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compositionComposition:ZOLEDRONIC ACID-4MG
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Prescription Medicine
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Zoltero 4 mg Injection 10 ml is used to treat osteoporosis (weak and brittle bones), Paget’s disease of bone and high calcium levels caused by cancer. It contains Zoledronic acid which works by preventing the bones from breaking down and keeps them strong. In some cases, this medicine may cause side effects such as headache, fever, nausea, dizziness, vomiting, diarrhoea, swelling, or pain at the infusion site. Inform the doctor if you are pregnant or breastfeeding, taking any other medication, or have any pre-existing medical conditions.

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Written By Veda Maddala , M Pharmacy
Reviewed By Dr Aneela Siddabathuni , MPharma., PhD
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More about the Product

Composition :

ZOLEDRONIC ACID-4MG

Manufacturer/Marketer :

Hetero Healthcare Ltd

Consume Type :

Parenteral

Expires on or after :

Jan-28

Return Policy :

Not Returnable

About Zoltero 4 mg Injection 10 ml

Zoltero 4 mg Injection 10 ml is a prescription medication used to treat and prevent osteoporosis in postmenopausal women and men. It is also used to treat Paget's disease of the bone and to manage bone complications caused by certain cancers, such as high blood calcium levels or bone metastases. Zoltero 4 mg Injection 10 ml helps strengthen bones, making them less likely to break.

Because of its long-lasting effects, this medication is given as an intravenous infusion at long intervals, such as once a year or every few months, depending on your condition. To help support your bone health during treatment, your doctor may suggest lifestyle changes like consuming enough calcium and vitamin D, doing weight-bearing exercises, and avoiding smoking.

While many patients tolerate the infusion well, some may experience temporary side effects like fever, muscle aches, or flu-like symptoms shortly after the treatment. In rare cases, more serious issues can occur, so you should always contact your healthcare provider if you experience severe jaw pain or changes in how much you urinate.

Talk to your doctor before starting Zoltero 4 mg Injection 10 ml if you have kidney problems, low blood calcium levels, or if you are planning any major dental procedures. Do not take this if you have severe kidney disease, low blood calcium, or if you are pregnant or breastfeeding.

Zoltero 4 mg Injection 10 ml can interact with certain other drugs, such as strong antibiotics or water pills, which can put extra strain on your kidneys. Always consult your doctor or pharmacist if you are elderly or have other underlying health conditions before receiving this treatment.

Uses of Zoltero 4 mg Injection 10 ml

Zoltero 4 mg Injection 10 ml is used in the treatment of Postmenopausal osteoporosis, Pagets disease, Hypercalcemia (high level of calcium) in cancer. The detailed uses of Zoltero 4 mg Injection 10 ml are as follows:

  • Osteoporosis in postmenopausal women and men: Zoltero 4 mg Injection 10 ml helps by strengthening weak bones and significantly reducing the risk of spine, hip, and other bone fractures.
  • Paget's disease of bone: Zoltero 4 mg Injection 10 ml helps slow down the abnormal and rapid bone breakdown and rebuilding cycle, which reduces bone pain and prevents permanent deformities.
  • Bone complications from cancer: Zoltero 4 mg Injection 10 ml helps protect bones from damage caused by cancer that has spread, reducing the risk of painful fractures and the need for bone surgery.
  • High calcium levels caused by cancer: Zoltero 4 mg Injection 10 ml helps by rapidly lowering dangerously high levels of calcium in the blood to safer, normal levels.

Key Benefits

Zoltero 4 mg Injection 10 ml helps strengthen bones and protect against fractures, supporting long-term bone health and physical independence. Improving bone strength helps you stay active and carry out daily activities with greater confidence.

Benefits may include:

