Zolorix belongs to the class of bisphosphonates and selectively affects the bone, prevents its resorption, is released as a concentrate in vials. The active substance is zoledronic acid.
The selective action of the active substance on the bone is explained by the high affinity for mineralized bone tissue, however, the exact mechanism providing blockage of osteoclast activity is currently unclear.
In addition to blocking the resorption of bone, the active substance has an antitumor effect in bone metastases, changes the microenvironment of the bone marrow, as a result, the growth of cancer cells stops, the pain syndrome is arrested.
The drug reduces the high level of calcium in the systemic circulation caused by malignant neoplasms and reduces its elimination in the urine. Also zoledronic acid suppresses the growth of endothelial cells, the proliferation of atypical cells in myeloma and breast cancer.
The content of the article
- Pharmacokinetic properties
- Indications for prescribing medication
- Contraindications to infusions
- Special patients
- For violations of kidney function
- Prescribing and dosage regimen
- Pharmacological compatibility
- Possible undesired reactions
- Precautions
- A voice from the public
- Opinion of the doctor
- Conditions of storage and leavefrom the pharmacy
- How can I replace the concentrate?
Pharmacokinetic properties of
After the onset of slow intravenous fluids, the concentration of the active substance in the serum increases rapidly, reaching a maximum at the end of the infusion, then rapidly decreases by 10% after 4 hours and not less than 1% after 24 hours and then remains 0 for 28 days,1% of the peak concentration.
The drug is excreted mainly by the kidneys in unchanged form, in three steps, first quickly( half-life is 0.24 and 1.87), and then slowly( final T1 / 2, last 146 hours).
For the first day in urine, 39 ± 16% of the administered dosage is detected. The rest of the zoledronic acid binds to the bone tissue. Through the intestine, less than 3% is excreted.
The drug in the body does not cumulate, weakly binds to blood proteins.
How does Zometa work - a direct analog of Zolerix:
Indications for the prescription of the drug
The following are the medical conditions for the prescription of the medicine: 
- various types of osteoporosis ( senile, postmenopausal, caused by glucocorticosteroids) to reduce the risk of fractures and increase bone mineral density;
- osteodystrophy ;
- hypercalcemia , provoked by oncology;
- metastases in bone tissue .
Contraindications to infusions
Treatment with Zolericx is contraindicated:
- for allergies to bisphosphonates;
- in severe renal failure;
- to women in the state;
- during breastfeeding;
- for patients under the age of 18;
- for severe metabolic disorders.
With extreme caution, it is necessary to prescribe the drug if observed:
- pronounced dehydration of the body;
- kidney disease with creatinine clearance more than 35 ml / min;
- liver pathology;
- bronchial asthma on acetylsalicylic acid;
- associated malignant neoplasms and experienced chemotherapy;
- concurrent treatment with drugs that affect the functioning of the kidneys( eg, aminoglycosides and diuretics).
Special patients
No adjustment is needed for older patients. 
Do not prescribe the drug to women in the situation, since there is currently insufficient experience in their treatment with this drug, and whether the active substance is known to have teratogenic and fetotoxic properties.
It is not advisable to infuse infants with breastfeeding women, because it is not known whether the drug penetrates into the mother's milk.
Do not administer infusion to patients under the age of 18, since it is not known how zoledronic acid will affect the growing body.
In case of impaired renal function
It is prohibited to administer the drug to patients with severe kidney problems when the creatine concentration in the serum is at least 400 μmol / ml, of course, if the expected benefit does not prevail over the possible risk.
In addition, there are data on abnormalities in kidney function against zoledronic acid therapy, especially with long-term courses at high dosages( 8 mg) and in patients with renal insufficiency.
Assignment and dosage regimen
Zolerix is administered intravenously drip for a minimum of a quarter of an hour in a dosage of 4 to 8 mg. 
Prepare a solution for infusions in accordance with the rules of asepsis. First, 4 mg of the concentrate is dissolved in 5 ml of water for injection, which is then added to either 100 ml of a 5% glucose solution or 0.9% sodium chloride. Store ready solution is prohibited .
