Drug General Information (ID: DDITDQAGB4)
Drug Name			Zoledronic acid		Drug Info		Thalidomide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Bone Density Conservation Agents				Immunosuppressive Agents
Structure

Mechanism of Zoledronic acid-Thalidomide Interaction (Severity Level: Moderate)
Increased risk of nephrotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Zoledronic acid				Thalidomide
Mechanism		Nephrotoxicity				Nephrotoxicity
Key Mechanism Factor 1
		Factor Name		Nephrotoxicity
		Factor Description		The combination of drugs that can induce nephrotoxicity may increase the risk of kidney injury. When kidney injury occurs, the inability to remove excess urine and waste from the body can lead to high levels of urea nitrogen, creatinine, and electrolytes (such as potassium and magnesium) in the blood.
Mechanism Description		Increased risk of nephrotoxicity by the combination of Zoledronic acid and Thalidomide

Recommended Action
Management		Caution is advised if pamidronate, zoledronic acid, or other intravenous formulations of bisphosphonates must be used in multiple myeloma patients who are receiving treatment with thalidomide. Renal function and serum electrolytes should be monitored. Product labelings for pamidronate and zoledronic acid recommend that single doses not exceed 90 mg and 4 mg, respectively, and the duration of infusion not less than 2 hours and 15 minutes, respectively. Patients should have serum creatinine assessed prior to each treatment, and treatment should be withheld for renal deterioration. In those treated for bone metastases, treatment should not be resumed until renal function returns to baseline.

References
1	Product Information. Zometa (zoledronic acid). Novartis Pharmaceuticals, East Hanover, NJ.