Drometa contains Zoledronic acid, a nitrogen-containing bisphosphonate with potent antiresorptive properties. It acts by inhibiting osteoclast-mediated bone breakdown, a process crucial in conditions like metastases and osteoporosis. Zoledronic acid has a high affinity for bone mineral, allowing it to localize to areas of active bone remodeling.
Its primary mode of action involves inhibition of farnesyl pyrophosphate synthase in the osteoclasts, disrupting the mevalonate pathway essential for osteoclast function. This leads to decreased bone resorption and turnover. Moreover, Zoledronic acid also exhibits antitumor, antiangiogenic, analgesic, cytostatic, and pro-apoptotic effects, and may enhance the efficacy of other chemotherapeutics. It is not metabolized and is eliminated unchanged by the kidneys.
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Drometa is indicated for the management and treatment of various bone-related conditions, particularly where there is excessive bone resorption. Its clinical uses include:
Hypercalcemia of Malignancy:
Recommended Dose: 4 mg as a single IV infusion over a minimum of 15 minutes.
Retreatment may be considered after 7 days if calcium levels do not normalize.
Multiple Myeloma & Bone Metastases from Solid Tumors:
Dose: 4 mg IV every 3 to 4 weeks.
Supplementation: Patients should take 500 mg of calcium and 400 IU of vitamin D orally every day.
Renal Impairment Dosage Adjustments:
Renal impairment: Avoid use if CrCl <30 mL/min. Use adjusted dose based on renal function for CrCl 30–60 mL/min.
Elderly: No specific dose adjustment, but hydration and renal function monitoring are crucial.
Common side effects include:
Headache, nausea, vomiting, anorexia, and fatigue
Flu-like symptoms, fever, bone pain, and muscle aches (myalgia)
Electrolyte imbalances: hypocalcemia, hypophosphatemia, hypomagnesemia
Osteonecrosis of the jaw (ONJ) (rare but serious)
Anemia, constipation, and arthralgia
Pregnancy Category D: Contraindicated due to potential harm to the fetus.
Not recommended during breastfeeding, as excretion in human milk and effects on the infant are unknown.
Reconstitute the dose in 100 mL of 0.9% sodium chloride or 5% dextrose.
Infuse over 15 minutes using a separate IV line.
Known hypersensitivity to Zoledronic acid, other bisphosphonates, or excipients.
Pediatric use (under 18 years) is not recommended.
Aminoglycosides may synergistically increase the risk of prolonged hypocalcemia.
Loop diuretics can exacerbate the risk of hypocalcemia.
Thalidomide may increase the risk of renal toxicity when used with Zoledronic acid.
Exercise caution when combined with other nephrotoxic agents.
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At ePharma, we’re committed to providing accurate and accessible health information. However, all content is intended for informational purposes only and should not replace medical advice from a qualified physician. Please consult your healthcare provider for personalized guidance. We aim to support, not substitute, the doctor-patient relationship.