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Drugs and Supplements

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

  • Agitation
  • Black, tarry stools
  • Blurred vision
  • Chest pain
  • Chills
  • Coma
  • Confusion
  • Convulsions
  • Cough
  • Depression
  • Difficult or labored breathing
  • Dizziness
  • Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • Fever
  • Irregular heartbeat
  • Irritability
  • Lack or loss of strength
  • Lethargy
  • Lower back or side pain
  • Mood or mental changes
  • Muscle pain or cramps
  • Muscle trembling or twitching
  • Nausea or vomiting
  • Numbness and tingling around the mouth, fingertips, or feet
  • Painful or difficult urination
  • Pale skin
  • Rapid weight gain
  • Seizures
  • Shaking of the hands, arms, feet, legs, or face
  • Shortness of breath
  • Skin rash, cracks in the skin at the corners of the mouth, or soreness or redness around the fingernails and toenails
  • Sore throat
  • Sores, ulcers, or white spots on the lips or mouth
  • Stupor
  • Sudden sweating
  • Swollen glands
  • Tightness in the chest
  • Trouble breathing with exercise
  • Unusual bleeding or bruising
  • Unusual tiredness or weakness
  • Wheezing

Less common

  • Feeling of constant movement of self or surroundings
  • Muscle cramps in the hands, arms, feet, legs, or face
  • Muscle spasms
  • Neck pain
  • Pounding in the ears
  • Rapid breathing
  • Sensation of spinning
  • Slow or fast heartbeat
  • Sunken eyes
  • Tingling of the hands or feet
  • Tremor

Incidence not known

  • Blurred vision or other change in vision
  • Decreased frequency or amount of urine
  • Decreased vision
  • Eye pain
  • Eye tenderness
  • Heavy jaw feeling
  • Increased blood pressure
  • Increased tearing
  • Increased thirst
  • Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • Loosening of a tooth
  • Pain, swelling, or numbness in the mouth or jaw
  • Redness of the eye
  • Sensitivity of the eye to light
  • Severe eye pain
  • Swelling of the face, hands, fingers, lower legs, or ankles
  • Troubled breathing
  • Weight gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Abdominal or stomach pain
  • Anxiety, nervousness, restlessness, or irritability
  • Back pain
  • Bad, unusual, or unpleasant (after) taste
  • Bladder pain
  • Blistering, crusting, irritation, itching, or reddening of the skin
  • Bloody or cloudy urine
  • Bone pain
  • Burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
  • Change in taste
  • Constipation
  • Cracked lips
  • Cracked, dry, or scaly skin
  • Diarrhea
  • Difficulty with swallowing
  • Discouragement
  • Dry mouth
  • Ear congestion
  • Fear or nervousness
  • Feeling sad or empty
  • Frequent urge to urinate
  • Hair loss or thinning hair
  • Headache
  • Hyperventilation
  • Joint pain or swollen joints
  • Loss of appetite
  • Loss of interest or pleasure
  • Loss of voice
  • Muscle stiffness or difficulty with moving
  • Nasal congestion or runny nose
  • Pain, swelling, or redness in the joints
  • Partial loss of feeling
  • Seeing, hearing, or feeling things that are not there
  • Sleepiness or unusual drowsiness
  • Sleeplessness, trouble sleeping, or unable to sleep
  • Swelling or inflammation of the mouth
  • Thirst
  • Trouble with concentrating
  • Unusually cold, shivering
  • Vomiting
  • Weight loss

Less common

  • Acid or sour stomach
  • Belching
  • Heartburn
  • Indigestion
  • Red streaks on the skin
  • Stomach discomfort or upset
  • Swelling, tenderness, or pain at the injection site
  • Unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  • Wrinkled skin

Rare

  • Burning, dry, or itching eyes
  • Discharge or excessive tearing
  • Redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • Throbbing pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Precautions

It is very important that your doctor check your progress at regular visits after you have received zoledronic acid injection. If your condition has improved, your progress must still be checked. The results of laboratory tests or the occurrence of certain symptoms will tell your doctor if your condition is coming back and if a second treatment is needed. You will need a yearly dose of this medicine if you are being treated for postmenopausal osteoporosis, so check with your doctor regularly.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

You should not use other medicines that also contain zoledronic acid, such as Reclast® or Zometa®. Using these medicines together may increase your chance for more serious side effects.

