronic Acid can cause these side effects after a dose: headache, nausea, anorexia, fatigue, osteonecrosis of jaw, anemia, bone pain, constipation, fever, vomiting, flu-like syndrome, hypocalcemia, myalgia, arthralgia and hypophosphataemia.
Cautions & Contraindications
Warnings & Precautions
Patients must be well hydrated before they receive Zoledronic Acid [For hypercalcemia]. This matters most for elderly patients and for those taking diuretics. A simple way to get there is for the patient to drink two glasses of fluid (water, for example) before the infusion and two more after it. After Zoledronic Acid [For hypercalcemia] treatment starts, serum levels of calcium, phosphate, magnesium and potassium should be checked carefully, along with serum creatinine. If hypocalcemia, hypophosphatemia or hypomagnesemia develops, short-term supplements may be needed. Careful monitoring of renal function should also be considered.
Contraindications
Zoledronic Acid should not be given to patients who are hypersensitive to the active substance, to any of the excipients, or to any other bisphosphonate. It is also contraindicated in severe renal impairment (creatinine clearance below 30 ml/min), and during pregnancy and breastfeeding.
Pregnancy & Breastfeeding
Zoledronic acid must not be used during pregnancy or by women who are breast-feeding. It is also not recommended for children and adolescents under 18 years of age.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Zoledronic Acid [For hypercalcemia] is not recommended for patients with severe renal impairment (creatinine clearance <30 ml/min). If creatinine clearance is above 60 ml/min, no dose adjustment is needed. For patients with impaired kidney function, the dose depends on creatinine clearance (CrCl). When CrCl is above 60 ml/min, the dose is 4 mg (5 ml). At CrCl 50 to 60 ml/min, it is 3.5 mg (4.4 ml). At CrCl 40 to 49 ml/min, it is 3.3 mg (4.1 ml), and at CrCl 30 to 39 ml/min, it is 3 mg (3.8 ml).
Overdose
Experience with acute overdose of Zoledronic Acid is limited. An overdose may cause hypocalcemia, hypophosphatemia and hypomagnesemia. If this happens, the low levels of calcium, phosphorus and magnesium in the blood should be corrected with intravenous calcium gluconate, potassium or sodium phosphate, and magnesium sulfate, given in that order.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Zoledronic Acid [For hypercalcemia] below 30° C until you open it. Protect it from moisture and light. Always keep it out of the reach and sight of children.
Drug Interactions
Common questions about Adronic 4 mg/5 ml
What is Adronic 4 mg/5 ml IV Infusion?
Adronic 4 mg/5 ml IV Infusion is a medicine that contains Zoledronic Acid [For hypercalcemia]. It is made by Aristopharma Limited. It belongs to the Bisphosphonate preparations group of medicines.
What is Adronic used for?
Adronic is used for: Osteoporosis.
What are the side effects of Adronic?
Zoledronic Acid can cause these side effects after a dose: headache, nausea, anorexia, fatigue, osteonecrosis of jaw, anemia, bone pain, constipation, fever, vomiting, flu-like syndrome, hypocalcemia, myalgia, arthralgia and hypophosphataemia.
Can I take Adronic during pregnancy or while breastfeeding?
Zoledronic acid must not be used during pregnancy or by women who are breast-feeding. It is also not recommended for children and adolescents under 18 years of age. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Adronic?
Experience with acute overdose of Zoledronic Acid is limited. An overdose may cause hypocalcemia, hypophosphatemia and hypomagnesemia. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Adronic?
Keep Zoledronic Acid [For hypercalcemia] below 30° C until you open it. Protect it from moisture and light.
Can I take other medicines with Adronic?
Some medicines can interact with Zoledronic Acid [For hypercalcemia], for example: Thalidomide. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Adronic?
Adronic is a prescription (Rx) medicine. Take it as your doctor advises.