  • Helps strengthen bones and reduce the risk of fractures.
  • Supports the treatment and prevention of bone loss in appropriate patients.
  • Helps maintain mobility and independence during daily activities.
  • Supports long-term bone health and overall skeletal strength.
  • Provides long-lasting protection with convenient dosing schedules, depending on the prescribed treatment.
  • Improves treatment adherence by reducing the need for frequent dosing.
Side effects of Zoltero 4 mg Injection 10 ml
Overcome Medication-Induced Nausea: A 9-Step Plan
  • Inform your doctor about the nausea and discuss possible alternatives to the medication or adjustments to the dosage.
  • Divide your daily food intake into smaller, more frequent meals to reduce nausea.
  • Opt for bland, easily digestible foods like crackers, toast, plain rice, bananas, and applesauce.
  • Avoid certain foods that can trigger nausea, such as fatty, greasy, spicy, and smelly foods.
  • Drink plenty of fluids, such as water, clear broth, or electrolyte-rich beverages like coconut water or sports drinks.
  • Use ginger (tea, ale, or candies) to help relieve nausea.
  • Get adequate rest and also avoid strenuous activities that can worsen nausea.
  • Talk to your doctor about taking anti-nausea medication if your nausea is severe.
  • Record when your nausea occurs, what triggers it, and what provides relief to help you identify patterns and manage your symptoms more effectively.
  • Rest well; get enough sleep.
  • Eat a balanced diet and drink enough water.
  • Manage stress with yoga and meditation.
  • Limit alcohol and caffeine.
  • Physical activities like walking or jogging might help boost energy and make you feel less tired.
Here are the steps to cope with constipation as a side effect of medication:
  • Inform your doctor about your constipation symptoms. They may adjust your medication or advise alternative treatments.
  • Stay hydrated by drinking sufficient of water (at least 8-10 glasses a day) to help soften stool and promote bowel movements.
  • Increase fibre intake by eating foods high in fibre, such as fruits, whole grains, vegetables and legumes, to help bulk up the stool.
  • Establish a bowel routine by trying to go to the bathroom at the same time each day to train your bowels.
  • Engaging in regular exercise, like walking or yoga, can support in bowel movement stimulation.
  • Consult your doctor if constipation persists, and discuss alternative treatments or adjustments to your medication.
To prevent, manage, and treat Constipation caused by medication usage, follow these steps:
  • Preventing Vomiting (Before it Happens)
  • Take medication exactly as prescribed by your doctor. This can help minimize side effects, including vomiting.
  • Having a small meal before taking your medication can help reduce nausea and vomiting.
  • Talk to your doctor about taking anti-nausea medication along with your prescribed medication.
  • Managing Vomiting (If it Happens)
  • Try taking ginger in the form of tea, ale, or candy to help alleviate nausea and vomiting.
  • What to Do if Vomiting Persists
  • Consult your doctor if vomiting continues or worsens, consult the doctor for guidance on adjusting your medication or additional treatment.
Here are the seven steps to manage medication-triggered Dyspnea (Difficulty Breathing or Shortness of Breath):
  • Tell your doctor immediately if you experience shortness of breath after taking medication.
  • Your doctor may adjust the medication regimen or dosage or give alternative medical procedures to minimize the symptoms of shortness of breath.
  • Monitor your oxygen levels and breathing rate regularly to track changes and potential side effects.
  • For controlling stress and anxiety, try relaxation techniques like deep breathing exercises, meditation, or yoga.
  • Make lifestyle changes, such as quitting smoking, exercising regularly, and maintaining a healthy weight.
  • Seek emergency medical attention if you experience severe shortness of breath, chest pain, or difficulty speaking.
  • Follow up regularly with your doctor to monitor progress, adjust treatment plans, and address any concerns or questions.

Directions for Use

  • Follow your doctor's instructions on the dosage and timing of Zoltero 4 mg Injection 10 ml. Typically, it is administered once every 3-4 weeks.
  • Zoltero 4 mg Injection 10 ml will be administered intravenously (through the vein) by a healthcare professional in a medical setting.
  • Do not self-administer it.

How Zoltero 4 mg Injection 10 ml Works

Zoltero 4 mg Injection 10 ml helps slow the breakdown of bone by reducing the activity of cells that remove old bone. This allows the body to build stronger, healthier bones, helping increase bone strength, improve bone density, and reduce the risk of fractures.
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Alcohol

Caution

Interaction of alcohol with Zoltero 4 mg Injection 10 ml is unknown. Please consult a doctor before consuming alcohol with Zoltero 4 mg Injection 10 ml.

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Pregnancy

Unsafe

Zoltero 4 mg Injection 10 ml is a category D pregnancy drug and is not recommended for pregnant women as it may harm an unborn baby. Please consult a doctor if you are pregnant.

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Breast Feeding

Unsafe

Zoltero 4 mg Injection 10 ml is contraindicated in breastfeeding mothers. Therefore, please consult a doctor if you are breastfeeding.

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Driving

Caution

Zoltero 4 mg Injection 10 ml may cause dizziness. Therefore, avoid driving or operating machinery if you feel dizzy after taking Zoltero 4 mg Injection 10 ml.

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Liver

Caution

Take Zoltero 4 mg Injection 10 ml with caution, especially if you have a history of Liver diseases/conditions. The dose may be adjusted by your doctor as required.