This medicine may rarely cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after receiving the medicine.

This medicine may cause low calcium in your blood. Check with your doctor immediately if you have numbness or tingling around the mouth, or if you have muscle spasms.

Tell your doctor right away if you have agitation; blood in the urine; confusion; decreased urine output; depression; dizziness; headache; irritability; lethargy; muscle twitching; nausea; rapid weight gain; seizures; stupor; swelling of the face, ankles, or hands; or unusual tiredness or weakness. These could be symptoms of serious kidney problems.

Your doctor will need to know if you have a history of problems with your mouth or teeth (e.g., gum disease). Make sure your doctor knows if you have been treated with a bisphosphonate medicine, such as alendronate (Fosamax®), etidronate (Didronel®), pamidronate (Aredia®), risedronate (Actonel®), or tiludronate (Skelid®) in the past.

You may need to have a dental exam before you start using this medicine.

It is important that you check with your doctor before having any dental procedures or surgeries done while you are receiving zoledronic acid. Tell your doctor right away if you have jaw tightness, swelling, numbing, or pain or a loose tooth. This could be symptoms of a severe problem of your jaw.

Make sure you tell your doctor about any new medical problems, especially with your teeth or jaws. Tell your doctor if you have severe muscle, bone, or joint pain after receiving this medicine.

This medicine may increase your risk of developing fractures of the thigh bone. This may be more common if you use it for a long time. Check with your doctor right away if you have a dull or aching pain in the thighs, groin, or hips.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription (e.g., other medicines that also contain zoledronic acid) or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Proper Use

A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins. The medicine must be injected slowly, so your IV tube will need to stay in place for at least 15 minutes.

For hypercalcemia, this medicine is usually given only once. If your doctor decides that you need additional doses, you will receive the medicine again after at least 7 days have passed. This treatment will continue until your body responds to the medicine.

For bone cancer and multiple myeloma, this medicine is usually given every 3 to 4 weeks. This treatment will continue until your body responds to the medicine.

For osteoporosis, this medicine is usually given once a year and will continue until your body responds to the medicine.

You may also receive other medicines to help keep your body from losing too much fluid.

Your doctor may also give you vitamins containing Vitamin D and calcium. Tell your doctor if you are unable to take these supplements.

Drink extra fluids so you will pass more urine while you are using this medicine. This will keep your kidneys working well and help prevent kidney problems. However, it is very important to not drink too much liquid. Talk to your doctor about the right amount of liquids for you.

This medicine comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Zoledronic acid injection is not indicated for use in children.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of zoledronic acid injection in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution in patients receiving zoledronic acid injection.

Pregnancy

Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Anemia or
  • Bleeding problems or
  • Cancer, history of or
  • Dental or tooth problems or
  • Dental procedures or
  • Poor oral hygiene, or
  • Surgery (e.g., dental surgery)—May increase risk for severe jaw problems.
  • Asthma, aspirin-sensitive or
  • Heart disease or
  • Kidney disease or
  • Mineral imbalance (e.g., high or low calcium, magnesium, phosphorus, or potassium in the blood)—Use with caution. May make these conditions worse.
  • Bowel resection or
  • Parathyroid disease (e.g., hypoparathyroidism) or
  • Parathyroid surgery or
  • Stomach absorption problems or
  • Thyroid surgery—These conditions may increase your risk of having hypocalcemia (low levels of calcium in the blood).
  • Dehydration (not enough water or fluid in your body)—May increase risk of severe kidney problems.
  • Hypocalcemia (low calcium in the blood) or
  • Kidney disease, severe (e.g., kidney failure)—Should not be used in patients with these conditions.

Description

Zoledronic acid injection is used to treat hypercalcemia (high levels of calcium in the blood) that may occur in patients with some types of cancer. It is also used to treat a cancer called multiple myeloma (tumors formed by the cells of the bone marrow) or certain types of bone metastases (the spread of cancer to the bone).

