How does Zoltero 4 mg Injection 10 ml work?

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.

Can I take Zoltero 4 mg Injection 10 ml if I have hypocalcemia?

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.

Does Zoltero 4 mg Injection 10 ml cause osteonecrosis of the jaw?

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.

Can I take Zoltero 4 mg Injection 10 ml with gentamicin?

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.

Why did my doctor prescribe calcium and vitamin D supplements?

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.

Does Zoltero 4 mg Injection 10 ml cause flu-like symptoms?

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.

What is Osteonecrosis of the jaw?

Osteonecrosis of the jaw (ONJ) is a condition where part of the jawbone doesn't get enough blood, causing it to die. This can happen after dental work or on its own, often linked to certain medications used for osteoporosis and cancer. Symptoms include pain, swelling, exposed bone, and trouble chewing.

What is Paget’s disease?

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.

Is Zoltero 4 mg Injection 10 ml a habit-forming medicine?

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.

How long should I take Zoltero 4 mg Injection 10 ml?

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.

How is Zoltero 4 mg Injection 10 ml administered?

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.

Is Zoltero 4 mg Injection 10 ml safe?

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.

What other lifestyle changes should I make?

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.

Zoltero 4 mg Injection 10 ml

Prescription drug

MRP ₹2511

(Inclusive of all Taxes)

₹376.6 Cashback (15%)

Extra 15% Off with Bank Offers

Written By Veda Maddala , M Pharmacy

Reviewed By Dr Aneela Siddabathuni , MPharma., PhD

Zoltero 4 mg Injection 10 ml is used to treat osteoporosis (weak and brittle bones), Pagetâ€™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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About Zoltero 4 mg Injection 10 ml

Zoltero 4 mg Injection 10 ml belongs to the class of medicines called 'bisphosphonates' used to treat osteoporosis (weak and brittle bones) caused by menopause or long-term steroid use. Zoltero 4 mg Injection 10 ml also treats Paget’s bone and high calcium levels caused by cancer. Osteoporosis is a bone disease that weakens and thins bones by decreasing bone density, common in post-menopausal women. As the density of bones decreases, they weaken and are more likely to break.

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 cell that destroys bone tissue). This prevents osteoclasts from breaking down the bone and keeps the bones strong and minimizes the risk of bones breaking.

A doctor or nurse will administer Zoltero 4 mg Injection 10 ml. In some cases, you may experience 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 of Zoltero 4 mg Injection 10 ml do not require medical attention and gradually resolve over time. However, if the side effects persist or worsen, please consult your doctor.

If you are allergic to Zoltero 4 mg Injection 10 ml or any other medicines, please tell your doctor. Avoid taking Zoltero 4 mg Injection 10 ml if you are pregnant or breastfeeding and consult a doctor. Zoltero 4 mg Injection 10 ml is not recommended for children below 18 years as the safety and effectiveness were not established. Avoid taking Zoltero 4 mg Injection 10 ml if you have hypocalcemia (low calcium levels in the blood) and severe kidney problems. Drive only if you are alert as Zoltero 4 mg Injection 10 ml may cause dizziness. Zoltero 4 mg Injection 10 ml may cause osteonecrosis of the jaw (ONJ) in some patients. Therefore, 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.

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: Zoltero 4 mg Injection 10 ml treats and prevents bone loss in postmenopausal women and men at high risk of fractures.
Paget’s disease of Bone: Zoltero 4 mg Injection 10 ml reduces abnormal bone turnover and strengthens weakened bones.
Hypercalcemia of Malignancy: Zoltero 4 mg Injection 10 ml lowers dangerously high calcium levels caused by cancer.

Have a query?

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.

Medicinal Benefits

Zoltero 4 mg Injection 10 ml contains Zoledronic acid used to treat postmenopausal osteoporosis, Paget’s disease, and hypercalcemia of malignancy (bone cancer in which excess of calcium exits). Zoltero 4 mg Injection 10 ml binds to the bone tightly and prevents calcium removal by osteoclasts (a type of bone cell that destroy bone tissue). This prevents osteoclasts from breaking down the bone, strengthening bones, and minimizing the risk of bones breaking. Also, Zoltero 4 mg Injection 10 ml may reduce calcium levels in the blood by preventing calcium reabsorption from bones to the blood. Thus, it helps in treating high calcium levels in the blood caused by cancer.

How Zoltero 4 mg Injection 10 ml Works

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 cell that destroys bone tissue). This prevents osteoclasts from breaking down the bone and keeps the bones strong and minimizes the risk of bones breaking.

Storage

• Store in a cool and dry place away from sunlight.• Keep Zoltero 4 mg Injection 10 ml out of reach and sight of children. • Non cold chain - To be stored in cool places at 10ºC to 25ºC or below 30ºC.