The frequency of infusion assignment is selected individually depending on the severity of the disease and the outcome of the treatment.
The interval between repeated injections should be at least a week. As a rule, with joint diseases, the drug is prescribed once every 12 months.
Pharmacological compatibility
With the combination of zoledronic acid and medications that may have a nephrotoxic effect, the likelihood of a negative effect on the kidneys increases.
With concomitant administration of Zolerix and aminoglycosides, due to the additive effect, the serum calcium concentration may remain lowered for a longer time.
Do not dilute the concentrate with preparations containing calcium, for example, Ringer's solution.
Possible unwanted reactions
The drug can cause many negative reactions from various body systems:
- hematopoiesis : lowering of platelets, hemoglobin, leukocytes, sometimes it is possible to simultaneously reduce all the blood elements.
- eye : inflammation of the conjunctiva, decreased visual acuity;
- Respiratory System : cough and shortness of breath;
- GI tract : anorexia, nausea followed by vomiting, abdominal pain, diarrhea or vice versa constipation, xerostomia, stomatitis;
- of the heart : a decrease in heart rate;
- of the urinary system : acute renal failure, protein and erythrocytes in the urine;
- of the nervous system : tremor, decreased sensitivity, hyperesthesia, changes in taste, headaches, fatigue, sleep problems, confusion, anxiety, paresthesia.
- skin : itching, rash, hyperhidrosis;
- of the musculoskeletal system : pain in the muscles, bones, spasms of the calf muscles;
- Allergy : Quincke's edema, urticaria.
- local reactions : pain, irritation, edema and the appearance of an infiltrate at the site of injection;
- from the whole organism : fever, aches all over the body, asthenic condition, swelling of the limbs, chest pains, weight gain;
- disruption of mineral metabolism : deficiency of phosphorus, magnesium, calcium, potassium, sometimes on the contrary, hyperkalemia, excess sodium;
- In addition, may show an increase in the concentration of creatinine and urea in the systemic circulation.
Precautions
Before the next infusion, you need to determine the level of serum creatinine, to assess the state of kidney function. In case of worsening of their function, it is necessary to decide about the advisability of further treatment with Zolorix.
Before the infusion of the drug, it is necessary to exclude the presence of dehydration in the patient. For this purpose, it is necessary to administer the physiological solution before, at the same time, or after the infusion of the drug. But it is necessary to avoid hyperhydration of the patient due to the increased increased stress on the cardiovascular system.
During treatment, you need to constantly give blood to determine the level of calcium, magnesium, phosphorus, creatinine.
Because of the impact on the psyche, you need to be especially careful when driving a vehicle.
Reviews of patients and doctors about the preparation Zolorix can be found below.
A voice from the public
I am 74 years old, I have been suffering from osteoporosis for more than 10 years. Once a year I make infusions of Zolerix. The first few days there are signs resembling the flu, at this time I take Panadol or Mig to lower the body temperature and eliminate the aches in the joints.
Regularly check the bone tissue values while they keep within the normal range.
Maria, Kazan
Doctor's opinion
Zolerix has proven itself in the treatment of various forms of osteoporosis, with all precautions well tolerated by patients, rarely treatment with undesirable effects.
If only in patients at risk( cancer patients or persons suffering from kidney pathology) and with increasing tolerable doses. But some injections are few. It is necessary to normalize the body weight, adhere to a special diet rich in calcium and vitamin D, regularly give time to physical exertion, for example, you can do yoga or by the method of Bubnovsky.
Exercises developed by Sergei Mikhailovich, exclude the burden on the spine and joints and they can be done at any age.
Inna Sergeevna, rheumatologist
Storage conditions and leave from the pharmacy
Store the concentrate in its original packaging, at an air temperature of no more than 25 degrees, in a place inaccessible to children.
The drug is released strictly on the prescription form.
How can I replace the concentrate?
Today on sale quite a lot of preparations based on zoledronic acid among them: 
- Zotema;
- Zometa;
- Veroclast;
- Blazter.
In addition, the pharmaceutical industry produces analogues of Zolericx concentrate according to the therapeutic effect:
- Don;
- Teraflex;
- Structur.
