Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Zoledronic acid is an injectable drug belonging to a class
of drugs called bisphosphonates that strengthen bone and are used primarily to
treat osteoporosis. Zoledronic
acid also is the active drug in Zometa. Other injectable bisphosphonates
include etidronate (Didronel) and pamidronate (Aredia). Bone is in a
constant state of remodeling in which
old bone is removed by cells called osteoclasts, and new bone is laid down
by cells called osteoblasts. Zoledronic acid inhibits bone removal by osteoclasts. The
FDA approved Reclast in August 2007.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Solution: 5 mg/100 ml
STORAGE: Unopened bottles should be kept at room temperature 15-30 C
(59-86 F). Opened bottles of solution are stable for 24 hours at 2-8 C
(36-46 F).
PRESCRIBED FOR: Zoledronic
acid is used for treatment of osteoporosis in postmenopausal women and men
as well as Paget's disease of bone
in men and women. It also is used to prevent osteoporosis in postmenopausal
women and treatment of steroid-induced osteoporosis.
DOSING: Zoledronic acid is given intravenously over no less than 15 minutes.
Administration of acetaminophen or
ibuprofen may reduce infusion related
reactions.
For treatment of postmenopausal osteoporosis, a
single 5 mg infusion once a year is recommended.
For prevention of postmenopausal osteoporosis the recommended dose is 5 mg
every two years.
Paget's disease of bone is treated with a single 5 mg infusion. Patients
with Paget's disease should also receive 1500 mg of elemental calcium and 800
IU vitamin D daily, especially during the 2 weeks after the injection of
zoledronic acid.
For prevention or treatment of steroid-induced osteoporosis, the
recommended dose is 5 mg once yearly.
DRUG INTERACTIONS: Combining zoledronic acid with aminoglycosides or loop
diuretics may lead to reduced calcium in blood. Zoledronic acid should be used
with caution in patients who are taking drugs that affect kidney function.
Since Reclast contains the same active ingredient as Zometa (zoledronic acid),
patients treated with Zometa should not receive Reclast.
PREGNANCY: Zoledronic acid should not be administered to
pregnant women.
Women of childbearing age should be advised to use a reliable method of birth
control.
NURSING MOTHERS: It is not known whether zoledronic acid is excreted in human
milk. Since many drugs are excreted in human milk, and zoledronic acid binds to
bone long-term, zoledronic acid should not be administered to
nursing women.
SIDE EFFECTS: The most common adverse reactions of zoledronic acid are fever,
muscle pain, and headache, arthralgia, and pain in hands and feet. Severe bone,
joint, and muscle pain may occur. Postmenopausal women treated with Reclast have
rarely reported osteonecrosis (bone death) of the jaw.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Learn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.
Paget's disease is a chronic bone disorder due to irregular breakdown and formation of bone tissue. Symptoms of Paget's disease include bone pain, headaches and hearing loss, pressure on nerves, increased head size, hip pain, and damage to cartilage of joints.
Osteopenia is a bone condition characterized by bone loss that is not as severe as in osteoporosis. Bone fracture is the typical symptom of osteopenia, though the condition may be present without symptoms. Treatment involves lifestyle modifications (quitting smoking, not drinking in excess) and ensuring an adequate intake of vitamin D and calcium.
Male menopause refers to the decline in testosterone production in men. As men age, they often experience many of the same symptoms that women experience in menopause. Testosterone replacement therapy may relieve some of these symptoms.
Premature menopause is when a woman goes through menopause before the age of 40 because of genetics, illness, or a medical procedure. Symptoms of premature menopause include irregular or missed periods, mood swings, hot flashes, periods that are heavier or lighter than usual, vaginal dryness, bladder irritability, incontinence, dry skin, eyes or mouth, sleeplessness, and decreased sex drive. Though premature menopause cannot be reversed, the symptoms can be managed with methods similar to those used for natural menopause.
Surgical menopause happens when a premenopausal woman has her ovaries removed in a surgical procedure called a bilateral oophorectomy. An abrupt menopause follows, with women often experiencing more severe menopausal symptoms than if they were to go through natural menopause. Chemotherapy and pelvic radiation therapy may also cause menopause by damaging the ovaries.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
Screening tests are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may
be available elsewhere. Take an active role and discuss screening tests with
your doctor early in life. The following charts are beneficial (generally simple
and safe) screening tests that can help detect diseases and conditions before
they become harmful.
Osteoporosis
Osteoporosis is a condition with progressive loss of bone density leading to
bone fractures. Estrogen is important
in maintaining bone density. When estrogen levels drop after menopause, bone loss accelerates. Thus osteoporosis is most
common among postmenopausal women.
Screening tests
Measurement of bone density using dual energy X-ray
absorptiometry (DEXA) scan
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