Side effects of Zoltero 4mg/10ml Inj

Nausea

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.

Fatigue

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.

Bone Pain

Constipation

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.

Vomiting

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.

Shortness Of Breath

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.

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

Overdose may cause hypocalcemia (low calcium levels in the blood), hypophosphatemia (low levels of phosphate in the blood), and hypomagnesemia (low magnesium levels). Since Zoltero 4 mg Injection 10 ml is administered by a healthcare professional, an overdose is unlikely to occur. However, seek medical attention if you experience any unusual symptoms.

Drug Warnings

If you are allergic to Zoltero 4 mg Injection 10 ml or any other medicines, please tell your doctor. Avoid taking Zoltero 4 mg Injection 10 ml if you are pregnant or breastfeeding and consult a doctor. Zoltero 4 mg Injection 10 ml is not recommended for children below 18 years as the safety and effectiveness were not established. Avoid taking Zoltero 4 mg Injection 10 ml if you have hypocalcemia (low calcium levels in the blood) and severe kidney problems. Drive only if you are alert as Zoltero 4 mg Injection 10 ml may cause dizziness. If you are not able to take daily calcium supplements, have had sections of the intestine or some or all of the parathyroid glands in the neck surgically removed, have cancer, gum disease, poor dental health, or planned tooth extraction or kidney problem, inform your doctor before taking Zoltero 4 mg Injection 10 ml. If you are a smoker, inform your doctor before receiving Zoltero 4 mg Injection 10 ml as it may increase the risk of dental problems. Zoltero 4 mg Injection 10 ml may cause osteonecrosis of the jaw (ONJ) in some patients. Therefore, 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 recommended to drink at least 2 glasses of fluids before and after treatment with Zoltero 4 mg Injection 10 ml as advised by your doctor to prevent dehydration. Take calcium and vitamin D supplements as prescribed by your doctor as Zoltero 4 mg Injection 10 ml may reduce calcium levels in the blood.

Drug-Drug Interactions

Zoledronic acidCidofovir

Critical

Zoledronic acidDeferasirox

Severe

Drug-Drug Interactions

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Zoledronic acidCidofovir

Critical

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

How to manage the interaction:
Taking Cidofovir and Zoltero 4mg/10ml Inj 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 4mg/10ml Inj:
Co-administration of Zoltero 4mg/10ml Inj (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 4mg/10ml Inj 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 4mg/10ml Inj:
Co-administration of Human immunoglobulin with Zoltero 4mg/10ml Inj, may raise the risk of kidney problems.

How to manage the interaction:
There may be a possibility of interaction between Human immunoglobulin and Zoltero 4mg/10ml Inj, 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 acidTacrolimus

Severe

How does the drug interact with Zoltero 4mg/10ml Inj:
Taking Tacrolimus with Zoltero 4mg/10ml Inj may increase risk of kidney problems.

How to manage the interaction:
Although taking Tacrolimus and Zoltero 4mg/10ml Inj 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 acidSirolimus

Severe

How does the drug interact with Zoltero 4mg/10ml Inj:
Co-administration of Sirolimus and Zoltero 4mg/10ml Inj can increase the risk or severity of kidney problems.

How to manage the interaction:
Taking Sirolimus and Zoltero 4mg/10ml Inj 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 acidTenofovir alafenamide

Severe

How does the drug interact with Zoltero 4mg/10ml Inj:
Co-administration of Zoltero 4mg/10ml Inj and Tenofovir alafenamide can increase the risk of kidney problems.

How to manage the interaction:
Taking Zoltero 4mg/10ml Inj 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

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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Diet & Lifestyle Advise

Include dairy products like milk, yoghurt, cheese, or milk-based custard in your diet.
Eat daily a serving of broccoli, cabbage, bok choy (Chinese white cabbage), spinach, and other green leafy vegetables.
Snack on calcium-rich nuts like Brazil nuts or almonds.
Sprinkle sesame seeds over your food, vegetables, and salads. Sesame seeds are high in calcium.
Avoid or reduce the intake of caffeine, soft drinks, and alcohol that inhibit calcium absorption.
Replace the meat with tofu or tempeh for extra calcium in your food.

Habit Forming

No

Therapeutic Class

BONE ENHANCERS

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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.

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.

Breast Feeding

Unsafe

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

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.

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.

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.

Children

Unsafe

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

FAQs

Country of origin

India

Manufacturer/Marketer address

HALL NO 3, BASEMENT, A37, MANGOLPURI, INDUSTRIALAREA, PHASE 11, NEW DELHI, DELHI, 110034.

Other Info - ZOL0341

Author Details

Written By

Veda Maddala

M Pharmacy

Reviewed By

Dr Aneela Siddabathuni

MPharma., PhD

Last Updated

Sep 8, 2025 | 8:45 AM IST

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