Zoledronic acid injection is used to treat Paget’s disease of the bone in men and women. It is also used in men with osteoporosis and in women with osteoporosis who have gone through menopause. This medicine is used to reduce the risk of having more fractures in patients who have had a recent hip fracture.

This medicine is to be administered only by or under the supervision of your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, zoledronic acid is used in certain patients with the following medical conditions:

  • Bone loss, in men, from taking certain medicines for prostate cancer.
  • Bone loss, in breast cancer patients, from hormone therapy (prevention).
June 23, 2015

Zoledronic Acid

Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor or nurse immediately if any of the following side effects occur: More common Agitation Black, tarry stools Blurred vision Chest pain Chills Coma Confusion Convulsions Cough Depression Difficult or labored breathing Dizziness Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position Fever Irregular heartbeat Irritability Lack or loss of strength Lethargy Lower back or side pain Mood or mental changes Muscle pain or cramps Muscle trembling or twitching Nausea or vomiting Numbness and tingling around the mouth, fingertips, or feet Painful or difficult urination Pale skin Rapid weight gain Seizures Shaking of the hands, arms, feet, legs, or face Shortness of breath Skin rash, cracks in the skin at the corners of the mouth, or soreness or redness around the fingernails and toenails Sore throat Sores, ulcers, or white spots on the lips or mouth Stupor Sudden sweating Swollen glands Tightness in the chest Trouble breathing with exercise Unusual bleeding or bruising Unusual tiredness or weakness Wheezing Less common Feeling of constant movement of self or surroundings Muscle cramps in the hands, arms, feet, legs, or face Muscle spasms Neck pain Pounding in the ears Rapid breathing Sensation of spinning Slow or fast heartbeat Sunken eyes Tingling of the hands or feet Tremor Incidence not known Blurred vision or other change in vision Decreased frequency or amount of urine Decreased vision Eye pain Eye tenderness Heavy jaw feeling Increased blood pressure Increased tearing Increased thirst Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs Loosening of a tooth Pain, swelling, or numbness […]
June 23, 2015

Zolmitriptan

Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Stop taking this medicine and get emergency help immediately if any of the following effects occur: More common Chest pain (severe) Heaviness, tightness, or pressure in chest and/or neck Sensation of burning, warmth, heat, numbness, tightness, or tingling Less common or rare Abdominal pain (severe) Changes in facial skin color Cough or hoarseness Diarrhea Fast or irregular heartbeat Fever or chills Loss of appetite Lower back or side pain Nausea Painful or difficult urination Puffiness or swelling of the eyelids or around the eyes, face, or lips Shortness of breath, troubled breathing, tightness in chest, and/or wheezing Skin rash, hives, and/or itching Weakness Other side effects may occur that usually do not need medical attention. Some of the following effects, such as nausea, vomiting, drowsiness, dizziness, and general feeling of illness or tiredness, often occur during or after a migraine, even when zolmitriptan has not been used. However, check with your doctor if any of the following side effects continue or are bothersome: More common Dizziness Nausea Sleepiness Unusual tiredness or muscle weakness Less common Agitation Anxiety Depression Discomfort in jaw, mouth, or throat Difficulty in swallowing Dry mouth Fainting Heartburn Itching of the skin Large nonelevated blue or purplish patches in the skin Muscle aches Pounding heartbeat Sudden large increase in frequency and quantity of urine Sweating Swelling of face, fingers, feet and/or lower legs Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Precautions […]
June 23, 2015

Zolpidem

Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: Less common Clumsiness or unsteadiness Confusion Mental depression Rare Dizziness, lightheadedness, or fainting Falling Fast heartbeat Hallucinations (seeing, hearing, or feeling things that are not there) Skin rash Swelling of the face Trouble with sleeping Unusual excitement, nervousness, or irritability Wheezing or difficulty with breathing Get emergency help immediately if any of the following symptoms of overdose occur: Symptoms of overdose Clumsiness or unsteadiness (severe) Dizziness (severe) Double vision or other vision problems Drowsiness (severe) Nausea (severe) Slow heartbeat Troubled breathing Vomiting (severe) Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Sleepiness or unusual drowsiness Less common Abdominal or stomach pain Abnormal or decreased touch sensation Abnormal sensation of movement Appetite disorder Balance disorder Binge eating Bladder pain Bloated Bloody or cloudy urine Burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings Change in hearing Chest discomfort Chills Confusion about identity, place, and time Constipation Continuing ringing or buzzing or other unexplained noise in the ears Daytime drowsiness Diarrhea Difficult, burning, or painful urination Difficulty with moving Difficulty with swallowing Discouragement Double vision or other vision problems Drugged feelings Dryness of mouth Ear drainage Earache […]
June 23, 2015

