GlobalRPh Renal Dosing Masterv6.6
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Zoledronic acid - Zometa indications

Local RX List renal extractBase record retrieved 2026-09-05See the evidence for this drug2 sources available - open source summaries, references and comparisons
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Rxlist source

GlobalRPh RX List - ZOMETA

Product / population
Adult ZOMETA oncology indications; not RECLAST osteoporosis/Paget dosing.
Renal measure
Cockcroft-Gault CrCl for oncology reduction; a separate serum-creatinine criterion for hypercalcemia.

RX mirror: this is not independent corroboration of its underlying label. Check dated-label and formulation limitations.

Renal dosing, restrictions and evidence limits

For myeloma or bone metastases, total doses every three to four weeks are 4 mg at CrCl above 60, 3.5 mg at 50-60, 3.3 mg at 40-49, and 3 mg at 30-39 mL/min, infused over at least 15 minutes. These reductions do not create a regimen below 30. Check creatinine before each dose. In the source trials, hold for a rise of 0.5 mg/dL with normal baseline creatinine or 1 mg/dL with abnormal baseline; resume when within 10% of baseline. Hypercalcemia of malignancy is a different pathway: the source uses 4 mg and no initial reduction for its mild/moderate group with serum creatinine below 4.5 mg/dL. Do not transfer that serum-creatinine criterion to bone-metastasis treatment or RECLAST.

Source revision: Source revision date not established in selected retrieval. | Retrieved: 2026-09-07. Retrieval date is not the revision date.

Source: https://globalrph.com/rx-list/zometa-drug/

Scope: Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph. GlobalRPh v6.6.

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Renal method: Read the measure and population stated in the original source sections.
Retrieved: 2026-09-05

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GlobalRPh RX List

GlobalRPh RX List - ZOMETA

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

Adult ZOMETA oncology indications; not RECLAST osteoporosis/Paget dosing.

Renal method: Cockcroft-Gault CrCl for oncology reduction; a separate serum-creatinine criterion for hypercalcemia.
Retrieved: 2026-09-07

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Renal dosing and precautions

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Original content / product scopeGlobalRPh RX List - ZOMETA
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Historical source content is not a current prescription. Original GlobalRPh recommendations are preserved, not automatically certified as current. Product-label and professional additions below are separately attributed. Confirm indication, population, kidney-function method, monitoring and the full prescribing information before applying a regimen.

Important source distinctions

This source covers Zometa malignancy indications and dose sizes, not the 5 mg osteoporosis/Paget formulation. Hypercalcemia and bone-metastasis renal instructions remain separate.

Locally stored source content

Original GlobalRPh protocol

Clinical facts and comments transcribed into a structured reading format. This is not a byte-for-byte HTML archive. Original source: https://globalrph.com/renal/zoledronic-acid/

Hypercalcemia of malignancy

Corrected calcium at least 12 mg/dL (3 mmol/L): maximum 4 mg once IV over at least 15 minutes. Check creatinine before each dose; consider retreatment only after at least 7 days to allow the full initial response, and reassess renal function first.

No initial adjustment for mild/moderate impairment in this indication when serum creatinine is below 4.5 mg/dL (400 micromol/L) in the source. Rehydrate before treatment. Consider severity/symptoms; mild/asymptomatic cases may be managed conservatively with saline, with or without loop diuretic after hypovolemia is corrected.

Begin saline promptly and aim for urine output around 2 L/day in the historical discussion, but avoid overhydration, particularly with cardiac failure. Inspect parenteral solution for particles/discoloration.

GRPH-zoledronic-acid-01 · Source section: Hypercalcemia of malignancyRenal section finder

Multiple myeloma and metastatic bone lesions

CrCl above 60 mL/min: 4 mg IV over at least 15 minutes every 3-4 weeks; optimal duration was unknown in the source.

Initial Cockcroft-Gault renal doses: CrCl 50-60, 3.5 mg; 40-49, 3.3 mg; 30-39, 3 mg. These were calculated for target AUC 0.66 mg-hour/L corresponding to CrCl 75 mL/min. Below 30: insufficient data.

GRPH-zoledronic-acid-02 · Source section: Multiple myeloma and metastatic bone lesionsRenal section finder

Renal deterioration during treatment

The source defines deterioration as a creatinine increase of 0.5 mg/dL with a normal baseline or 1 mg/dL with an abnormal baseline. Evaluate benefit-risk and withhold further dosing until renal function is within 10% of baseline; then resume at the previous dose.

GRPH-zoledronic-acid-03 · Source section: Renal deterioration during treatmentRenal section finder

Hemodialysis

Insufficient data.

GRPH-zoledronic-acid-04 · Source section: HemodialysisRenal section finder
Locally imported selected renal sections

GlobalRPh RX List renal information

Rxlist

GlobalRPh RX List - ZOMETA

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GlobalRPh-hosted RX List · Adult ZOMETA oncology indications; not RECLAST osteoporosis/Paget dosing.

Renal method: Cockcroft-Gault CrCl for oncology reduction; a separate serum-creatinine criterion for hypercalcemia.
Source date: Source revision date not established in selected retrieval.
Retrieved: 2026-09-07

Label mirror, not independent corroboration. This is selected locally stored RX List content. Full monograph import and current official-label review are not implied.
Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.

Renal dosing, restrictions and evidence limits

For myeloma or bone metastases, total doses every three to four weeks are 4 mg at CrCl above 60, 3.5 mg at 50-60, 3.3 mg at 40-49, and 3 mg at 30-39 mL/min, infused over at least 15 minutes. These reductions do not create a regimen below 30. Check creatinine before each dose. In the source trials, hold for a rise of 0.5 mg/dL with normal baseline creatinine or 1 mg/dL with abnormal baseline; resume when within 10% of baseline. Hypercalcemia of malignancy is a different pathway: the source uses 4 mg and no initial reduction for its mild/moderate group with serum creatinine below 4.5 mg/dL. Do not transfer that serum-creatinine criterion to bone-metastasis treatment or RECLAST.

RDM37-rxlist-zoledronic-acid-9a80e95999-C1 · Source locator: Hypercalcemia dosage; Table 1 reduced doses; renal deterioration withholding rules.

Source identity and provenance
Source family
product_label_mirror
Source
https://globalrph.com/rx-list/zometa-drug/
Retrieved
2026-09-07
Renal-function method
Cockcroft-Gault CrCl for oncology reduction; a separate serum-creatinine criterion for hypercalcemia.
Source date/version
Source revision date not established in selected retrieval.
Hash meaning
SHA-256 of local authored summary only; not original HTML, PDF or SPL bytes.
Local summary SHA-256
9c8b99138029ad4a4c2826cc6f727a25999ed6ce89bc5b22149dc29a834302b6

Provenance and preservation

Additional summaries stored on this page: 0 official-label, 1 RX List, 0 professional, 0 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source
https://globalrph.com/renal/zoledronic-acid/
Source retrieval
2026-09-05. This is not the source publication or label revision date.
Original source type
globalrph individual
Local text SHA-256
a305c8c8a3b921cd8d18d7d089a6ad005a12f3409e0e3596da243db69fdb4821
Import versus clinical validation
Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

The original individual GlobalRPh pages commonly cite NIH/NLM DailyMed and instruct readers to review the applicable package insert for updates. That historical reference is preserved as context; it is not counted as an independently retrieved current label.

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