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Kidney

Caution

Take Zoltero 4 mg Injection 10 ml with caution, especially if you have a history of Kidney diseases/conditions. The dose may be adjusted by your doctor as required. Avoid taking Zoltero 4 mg Injection 10 ml if you have severe kidney problems.

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Children

Unsafe

Zoltero 4 mg Injection 10 ml is not recommended for children below 18 years as the safety and effectiveness were not established.

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Heart

Consult your doctor

Please inform your doctor if you have a history of heart disease before using Zoltero 4 mg Injection 10 ml. Your doctor will prescribe it only if the benefits outweigh the risks.

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Geriatrics

Consult your doctor

Limited information available for use of Zoltero 4 mg Injection 10 ml in elderly patients. Please consult your doctor.

What if I have taken an overdose of Zoltero 4 mg Injection 10 ml

Since this medication is prepared and given by a trained medical professional in a controlled setting, an overdose is extremely rare. However, if you suspect an error has occurred or experience severe muscle cramping, spasms, or numbness shortly after an infusion, seek medical help immediately.

Diet & Lifestyle Advise

  • Prioritize Calcium and Vitamin D: Ensure you consume enough calcium-rich foods like yogurt, cheese, and dark leafy greens, along with vitamin D, to help your body build and maintain strong bones. Talk to your doctor about whether you need supplements.
  • Stay Well-Hydrated: Drink plenty of water throughout the day, especially on the day of your infusion, to protect your kidneys from stress.
  • Incorporate Weight-Bearing Exercise: Engage in regular, gentle physical activities like walking, climbing stairs, or using light resistance bands to stimulate bone strength.
  • Practice Good Dental Hygiene: Brush and floss your teeth regularly, and schedule routine dental check-ups to keep your mouth healthy and minimize the risk of rare jaw complications.
  • Limit Alcohol and Avoid Tobacco: Both smoking and excessive drinking can weaken your bones over time, making your treatment less effective.
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Have a query?

How Soon It Starts Working

The time required for Zoltero 4 mg Injection 10 ml to start to work: The time required for Zoltero 4 mg Injection 10 ml to show its action is unknown. The time for which the effects of Zoltero 4 mg Injection 10 ml last: The duration of action for Zoltero 4 mg Injection 10 ml is clinically unknown.

What if you forget to take Zoltero 4 mg Injection 10 ml

If you miss a scheduled appointment for your infusion, contact your doctor's office or clinic as soon as possible to reschedule. It is important to stay on track with your treatment plan, but you should never attempt to receive a double dose close together to make up for a missed one.

Storage

• Unopened vials of this medication are stored by the clinic or hospital at controlled room temperature, typically between 20°C to 25°C (68°F to 77°F).

Drug Warnings

  • Inspect the solution before use: The solution should be completely clear, colorless, and free of visible particles. Do not use it if you notice any changes in appearance.
  • Inform your dentist before dental procedures: Tell your dentist that you are receiving Zoltero 4 mg Injection 10 ml before undergoing any dental treatment, tooth extraction, or oral surgery.
  • Complete a dental examination before treatment: Have a thorough dental check-up and complete any necessary dental work before your first infusion to help reduce the risk of jaw problems.
  • Attend regular monitoring appointments: Your doctor should check your kidney function and blood calcium levels before each Zoltero 4 mg Injection 10 ml infusion to ensure treatment remains safe.
  • Inform your healthcare providers about all medicines: Tell your doctor about all prescription medicines, over-the-counter products, vitamins, and herbal supplements you are taking before and during treatment.

Drug-Drug Interactions

verifiedApollotooltip
  • Aminoglycoside antibiotics: Taking these medicines alongside Zoltero 4 mg Injection 10 ml may increase the risk of dangerously low calcium levels in the blood.
  • Loop diuretics (water pills): Combining these with Zoltero 4 mg Injection 10 ml may increase the risk of low calcium levels and kidney-related side effects.
  • Medicines that may affect the kidneys (e.g., certain anti-inflammatory pain relievers): Taking these alongside Zoltero 4 mg Injection 10 ml may increase the risk of kidney damage and require closer monitoring.
Zoledronic acidCidofovir
Critical
Zoledronic acidDeferasirox
Severe

Drug-Drug Interactions

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Zoledronic acidCidofovir
Critical
How does the drug interact with Zoltero 4 mg Injection 10 ml:
Co-administration of Cidofovir and Zoltero 4 mg Injection 10 ml can increase the risk of kidney problems.

