Zoledronic acid 4mg powder and solvent for solution for infusion vials
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Safety monitoring data
Yellow Card reports
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Suspected adverse reactions reported for Zoledronic acid
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Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
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Suspected adverse reactions reported for Zoledronic acid
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1 branded products available
MHRA licensed products
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Zometa 4mg powder and solvent for solution for infusion vials
Novartis Pharmaceuticals UK Ltd
WHO defined daily dose (DDD)
4 mg
Not a recommended dose. The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. It is a statistical measure used for research and comparison purposes only.
Source: WHO Collaborating Centre for Drug Statistics Methodology, distributed via the NHS dm+d supplementary BNF/ATC mapping files (NHSBSA). Contains public sector information licensed under the Open Government Licence v3.0.
Therapeutically similar medicines
Similarity is based on WHO Anatomical Therapeutic Chemical (ATC) classification and on a factual NHS dm+d therapeutic-grouping code prefix. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
NHS prescribing volume and spending trends
Guidelines from the National Institute for Health and Care Excellence
NICE clinical guidance(7)
Myeloma: diagnosis and management (NG35)
Denosumab for the prevention of skeletal-related events in adults with bone metastases from solid tumours (TA265)
Osteoporosis (QS149)
Bisphosphonates for treating osteoporosis (TA464)
Prostate cancer: diagnosis and management (NG131)
Romosozumab for treating severe osteoporosis (TA791)
Early and locally advanced breast cancer: diagnosis and management (NG101)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
Check stock at pharmacies and supply information
Pharmacy stock checkers
Search for this medicine at major UK pharmacy chains. These links open the retailer's own website — results depend on their current online catalogue.
Supply & safety information
Official UK regulator monitoring and safety alerts
Pharmacy links redirect to the retailer's own search and do not represent real-time stock levels. Shortage and safety information sourced from MHRA drug safety updates (gov.uk, Crown Copyright under OGL v3.0).
Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
Browse tools
SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF code shown is the factual mapping value distributed by NHS Business Services Authority (NHSBSA) in the dm+d supplementary file under OGL v3.0; it is not affiliated with, nor licensed from, the publishers of the British National Formulary. ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Academic studies and reviews for this medicine's active substance
Showing the 50 most relevant studies.
Reviews & meta-analyses: 12 · Randomised trials: 35 · 2002–2026
Showing the 50 most relevant studies, sorted by most relevant.
Álvaro Limones, L. Sáez-Alcaide, S. Díaz-Parreño, et al.
Medicina Oral, Patología Oral y Cirugía Bucal, 2020
Nicholas D. James, Matthew R. Sydes, Noel W. Clarke, et al.
The Lancet, 2015
- Docetaxel
- Zoledronic Acid
- Androgen Antagonists
Fred Saad, Donald M. Gleason, Robin Murray, et al.
JNCI Journal of the National Cancer Institute, 2002
- Zoledronic Acid
- Adenocarcinoma
- Antineoplastic Agents
Lee S. Rosen, David Gordon, Simon Tchekmedyian, et al.
Journal of Clinical Oncology, 2003
- Zoledronic Acid
- Bone Neoplasms
- Diphosphonates
Dennis M. Black, Ian R. Reid, Steven Boonen, et al.
Journal of Bone and Mineral Research, 2011
- Zoledronic Acid
- Diphosphonates
- Imidazoles
Matthew R. Smith, James A. Eastham, Donald M. Gleason, et al.
The Journal of Urology, 2003
- Zoledronic Acid
- Androgen Antagonists
- Diphosphonates
Gareth J. Morgan, Faith E. Davies, Walter M. Gregory, et al.
The Lancet, 2010
- Zoledronic Acid
- Antineoplastic Agents
- Antineoplastic Combined Chemotherapy Protocols
Norio Kohno, Kenjiro Aogi, Hironobu Minami, et al.
Journal of Clinical Oncology, 2005
- Zoledronic Acid
- Bone Neoplasms
- Breast Neoplasms
David M. Reid, Jean‐Pierre Devogelaer, Kenneth G. Saag, et al.
The Lancet, 2009
- Risedronic Acid
- Zoledronic Acid
- Analysis of Variance
Michael Gnant, Brigitte Mlineritsch, Herbert Stoeger, et al.
The Lancet Oncology, 2011
- Zoledronic Acid
- Anastrozole
- Antineoplastic Agents
Sources: aggregated from Europe PMC (EMBL-EBI), OpenAlex, Crossref, PubMed and other open scholarly databases. Retracted articles are excluded. Study information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
107 found
Half-life
146 hours
Mechanism
Bisphosphonates are taken into the bone where they bind to hydroxyapatite.
