Zoledronic acid


Zoledronic acid is an osteoporosis medication prescribed to help strengthen your bones and reduce your risk of breaking a bone. It is available as an annual intravenous infusion (drip).

Zoledronic acid is a 'bisphosphonate' - a group of medications that work by slowing down the cells that break down bone. Bisphosphonates are the most commonly prescribed medication for people with osteoporosis and are often the first treatment option considered by your doctor.

Zoledronic acid doesn't reduce the pain caused by broken bones. But don't worry - if you're experiencing pain after breaking a bone, there are medications and treatments for pain that can help you.

Side effects

Known side effects include:

  • Flu-like symptoms
  • Bone, joint or muscle pain
  • A fast and irregular heartbeat
  • Inflammation in the eye, eye pain or disturbed vision

It’s unlikely you’ll experience any side effects. But if you do, they shouldn't last for long.

As research progresses, the list of known side effects may change. You can find more information on each side effect and how to reduce the symptoms on the zoledronic acid factsheet.

You may have seen other symptoms and side effects in your patient information leaflet. These side effects are listed because they were reported by patients in research trials, but it’s unclear if they were directly caused by zoledronic acid. They were also reported by patients taking the placebo (dummy treatment).

Who should take zoledronic acid?

Zoledronic acid is usually prescribed for postmenopausal women, men and occasionally younger women.

Zoledronic acid doesn't suit everyone. It may not be the best treatment for you if you:

  • have hypocalcaemia (low blood calcium levels)
  • have severe kidney problems
  • are pregnant or breast feeding.

If you're prescribed zoledronic acid

Be informed

Talk to your doctor about your medication, its side-effects and any risks. You can read the information on this page and in your patient information leaflet, so you know what to expect.

You can ask your doctor for a copy of the patient information leaflet.

Our specialist nurse Helpline is here for you, if you have any questions or concerns.

Getting your infusion

It’s important that you have adequate levels of calcium and vitamin D when you’re taking zoledronic acid. For this reason, your doctor takes a blood test before the infusion, to check your levels.

If you’re not getting enough calcium from your diet or enough vitamin D from sunlight exposure, you can consider supplements.

Before and after the infusion, make sure you drink one or two glasses of water, to prevent dehydration.

How long to take it

Zoledronic acid is generally prescribed for at least three years, so you need to be happy it is the right option for you.

It is recommended that your treatment is formally reviewed by your doctor after three years. The review checks that your benefits from taking zoledronic acid continue to outweigh any risks.

If you experience side effects

It's perfectly natural to be concerned by side effects although, in most cases, they do pass.

The best thing to do is speak to your doctor or pharmacist. They can assess if there's a better treatment for you. They can also help you work out whether zoledronic acid is causing the symptoms, or if something else is the cause, such as another medication.

Health risks

There are some more-serious but very rare health conditions associated with zoledronic acid:

If you are prescribed zoledronic acid, your doctor has decided the benefit of taking the treatment outweighs any risks.

It's perfectly natural to feel concerned and unsure, but be reassured that your risk of these is very small. Our specialist nurses are here for you, if you need to talk through your concerns and find out more about your risk.

Also see:

Content reviewed: January 2016 (Updated: March 2022)

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