How to manage the interaction:
Taking Cidofovir and Zoltero 4 mg Injection 10 ml together is not recommended as it can lead to an interaction, it can be taken if advised by a doctor. However, if you experience any symptoms like nausea, vomiting, loss of hunger, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, and irregular heart rhythm, contact your doctor immediately. Do not discontinue any medications without consulting a doctor.
Zoledronic acidDeferasirox
Severe
How does the drug interact with Zoltero 4 mg Injection 10 ml:
Co-administration of Zoltero 4 mg Injection 10 ml (oral form) with Deferasirox can increase the risk of bleeding and ulcers in the stomach and intestines.

How to manage the interaction:
Although taking Zoltero 4 mg Injection 10 ml and Deferasirox together can possibly result in an interaction, it can be taken if your doctor has prescribed it. However, if you experience nausea, vomiting, loss of appetite, increased or decreased urination, fluid retention, swelling, shortness of breath, bone pain, muscle cramps, tiredness, weakness, dizziness, confusion, or irregular heart rhythm, seek immediate medical attention. Drink plenty of water if you experience diarrhoea or vomiting while taking these medications, as dehydration can potentially affect the kidneys. Do not discontinue any medications without a doctor's advice.
Zoledronic acidHuman immunoglobulin
Severe
How does the drug interact with Zoltero 4 mg Injection 10 ml:
Co-administration of Human immunoglobulin with Zoltero 4 mg Injection 10 ml, may raise the risk of kidney problems.

How to manage the interaction:
There may be a possibility of interaction between Human immunoglobulin and Zoltero 4 mg Injection 10 ml, but it can be taken if prescribed by a doctor. However, if you experience nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, or an irregular heart rhythm, consult a doctor. Do not discontinue any medications without consulting a doctor.
Zoledronic acidSirolimus
Severe
How does the drug interact with Zoltero 4 mg Injection 10 ml:
Co-administration of Sirolimus and Zoltero 4 mg Injection 10 ml can increase the risk or severity of kidney problems.

How to manage the interaction:
Taking Sirolimus and Zoltero 4 mg Injection 10 ml together can lead to an interaction, but it can be taken if a doctor advises. However, if you experience any symptoms like nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, and irregular heart rhythm, contact a doctor immediately. Do not discontinue any medications without consulting a doctor.
Zoledronic acidTacrolimus
Severe
How does the drug interact with Zoltero 4 mg Injection 10 ml:
Taking Tacrolimus with Zoltero 4 mg Injection 10 ml may increase risk of kidney problems.

How to manage the interaction:
Although taking Tacrolimus and Zoltero 4 mg Injection 10 ml together can possibly result in an interaction, it can be taken if a doctor has prescribed it. However, consult the doctor immediately if you experience symptoms such as nausea, vomiting, loss of hunger, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, and irregular heart rhythm. Do not discontinue any medications without consulting a doctor.
Zoledronic acidTenofovir alafenamide
Severe
How does the drug interact with Zoltero 4 mg Injection 10 ml:
Co-administration of Zoltero 4 mg Injection 10 ml and Tenofovir alafenamide can increase the risk of kidney problems.

How to manage the interaction:
Taking Zoltero 4 mg Injection 10 ml and Tenofovir alafenamide together can lead to an interaction, it can be taken if advised by a doctor. However, if you experience any symptoms like nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, bone pain, muscle cramps, tiredness, weakness, dizziness, confusion, and irregular heart rhythm, contact a doctor immediately. Do not discontinue any medications without consulting a doctor.

Drug-Food Interactions

verifiedApollotooltip
  • No clinically significant food interactions are known with Zoltero 4 mg Injection 10 ml when used as directed.
No Drug - Food interactions found in our database. Some may be unknown. Consult your doctor for what to avoid during medication.

