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Zoledronic acid is a third-generation, nitrogen-containing bisphosphonate used to treat and prevent various bone-related conditions, including osteoporosis, Paget’s disease of bone, hypercalcemia of malignancy, multiple myeloma, and bone metastases from solid tumors. It is administered intravenously. Zoledronic acid works by binding to mineralized bone at sites of high turnover and inhibiting osteoclast-mediated bone resorption. Its primary mechanism involves inhibition of the enzyme farnesyl pyrophosphate synthase within osteoclasts, leading to disruption of their cytoskeleton and cell death. This action reduces skeletal complications in cancer patients with bone involvement and helps maintain or increase bone density in metabolic disorders[1][4][5][6][8].
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