Zoledronic Acid (Reclast / Zometa)
Potent IV nitrogen-containing bisphosphonate. 5 mg IV once yearly for osteoporosis (Reclast) or 4 mg IV monthly for bone-metastasis / hypercalcemia of malignancy (Zometa). IV bioavailability 100%. Plasma clearance multiphasic; terminal bone-release half-life ~146 days but effective dosing cadence is yearly due to sustained bone-remodeling suppression. Modeled annual half-life captures the once-yearly dosing pharmacodynamics. Risk of acute-phase reaction, hypocalcemia, atypical femur fractures, ONJ.
Projected serum levels — 5 mg, custom (shown daily)
Maintenance schedule: 5 mg custom (shown daily) (oral).
Modeled steady state after ~1 days: peak ≈ 1.4 mg, trough ≈ 0.000 mg body load. Population-based estimate over 15 days for a 5 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.
Key facts
- Category
- Bisphosphonate
- Route modeled
- Oral
- Model confidence
- inferred
- Half-life
- 1.7 h
- Common dose
- 5 mg
- Suggested maximum
- 5 mg/day
- Reference dose range
- 2.5–5 mg (single dose)
- Suggested cadence
- custom (shown daily)
Research behind this entry
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Pharmacokinetics and pharmacodynamics of zoledronic acid in cancer patients with bone metastases
PK study characterizing zoledronic acid's multi-compartment disposition, rapid bone uptake, and prolonged skeletal retention.
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Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis (HORIZON-PFT)
HORIZON-PFT pivotal trial establishing once-yearly 5 mg IV zoledronic acid reduces vertebral, hip, and non-vertebral fractures in postmenopausal osteoporosis.
2 published studies referenced in the app, each with a plain-language summary.