Drug-Food Interactions

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All Substitutes & Brand Comparisons

Habit Forming

No

Therapeutic Class

[BONE ENHANCERS]

FAQs

Zoltero 4 mg Injection 10 ml is used to treat osteoporosis (weak and brittle bones) and Paget's bone.
Zoltero 4 mg Injection 10 ml contains Zoledronic acid that works by binding to the bone tightly and preventing the removal of calcium by osteoclasts (a type of bone cells that destroy bone tissue). This prevents osteoclasts from breaking down the bone and keeps the bones strong and minimizes the risk of bones breaking.
You are not recommended to take Zoltero 4 mg Injection 10 ml if you have hypocalcemia (low levels of calcium in the blood) as it may worsen the condition. However, the levels of calcium and vitamin D may be checked before starting treatment with Zoltero 4 mg Injection 10 ml.
Zoltero 4 mg Injection 10 ml may cause osteonecrosis (bone damage) of the jaw. Therefore, to prevent such condition, maintain good oral hygiene and have regular dental check-ups while taking Zoltero 4 mg Injection 10 ml. Also, is you wear dentures, make sure they fit properly. However, if you experience any problems with teeth or mouth such as loose teeth, swelling or pain, non-healing of sores or discharge, consult your doctor and dentist as these might be signs of osteonecrosis of the jaw.
You are not recommended to take Zoltero 4 mg Injection 10 ml with gentamicin as co-administration of these two medicines may increase the risk of very low calcium levels in the blood. However, please consult a doctor before taking Zoltero 4 mg Injection 10 ml with other medicines.
Zoltero 4 mg Injection 10 ml may reduce calcium levels in the blood by preventing calcium reabsorption from bones to the blood. Therefore, your doctor may prescribe calcium and vitamin D supplements, and you may be advised to take them for at least 10 days after receiving Zoltero 4 mg Injection 10 ml.
Zoltero 4 mg Injection 10 ml may cause flu-like symptoms (chills, tiredness, muscle and joint pain) in some patients as a common side effect. However, if the symptoms persist or worsen even after 2 weeks, please consult a doctor.
In Paget’s disease, bone remodeling (removal of old bone and replacement with new bone material) is too quick, and new bone is formed in a disordered manner making it weaker than normal. If left untreated, the bone may become deformed, painful, and broken.
No, Zoltero 4 mg Injection 10 ml is not a habit-forming medication. It is used to treat osteoporosis and high blood calcium levels, and it does not cause physical or psychological dependence.
Zoltero 4 mg Injection 10 ml belongs to the class of medicines called 'bisphosphonates' that contains Zolendronic acid.
Your doctor will evaluate your individual needs and determine the appropriate treatment duration, confirming personalized care and best results. Zoltero 4 mg Injection 10 ml will be administered by a healthcare professional in a clinical setting. Always follow your doctor's instructions regarding treatment duration.
Zoltero 4 mg Injection 10 ml is administered through an intravenous (IV) infusion by a healthcare professional. This medication is given directly into your vein, and self-administration is not allowed.
Zoltero 4 mg Injection 10 ml is generally considered safe when we exactly follow our doctor's instructions. However, like all medications, it can have side effects and potential interactions with other drugs. It's important to follow your doctor's instructions and inform them of any pre-existing and existing medical conditions or medication history to avoid negative complications.
To keep your bones healthy, you should exercise regularly, eat a diet rich in calcium and vitamin D, stop smoking, limit alcohol, stay hydrated, and make your home safer to prevent falls. These simple changes can make a big difference in maintaining strong bones.
The common side effects of the Zoltero 4 mg Injection 10 ml are headache, fever, nausea, dizziness, vomiting, back pain, diarrhea, pain in the muscles, joints, or bones, swelling, or pain at the infusion site. Most of these side effects do not require medical attention and gradually resolve over time. However, if the side effects persist or worsen, please consult your doctor.
Routine cleanings and fillings are generally safe, but major procedures like tooth extractions or dental implants should be avoided or carefully planned. Always inform your dentist that you are receiving this treatment before any work begins. Talk to your doctor or dentist if you have concerns.
This medication binds tightly to your bones, where it can remain active and protect your skeletal system for many months or even years, even though it clears from your bloodstream very quickly. Talk to your doctor for more details about how this works.
In some cases, especially if a patient is dehydrated or already has weak kidneys, this medication can place strain on the kidneys. Staying fully hydrated before and after your infusion significantly reduces this risk. Talk to your doctor if you have a history of kidney disease.
No, you should not receive this medication if you are pregnant, planning to become pregnant, or breastfeeding, as it can harm the developing baby or pass into breast milk. Talk to your doctor about safer alternatives.
For high blood calcium levels, it begins working within a few days to lower calcium. For osteoporosis and other long-term bone conditions, it starts protecting your bone structure immediately, though the full benefits are measured over several months to a year. Talk to your doctor to monitor your progress.

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Country of origin

India

Manufacturer/Marketer address

HALL NO 3, BASEMENT, A37, MANGOLPURI, INDUSTRIALAREA, PHASE 11, NEW DELHI, DELHI, 110034.
Other Info - ZOL0341
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