When This Medicine Should Not Be Used:
This medicine is not right for everyone. You should not receive it if you had an allergic reaction to zoledronic acid, or if you are pregnant.

How to Use This Medicine:
Injectable

• A nurse or other health provider will give you this medicine.
• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• Your doctor may tell you to drink extra liquids before your treatment to prevent kidney problems.
• Your doctor may also give you vitamin D and calcium supplements. Tell your doctor if you are not able to take these medicines.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose:You must use this medicine on a fixed schedule. Call your doctor or pharmacist if you miss a dose.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use other medicines that also contain zoledronic acid. Do not use zoledronic acid together with another bisphosphonate medicine.
• Some foods and medicines can affect how zoledronic acid works. Tell your doctor if you are using digoxin, antibiotics, diuretics (water pills), an NSAID pain or arthritis medicine (such as aspirin, celecoxib, ibuprofen, naproxen), steroid medicines, or cancer medicines.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Tell your doctor if you are breastfeeding, or if you have kidney disease, anemia, aspirin-sensitive asthma, bleeding problems, cancer, congestive heart failure, low blood calcium levels, stomach absorption problems, mineral imbalance, dental problems or gum disease. Also tell your doctor if you had surgery on your bowel or parathyroid or thyroid gland.
• This medicine may cause the following problems:
  
  • Jaw or teeth problems
  • Severe bone, joint, or muscle pain
  • Increased risk of thigh bone fracture
  • Low calcium levels in your blood
• You must have regular dental exams while you are being treated with this medicine. Tell your dentist or oral surgeon that you are using this medicine.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain, trouble breathing, fast or uneven heartbeat
• Decrease in how much or how often you urinate, blood in the urine, lower back or side pain, burning or painful urination
• Muscle spasm or twitching, or numbness or tingling in your fingers, feet, or around your mouth
• Pain, swelling, or numbness in the mouth or jaw, loose teeth or other teeth problems
• Severe muscle, bone, or joint pain
• Unusual pain in your thigh, groin, or hip

If you notice these less serious side effects, talk with your doctor:

• Fever, chills, cough, sore throat, and body aches
• Headache
• Mild nausea, constipation, diarrhea, stomach pain or upset
• Redness, pain, or swelling of your skin where the needle is placed

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088