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Scholars Journal of Medical Case Reports | Volume-14 | Issue-08
Early and Late Severe and Rare Adverse Events Associated with Zoledronic Acid in Cancer Patients: A Seven-Case Series and Literature Review
Roda Hassan Eltigani, Sihame Lkhoyaali, Salma Alaoui, Lamsyah Oumaima, Sara Naciri, Hanane Inrhaoun, Salma Najem, Ibrahim Ghissassi, Saber Butayeb, Hind M’rabti, Hassan Errihani
Published: Aug. 10, 2026 |
13
8
Pages: 1826-1831
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Abstract
Zoledronic acid (ZA) is a third-generation nitrogen-containing bisphosphonate widely used in oncology for the prevention of skeletal-related events (SREs) in patients with bone metastases, the treatment of hypercalcemia of malignancy, and the prevention of cancer treatment-induced bone loss (CTIBL). Although ZA has demonstrated substantial efficacy and an overall favorable safety profile, uncommon but potentially severe adverse events may occur, ranging from acute metabolic and immune-mediated reactions to delayed complications such as medication-related osteonecrosis of the jaw (MRONJ). We report a seven-case series of clinically significant early and late ZA-related adverse events observed in routine oncology practice and compare our findings with the available literature to emphasize their clinical presentation, management, and preventive strategies.