Your thoughts/experience with zoledronic acid?

[harleyharhar]

Good day, we had a consult with our urologist and he is prescribing zoldron for my dad because of metastasis, i have read some terrible side effects so i told our uro about that, to which he replied it probbly depends on the brand as some may have bad additives, also none of his patients reported any side effects and had worse experience with zoladex. Could you please reply your experience or what can be done to avoid any terrible effects please? Sorry for being paranoid but weve experienced terrible side effects with other medications before and it sure was stressful, also my father is already in pain so we really cant afford additional suffering

[Anish_11]

My father took Zolodronic acid since he was stage 4 and the cancer had spread to his bones. He started to have a bad cough and phlegm build up in his lungs as soonas he took the drug. His oncologist said it's probably a small side effect and the reaction should subside. Unfortunately it kept getting worse. Turns out, after 6 doses he had developed irreversible Interstetial Lung Disease or fibrosis of the lungs. He was immediately put on high steroids but the damage was done. 4yrs now, his cancer is in check but 50% of his lungs aren't working. He has persistent cough and it has degraded his quality of life. I would request you to discuss this with your doctor and have have a plan to take steroids just in case.

[harleyharhar in reply to Anish_11]

Hi, i dont know if youd notice this, but i am suspecting this could be happening to my dad, after re reading this post i checked how many doses my dad has got and it is also 6 doses, same with what happened to yours, would like to ask did you still continue zoledronic even with the lung disease?

All we are giving for his cough right now is acetylcysteine and it seems to work but there are times he coughs again

[Tall_Allen]

Side effects are cumulative over time. He should have had a DEXA scan to see what his bone mineral density is.

[harleyharhar in reply to Tall_Allen]

hi sir, sorry didnt see this earlier, is this the same as bone scan? not sure if this exists here in the Philippines

[Tall_Allen in reply to harleyharhar]

No, it is a simple kind of x-ray, available everywhere.

[Izas]

Good afternoon, My father took Zometa from June to December 2020 and in our case he did not have any side effects except at some very specific moment some stomach pain. After the treatment he said he felt better than ever and didn't notice any of the bone wasting pain he used to have. I wish you the best. Good luck.

[FearFracture in reply to Izas]

Did your father actually see an increase in his bone density after having the zoledronic acid infusion? And if yes, how long did it take for him to see the improvement in his bone density?

I have osteoporosis and had by 1st zoledronic acid infusion in mid-November 2021. I am due for another bone density scan but I wanted to wait to have it until a year after my first infusion so I can see if the meds are working. However, due to the fact that the imagining facility where I live can't give me an answer as to whether or not they can also do a TBS (trabecular bone scan) I have been thinking about having my next DEXA at a facility that is in a different city. Since this option requires an overnight trip, I was hoping to plan the DEXA during an already planned trip but that means having my DEXA just 10 months after the infusion and I am trying to figure out if I can expect to see results in just 10 months, or if I should go wait until November for to have the DEXA.

Thanks.

[tango65]

This is the information from the FDA about Zoledronic Acid:

accessdata.fda.gov/drugsatf...

I had several infusions in the past without complications, except for the first one. After 12 hours I had intense fatigue , low fever and some muscle and joint pain. I pre medicated myself with Tylenol and loratadine for the other infusions and I did not have any problem.

He should have a dental examination to rule any possible risk for a dental infection. Osteonecrosis of the jaw is more frequent in patients requiring dental extractions, implants or dental surgery during or after zoledronic acid treatment. Regular cleaning and cavities repair seem not to increase the risk of osteonecrosis of the jaw.

Renal function is other concern and creatinine should be checked periodically and perhaps it may be prudent to avoid NSAIDs which could have the potential to affect the kidneys.

[MateoBeach]

If the doc said he has no patients on Zoladex (Goserelin, an ADT drug) with side effects then he is either lying or has no patients. Zolendronic acid is completely different. Like denosumab it is a bone protective agent. Reduces skeletal adverse events such as spontaneous or pathological fractures due to bone metastasis in advanced PC. 90% of advanced PC patients may develop these along with severe pain by the end of their journey. In contrast, osteonecrosis of the jaw occurs in just around 2% of those on either Zometa or Xgeva. And these also appear to make bone micro environment less susceptible to forming bone metastasis. Make sure a dentist takes care of any existing dental problems, then you can give him the green light. I use the similar Xgeva in hopes of preventing future bone mets and their problems. I disagree with some her that they are only for osteoporosis shown on a DEXA scan for the above reasons.

[harleyharhar in reply to MateoBeach]

Much appreciated, as for the urologist he said it was the zoldron that he had no se, and zoladex had worse se, thanks

[Shooter1]

I have had no noticeable side effects at all from Zolendronic acid every 3 mo. since bone mets popped up as BCR. RT, Provenge and now Xofigo to try to hold them back.. Scans next mo. after 3rd Xofigo shot to see what effects it is having. Hoping for the best. Your dad should handle Zolendronic acid OK.

[harleyharhar in reply to Shooter1]

Hi and thanks but do you know the brand name of the zoledronic acid that you had? Just checking if the better the brand the lesser or no side effects

[Shooter1 in reply to harleyharhar]

Brand name?? Sorry, I don't know...

[NotDFL in reply to harleyharhar]

Zoledronic acid is a generic name. Reclast is a brand name for zoledronic acid.

[Atlpapa]

I'm taking Zolodronic acid infusion every 3 months since a DEXA scan showed I have osteoporosis. It's been almost a year and a half now. I've had no side effects at all. I went to dentist and had all dental work done before starting because there can be issues with some dental work (like extractions) once you are on it.

[FearFracture in reply to Atlpapa]

Have you had a DEXA scan since having started the zoledronic acid? And if yes, has your bone density score and t-scores improved? And if you've had a recent scan, would you consider sharing your t-scores?

I had a zoledronic acid infusion in November 2021 and I'm interested to know what results others have seen.

[Atlpapa in reply to FearFracture]

My MO said they wait until 2 years to do the DEXA scan again so he will schedule for January. My T were -3.1 in my lower spine and -2.5 in my hip. I'm hoping there will be some improvement in January.

[dentaltwin]

Yeah, you'd think the people responsible for naming drugs wouldn't name 2 widely used in PC as close as Zoladex and Zometa, but no such luck. As pointed out, they are entirely different drugs with different uses and modes of action. For that matter Zometa and denosumab (Prolia/Xgeva) have similar indications specifically wrt bone density and prevention of pathologic fracture, but different modes of action. Zometa (a bisphosphonate) sticks around much longer than Prolia (a RANKL inhibitor).

My dad was at one time on Zoladex, Casodex and Zometa at the same time. He had no serious side effects initially. I should say he had very significant periodontal disease at the time, but he was lucky and never developed any osteonecrosis or bone pain (at least not that he'd let on--he was a non-discloser). He was eventually taken off the Zometa, which was blamed for some impaired renal function. He survived probably about 10 years, and when he passed it was not from his PC, nor was it his treatment (at least not directly).

[j-o-h-n]

If you have a M.O. check with him/her, if you don't have a M.O. get a good one soon.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 05/03/2022 8:31 PM DST