Food interactions
None known
Human targets
3 targets
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
4mg
Half-life
146 hours
[L13712][L13715][L13721]
Protein binding
23-53%
[L13712][L13715][L13721]
Metabolism
[L13712][L13715][L13721]
Elimination
16%
[L13712][L13715][L13721]
Clearance
2.0 L/h
[L13712][L13715][L13721]
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
Zoledronic acid was granted FDA approval on 20 August 2001.[L13712]
[L13712][L13715][L13721]
Zoledronic acid is also indicated for the prevention of osteoporosis in post menopausal women and glucocorticoid induced osteoporosis.
[L13712][L13715][L13721]
Known interactions with other medications. Always consult a healthcare professional.
Showing 50 of 316 interactions
[L13712][L13715][L13721]
Overdose should be managed through intravenous administration of the insufficient ions.
[L13712][L13715][L13721]
Osteoclasts mediate resorption of bone.[A6366] When osteoclasts bind to bone they form podosomes, ring structures of F-actin.[A6366] Etidronic acid also inhibits V-ATPases in the osteoclast, though the exact subunits are unknown, preventing F-actin from forming podosomes.[A202229][A202247][A203360] Disruption of the podosomes causes osteoclasts to detach from bones, preventing bone resorption.[A6366]
Nitrogen containing bisphosphonates such as zoledronate are known to induce apoptosis of hematopoietic tumor cells by inhibiting the components of the mevalonate pathway farnesyl diphosphate synthase, farnesyl diphosphate, and geranylgeranyl diphosphate.[A202769][A203123] These components are essential for post-translational prenylation of GTP-binding proteins like Rap1.[A202769][A203123] The lack of prenylation of these proteins interferes with their function, and in the case of Rap1, leads to apoptosis.[A202769][A203123] zoledronate also activated caspases which further contribute to apoptosis.[A202769][A203123]
How the body processes this drug — absorption, distribution, metabolism, and elimination
[A203099]
A 5mg intravenous dose reaches a Cmax of 471±76.1ng/mL, with a Tmax of 0.368±0.005h, and an AUC of 917±226ng\*h/mL.
[A203099]
[L13712][L13715][L13721]
[L13712][L13715][L13721]
[L13712][L13715][L13721]
[L13712][L13715][L13721]
[L13712][L13715][L13721]
Proteins and enzymes this drug interacts with in the body
Proteins that transport this drug across cell membranes
PMID:10064732 PMID:11114332 PMID:16230346 PMID:7961706 PMID:9281595
Mediates ATP-dependent transport of glutathione and glutathione conjugates, leukotriene C4, estradiol-17-beta-o-glucuronide, methotrexate, antiviral drugs and other xenobiotics .
PMID:10064732 PMID:11114332 PMID:16230346 PMID:7961706 PMID:9281595
Confers resistance to anticancer drugs by decreasing accumulation of drug in cells, and by mediating ATP- and GSH-dependent drug export .
PMID:9281595
Hydrolyzes ATP with low efficiency .
PMID:16230346
Catalyzes the export of sphingosine 1-phosphate from mast cells independently of their degranulation .
PMID:17050692
Participates in inflammatory response by allowing export of leukotriene C4 from leukotriene C4-synthesizing cells (By similarity). Mediates ATP-dependent, GSH-independent cyclic GMP-AMP (cGAMP) export .
PMID:36070769
Thus, by limiting intracellular cGAMP concentrations negatively regulates the cGAS-STING pathway .
PMID:36070769
Exports S-geranylgeranyl-glutathione (GGG) in lymphoid cells and stromal compartments of lymphoid organs. ABCC1 (via extracellular transport) with GGT5 (via GGG catabolism) establish GGG gradients within lymphoid tissues to position P2RY8-positive lymphocytes at germinal centers in lymphoid follicles and restrict their chemotactic transmigration from blood vessels to the bone marrow parenchyma (By similarity).
Mediates basolateral export of GSH-conjugated R- and S-prostaglandin A2 diastereomers in polarized epithelial cells PMID:9426231
ATC M05BB08
ATC M05BA08
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Zoledronic acid
Additional database identifiers
Drugs Product Database (DPD)
12024
ChemSpider
61986
BindingDB
12578
PDB
ZOL
ZINC
ZINC000003803652
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4249
GeneCards
GGPS1
GenBank Gene Database
AB017971
GenBank Protein Database
4520350
Guide to Pharmacology
643
UniProt Accession
GGPPS_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:3631
GenAtlas
FDPS
GeneCards
FDPS
GenBank Gene Database
J05262
GenBank Protein Database
182399
Guide to Pharmacology
644
UniProt Accession
FPPS_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:51
GenAtlas
ABCC1
GeneCards
ABCC1
GenBank Gene Database
L05628
GenBank Protein Database
1835659
Guide to Pharmacology
779
UniProt Accession
MRP1_HUMAN
DrugBank citations
If you use DrugBank data in your research, please cite the following publications:
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Structured knowledge from the free knowledge base
ATC classifications (Wikidata)
Linked open data from Wikidata (Q218507), a free and open knowledge base operated by the Wikimedia Foundation. Data is available under the Creative Commons CC0 1.0 Public Domain Dedication. WHO INN from the World Health Organization.