Zometa Drug Interactions

Anticipated Interactions to be Considered: Caution is advised when bisphosphonates like Zometa are administered with aminoglycosides and loop diuretics, since both agents may have an additive effect, resulting in a lower serum calcium level for longer periods than required.
Caution is indicated when Zometa is used with other potentially nephrotoxic drugs.
Caution is advised when Zometa is administered with antiangiogenic drugs as cases of ONJ have been observed in patients treated concomitantly with these drugs.
Absence of Interactions: In clinical studies, Zometa has been administered concomitantly with commonly used anticancer agents, diuretics (except for loop diuretics), antibiotics and analgesics without clinically apparent interactions occurring.
No dose adjustment for Zometa is needed when co-administered with thalidomide, except in patients with mild to moderate renal impairment at baseline (see Dosage & Administration). Co-administration of thalidomide (100 or 200 mg once daily) with Zometa (4 mg given as a 15-min infusion) did not significantly change the pharmacokinetics of zoledronic acid and the CrCl of patients with multiple myeloma.
Incompatibilities: Studies with glass bottles, as well as several types of infusion bags and lines made from polyvinylchloride, polyethylene and polypropylene (pre-filled with 0.9% w/v sodium chloride solution or 5% w/v glucose solution), showed no incompatibility with Zometa.
To avoid potential incompatibilities, Zometa concentrate is to be diluted with 0.9% w/v sodium chloride solution or 5% w/v glucose solution.
Zometa concentrate and Zometa "ready-to-use" solution for infusion must not be mixed or come into contact with calcium- or other divalent cation-containing infusion solutions eg, lactated Ringer's solution, and should be administered as a single IV solution in a line separate from all other drugs.