Zoledronic acid is a potent bisphosphonate medication that binds to your bones to slow down bone breakdown.
 

It works by:

slowing excessive bone breakdown

improving bone strength

reducing fracture risk

reducing bone pain associated with some cancers

helping maintain normal blood calcium levels in certain conditions

EXPECTED BENEFITS

Treatment may:

☐ Reduce fracture risk

☐ Improve bone density

☐ Slow bone loss

☐ Reduce bone pain

☐ Reduce complications from bone metastases

☐ Improve long-term bone health

☐ Reduce future hospitalisation

I understand treatment benefits may not be immediate and may take several months to become evident.

 

ALTERNATIVE TREATMENTS

☐ Oral bisphosphonates

☐ Denosumab

☐ Hormone therapy

☐ Calcium and Vitamin D supplementation

☐ Lifestyle modification

☐ Exercise

☐ No treatment

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BEFORE TREATMENT

I understand my clinician may recommend:

☐ Kidney function tests

☐ Calcium level

☐ Vitamin D level

☐ Electrolytes

☐ Pregnancy assessment (where appropriate)

☐ Dental assessment

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DENTAL HEALTH

Zoledronic Acid has been associated with a rare complication called Medication-Related Osteonecrosis of the Jaw (MRONJ).

Before treatment I have been asked about:

☐ Recent dental surgery

☐ Planned dental surgery

☐ Dental infection

☐ Loose teeth

☐ Poor dental health

☐ Dentures

I understand it is important to maintain good oral hygiene and inform my dentist that I am receiving Zoledronic Acid.

 

COMMON SIDE EFFECTS

☐ Flu-like symptoms

☐ Fever

☐ Chills

☐ Headache

☐ Fatigue

☐ Muscle pain

☐ Joint pain

☐ Bone pain

☐ Nausea

☐ Temporary infusion site discomfort

These symptoms usually begin within 24–72 hours and generally resolve within several days.

 

LESS COMMON SIDE EFFECTS

☐ Dizziness

☐ Temporary low blood pressure

☐ Vomiting

☐ Diarrhoea

☐ Rash

☐ Mild allergic reaction

☐ Eye inflammation

☐ Injection site inflammation

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MATERIAL RISKS

Although uncommon, Zoledronic Acid may cause more significant complications.

I understand these include:

☐ Kidney impairment

☐ Acute kidney injury

☐ Hypocalcaemia

☐ Low phosphate

☐ Low magnesium

☐ Severe muscle cramps

☐ Cardiac rhythm disturbances secondary to electrolyte abnormalities

☐ Severe allergic reaction

☐ Anaphylaxis

☐ Infusion reaction

☐ Hospital admission

☐ Rare life-threatening complications

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OSTEONECROSIS OF THE JAW

I understand:

☐ Osteonecrosis of the jaw is uncommon.

☐ The risk increases with prolonged treatment.

☐ The risk increases after invasive dental procedures.

☐ Good oral hygiene may reduce the risk.

☐ I should notify my doctor or dentist if I develop:

• jaw pain

• loose teeth

• exposed bone

• delayed healing after dental treatment

 

ATYPICAL FEMUR FRACTURES

I understand that prolonged bisphosphonate therapy has been associated with rare atypical fractures of the thigh bone.

Symptoms may include:

☐ Persistent thigh pain

☐ Groin pain

☐ Hip pain

I should report these symptoms promptly.

 

PREGNANCY & BREASTFEEDING

I understand:

☐ Zoledronic Acid is generally not recommended during pregnancy.

☐ I should inform my clinician if I may be pregnant.

I should discuss breastfeeding with my treating clinician.

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AFTER MY INFUSION

Following treatment I should:

☐ Maintain adequate hydration unless otherwise instructed.

☐ Continue calcium supplementation if prescribed.

☐ Continue Vitamin D supplementation if prescribed.

Contact my clinician if symptoms become severe.

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SEEK URGENT MEDICAL REVIEW IF I DEVELOP

☐ Difficulty breathing

☐ Swelling of the face or throat

☐ Severe rash

☐ Persistent fever

☐ Severe muscle cramps

☐ Confusion

☐ Reduced urine output

☐ Severe jaw pain

☐ Persistent thigh pain

☐ Any other concerning symptoms

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PATIENT ACKNOWLEDGEMENT

I acknowledge that:

☐ My diagnosis has been explained.

☐ The reason Zoledronic Acid has been recommended has been explained.

☐ Expected benefits have been discussed.

☐ Reasonable alternatives have been discussed.

☐ The common side effects have been explained.

☐ The material risks relevant to my circumstances have been discussed.

☐ I understand the risk of kidney injury.

☐ I understand the risk of hypocalcaemia.

☐ I understand the rare risk of osteonecrosis of the jaw.

☐ I understand the rare risk of atypical femur fractures.

☐ I understand emergency treatment may become necessary.

☐ I understand no treatment outcome can be guaranteed.

☐ I have had sufficient opportunity to ask questions.

☐ My questions have been answered.

☐ I understand I may withdraw my consent before treatment commences.