How often should zoledronic acid be used?

In daily life, people may suffer varying degrees of bone damage due to age issues, accidents and other reasons. For example, fractures, bone metastases, osteoporosis, etc. When the above bone-related diseases occur, people generally use zoledronic acid for treatment. Zoledronic acid has a very high affinity for bones, so it is widely used in the medical field. However, zoledronic acid cannot be used frequently, and there must be a certain interval between uses. How often should zoledronic acid be used?

Bisphosphonates are a type of compound that specifically acts on bones and can inhibit bone resorption caused by increased osteoclast activity. They are currently the standard treatment for hypercalcemia and have become the main drug for the treatment of bone metastases of malignant tumors.

Zoledronic acid is administered intravenously in clinical practice once every 3 to 4 weeks. Bisphosphonate treatment is generally well tolerated, but some side effects are inevitable, such as osteonecrosis of the jaw, nephrotoxicity and hypocalcemia. The incidence of osteonecrosis of the jaw is related to the cumulative drug exposure, which can increase from 1.5% at 4 to 12 months of treatment to 7.7% at 37 to 48 months; renal toxicity is mainly manifested as increased serum creatinine levels, while hypocalcemia is rare clinically. As the duration of use increases, the risk of events such as renal impairment and jaw osteonecrosis increases. The risk of developing osteonecrosis of the jaw was 6.7% after 20 doses of zoledronic acid and 31.7% after 36 doses.