Zonisamide

Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: More common Discouragement Feeling sad or empty Irritability Lack of appetite Loss of interest or pleasure Mood or mental changes Shakiness or unsteady walking Tiredness Trouble with concentrating Trouble with sleeping Less common Agitation Bruising Delusions Hallucinations Large, flat blue or purplish patches on the skin Rash Get emergency help immediately if any of the following symptoms of overdose occur: Symptoms of overdose Difficult or labored breathing Faintness Loss of consciousness Slow or irregular heartbeat Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Abdominal or stomach pain Anxiety Difficulty with memory Dizziness Double vision Headache Loss of appetite Nausea Restlessness Sleepiness Sleeplessness Unusual drowsiness Unusual tiredness or weakness Less common Aching muscles or joints Acid or sour stomach Bad, unusual, or unpleasant taste in the mouth Belching Change in taste Chills Constipation Diarrhea Difficulty with speaking Difficulty with thinking Dry mouth Fever General ill feeling Headache Heartburn Indigestion Mental slowness Nervousness Runny or stuffy nose Sneezing Tingling, burning, or prickly feelings on the skin Uncontrolled, back and forth, or rolling eye movements Weight loss Other side effects not listed may also occur in some patients. If you […]
June 23, 2015

Zopiclone

Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor as soon as possible if any of the following side effects occur: More common Confusion—more common in older adults Clumsiness or unsteadiness—more common in older adults Daytime anxiety and/or restlessness Difficulty with coordination—more common in older adults Mood or mental changes Less common Drowsiness (severe) Shortness of breath Difficult or labored breathing Tightness in chest Wheezing Skin rash Aggressiveness Behavior changes Rare Memory problems—more common in older patients Behavior or mental changes Symptoms of overdose Get emergency help immediately if any of the following symptoms of overdose occur: Clumsiness Unsteadiness Mental or mood changes Drowsiness (severe) Unusual tiredness or weakness Sluggishness Reduced physical activity Unusual sleepiness Loss of consciousness Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Dizziness Dryness of mouth Heartburn Impaired vision Increased appetite Indigestion Loss of appetite—more common in older adults Stomach upset Difficulty speaking Constipation Decreased muscle tone Weight loss Less common Agitation—more common in older adults Chills Fast, irregular, or pounding heartbeat—more common in older adults Feeling of heaviness of arms and legs Increase in the amount of saliva—more common in older adults Increased sweating—more common in older adults Tingling, burning or prickly sensation Trembling and shaking of fingers, hands, arms, […]
June 23, 2015

Ziprasidone

Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: More common Cough Difficulty with speaking Drooling Fear or nervousness Fever Inability to sit still Loss of balance control Muscle trembling, jerking, or stiffness Need to keep moving Restlessness Shuffling walk Sneezing Sore throat Stiffness of the limbs Twisting movements of the body Uncontrolled movements, especially of the face, neck, and back Less common Blurred vision Body aches or pain Chest pain Congestion Dizziness Fast, pounding, or irregular heartbeat or pulse Headache Hoarseness Nervousness Pounding in the ears Runny nose Slow or fast heartbeat Swelling of the tongue Tender, swollen glands in the neck Trouble with swallowing Voice changes Rare Fainting or feeling faint Feeling faint upon standing Persistent, painful erection Seizures Incidence not known Inability to move the eyes Increased blinking or spasms of the eyelid Sticking out of tongue Trouble with breathing, speaking, or swallowing Uncontrolled twisting movements of the neck, trunk, arms, or legs Unusual facial expressions Get emergency help immediately if any of the following symptoms of overdose occur: Symptoms of overdose Drowsiness Shakiness in the legs, arms, hands, or feet Sleepiness Slurred speech Trembling or shaking of the hands or feet Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you […]