Zoledronic acid is administered as an intravenous infusion how often, and what monitoring is typical?

• A. Monthly infusion; monitor liver enzymes
• B. Biannual infusion; monitor renal function
• C. Quarterly infusion; monitor calcium
• D. Yearly infusion; monitor renal function, serum calcium, and vitamin D

Answer: (D)

Zoledronic acid is a potent IV bisphosphonate used to treat osteoporosis, so the dosing for this condition is typically a yearly infusion. Giving it once a year reduces fracture risk while limiting exposure to the drug’s effects on the kidneys. Because of its potency, renal function must be checked before each infusion to avoid nephrotoxicity, and calcium metabolism must be supported because the drug can lower serum calcium levels. That’s why monitoring focuses on renal function, calcium, and vitamin D levels, with calcium and vitamin D supplementation as needed to prevent hypocalcemia. Liver enzymes aren’t a primary concern with this therapy, and monthly, biannual, or quarterly schedules aren’t standard for osteoporosis.