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Zometa, Aredia and Bonefos: The “bisphosphonates”


	When breast cancer cells settle in the bone they can stimulate the activity of natural cells that remodel bone called osteoclasts. These cells can over-absorb bone, making it weak and prone to fracture. Their activity can also cause bone pain, and sometimes lead to dangerous elevation of blood calcium. The activity of osteoclasts can be dampened down by the use of one of the drugs called bisphosphonates. They significantly reduce the risk of fractures and the requirement for pain killers. They do not kill cancer cells. Zolendronate ("Zometa") and pamidronate ("Aredia") are given by intravenous infusion in the chemotherapy suite once a month, or once every 6 weeks. Zometa has the advantage of only taking 15 mins to infuse, as against 90 minutes for Aredia. Bonephos is an oral preparation taken as two large 800 mg tablets on an empty stomach. It is probably not quite as effective as the intravenous bisphosphonates. Bonefos is also used in different doseage for treating osteoporosis. All three drugs are on the PBS in Australia. Side-effects of Zometa and Aredia Fever: Usually within the first 24 hours. Paracetamol should be used, 500 mg, 2 4th hourly until the symptoms subside. Aches and pains (myalgia): Usually within the first 24 hours. Paracetamol should be used, 500 mg, 2 4th hourly until the symptoms subside. Allergic reactions (uncommon) Worsening of kidney function: We monitor for this carefully, checking your calcium and kidney function before each dose Nausea: rare Osteonecrosis of the jaw: rare. There is a serious risk that major dental work performed whilst you are on a course of Zometa may result in a rare condition called osteonecrosis of the jaw. This is a serious destructive disorder of the jaw bone and it is difficult to treat. It is not nearly so common in patients receiving Aredia, and it is more common if Zometa has been used for longer periods of time (e.g. >12 months). It may occur rarely in some patients even without the aggravating factor of dental procedures. The symptoms vary but can include dull heaviness in the jaw or loosening of the teeth. The condition MAY be worsened by concurrent radiotherapy to the jaw, and POSSIBLY by corticosteroids (prednisone) or chemotherapy drugs. Patients receiving Zometa should seek medical advice before having any major dental work performed, particularly extractions, crown and bridge and root canal therapy. Patients receiving bisphosphonates should seek immediate medical and dental advice for any dental pain or loose teeth. You should tell your dentist if you are on Zometa or Aredia, and it is a good policy while on these drugs to have a thorough dental check twice yearly. \| Tamoxifen \| Chemotherapy for Breast Cancer \| After Treatment - What Now? \| Causes of Breast Cancer \| Breast Cancer Myths \| Family History \| Herceptin \| Femara, Arimidex, Aromasin \| Adjuvant Chemotherapy \| Zoladex and Stopping the ovaries \| Stage, Grade, Receptors \| Zometa, Aredia and Bonefos \| Alopecia from Hormonal Therapy \| New treatments \| Lapatinib 'Tykerb' \| \| What's New \| FAQ Page \| Living with chemotherapy \| Dietary Advice \| Exercise \| The Flu Vaccine \| Insomnia \| Marijuana \| Alternative Medicine \| Managing Menopause \| Advice to Carers \| Breast Cancer \| Pain \| Useful Tips \| Chemotherapy: The What and How \| MRI Screening \| \| Your Cancer Information \| \| Return Home \| New Patients \| Services and Clinics \| Useful Links \| Contact Us \| Download Page \| Cancer Information \|