Zometa (zoledronic acid) is prescribed for certain cancer conditions and cancer’s high calcium levels. It comes as a liquid that a healthcare professional gives by infusion. What it’s treating determines how often you receive it.

Zometa is used in adults to treat:

* In this case, the cancer that started elsewhere in the body has spread to bone (it has metastasized).

The active ingredient in Zometa is zoledronic acid. (An active ingredient is what makes a drug work.) Zometa belongs to a group of drugs called bisphosphonates.

This article describes the dosages of Zometa, as well as its strengths and how it’s given. To learn more about Zometa, see this in-depth article.

This section describes the usual dosages of Zometa. Keep reading to learn more.

What are Zometa’s forms?

Zometa is available as a liquid solution in two dosage forms:

  • single dose in a bottle ready to use
  • single dose in a vial to be mixed before use

A healthcare professional gives you the drug by intravenous (IV) infusion (an injection into your vein given over time).

What strengths does Zometa come in?

Zometa comes in one strength in two dosage forms:

  • A single dose in a bottle ready to use: This form contains 4 milligrams (mg) per 100 milliliters (mL) of the drug.
  • A single dose in a vial to be mixed before use: This form contains 4 mg/5 mL of the drug. It becomes 4 mg/100 mL for administration once mixed with a saline solution.

What are the usual dosages of Zometa?

The Zometa dosage your doctor prescribes depends on the condition the drug is treating.

The information below describes dosages that are commonly used or recommended. Your doctor will determine the best dosage to fit your needs.

Dosage for multiple myeloma and bone metastases of solid tumors

Zometa is approved for adults to treat multiple myeloma. It’s also approved for adults to treat bone metastases (irregular bone growths) of solid tumors. In either case, the typical dosage is 4 mg every 3–4 weeks. A healthcare professional gives each dose by IV infusion for 15 minutes or longer.

For both conditions, your doctor may ask you to supplement your calcium and vitamin D intake during Zometa treatment. They’ll likely recommend 500 mg of calcium and 400 international units (IU) of vitamin D by mouth per day. This helps ensure that your calcium levels don’t become too low during treatment.

Your doctor will determine how long you’ll receive Zometa based on your condition and other individual factors. They’ll discuss this timeline based on your body’s response to Zometa treatment.

Dosage for hypercalcemia due to cancer

Zometa is approved for adults to treat hypercalcemia due to cancer. The typical dose is 4 mg to start treatment. After 7 days or more, you may receive a second dose of 4 mg. The second dose will occur if your blood calcium levels are still high or don’t stay at typical levels after the first dose. A healthcare professional gives each dose by IV infusion for 15 minutes or longer.

If you have questions about your dosage and how often you’ll receive treatment with Zometa, talk with your doctor.

Is Zometa used long term?

The condition Zometa is treating determines how often you receive it and how long.

You’ll receive only two doses of Zometa for hypercalcemia due to cancer. But for multiple myeloma and bone metastases of solid tumors, you may use Zometa long term. Your doctor will monitor your calcium levels and discuss how long you’ll need treatment with Zometa.

If you have questions about treatment with Zometa, talk with your doctor.

Dosage adjustments

You may need dosage adjustments for Zometa in certain cases.

If you have kidney problems, your doctor may need to adjust your dosage of Zometa.

Your dosage for Zometa is based on your creatinine clearance. Creatinine is a chemical removed by the kidneys that indicates kidney health. Before you receive a dose of Zometa, your doctor will check your creatinine clearance.

The dosage of Zometa your doctor prescribes may depend on several factors. These include:

  • the type and severity of the condition you’re using the drug to treat
  • other medications you may be taking
  • other conditions you may have (see the “Dosage adjustments” section above)

A healthcare professional will give you Zometa doses by IV infusion. This is an injection into your vein given over time. You’ll receive each infusion for 15 minutes or longer at a clinic or hospital.

Your doctor will monitor your blood calcium levels before each Zometa dose. They also check your kidney function.

For multiple myeloma and bone metastases of solid tumors

For multiple myeloma, you’ll receive an infusion every 3–4 weeks. Similarly, for bone metastases (irregular bone growths) of solid tumors, you’ll receive an infusion every 3–4 weeks.

Your doctor may ask you to supplement your calcium and vitamin D intake during your Zometa treatment. They’ll likely recommend 500 milligrams (mg) of calcium and 400 international units (IU) of vitamin D by mouth per day. This helps ensure that your calcium levels don’t become too low during treatment.

For hypercalcemia due to cancer

For hypercalcemia due to cancer, you’ll receive your first dose to start treatment. After 7 days or more, you may receive a second dose. The second dose will occur if your calcium levels are still high or don’t stay at typical levels after the first dose.

A healthcare professional will give you Zometa doses at a clinic or hospital. If you miss an appointment to receive a dose of Zometa, call your doctor’s office as soon as possible to reschedule.

If you need help remembering your appointments, try setting an alarm or downloading a reminder app on your phone.

Below are answers to some commonly asked questions about Zometa’s dosage.

Is Zometa’s dosage similar to the dosages of Xgeva or Prolia?

No, the dosages aren’t similar. Zometa (zoledronic acid) and Xgeva (denosumab) are approved to treat hypercalcemia. And they’re both approved to treat multiple myeloma and bone metastases from solid tumors. But the strengths and dosages of the two drugs differ.

Xgeva comes as a liquid solution in a strength of 120 milligrams per 1.7 milliliters (120 mg/1.7 mL). A healthcare professional gives the doses by injection under the skin. The condition Xgeva is treating determines how often you receive doses.

Prolia (denosumab) is approved to treat osteoporosis (weak bones) in people with a high risk of fracture. It’s also used to help treat bone loss. It comes as a liquid solution in a strength of 60 mg. A healthcare professional gives the doses by injection under the skin every 6 months.

Your doctor will prescribe the drug and the dosage that’s right for you. You can talk with your doctor to learn more about how these drugs compare.

How long does it take for Zometa to start working?

For multiple myeloma and bone metastases from solid tumors, Zometa starts working within a few days of the first dose.

For hypercalcemia due to cancer, Zometa helps lower your blood calcium level within a few days of starting treatment. Your doctor will check your calcium levels to determine whether you need a second dose.

You won’t feel Zometa working in your body. But your doctor will monitor your calcium levels and your kidney function before each Zometa dose.

If you have other questions about what to expect from your Zometa treatment, talk with your doctor.

The sections above describe the usual dosages provided by the drugmaker. If your doctor recommends Zometa for you, they’ll prescribe the dosage that’s right for you.

Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • I use Zometa for multiple myeloma. Will I need a dosage adjustment if I’m taking other medications?
  • Would a lower dosage of Zometa reduce my risk of kidney problems?
  • How long will I need Zometa doses for multiple myeloma or bone metastases of solid tumors?

To learn more about Zometa, see these articles:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.