First comes the temptation to crack your back. Eventually, most end up cracking their back without even thinking about it (habit), leading millions of people to back problems. The noise itself comes from a rush of nitrogen into your facet joints as they open up. Some side effects of zoledronic acid 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. Question: Are there any side effects to cracking knuckles? There is no evidence that cracking knuckles causes any damage such as arthritis in the joints. However, a couple of reports in the medical literature are available associating knuckle cracking with injury of the ligaments surrounding the joint or dislocation of the tendons ( attachments. Muscle around the joints may ache as well. The pain may be in the hips, shoulders, legs, or arms. If this side effect does occur it usually happens during treatment and possibly for several months to a year after receiving chemotherapy. Just like the other chemo side effects such as hair loss and fatigue, painful joints will go away eventually.
Generic Name:zoledronic acid
Does Knuckle Cracking Cause Arthritis? About the long-term effects of one popular childhood activity: knuckle cracking. Tips to Keep Joints Healthy. Eat fish to curb inflammation. Gentle yoga stretches are also great for releasing your back without the potentially harmful side effects of back and neck cracking. Child’s pose and cobra will feel nice, or even heading to a yin yoga class, where poses are traditionally held longer to give muscles time to open and adjust.
Medically reviewed by Drugs.com. Last updated on Feb 17, 2019.
- Side Effects
Note: This document contains side effect information about zoledronic acid. Some of the dosage forms listed on this page may not apply to the brand name Zometa.
In Summary
Common side effects of Zometa include: hypophosphatemia, hypokalemia, and hypomagnesemia. Other side effects include: hypocalcemia. See below for a comprehensive list of adverse effects.
For the Consumer
Applies to zoledronic acid: intravenous powder for solution, intravenous solution
Along with its needed effects, zoledronic acid (the active ingredient contained in Zometa) 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 while taking zoledronic acid:
More Common
- Agitation
- black, tarry stools
- blurred vision
- chest pain
- chills
- coma
- confusion
- convulsions
- cough
- difficult or labored breathing
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- fever
- irritability
- lack or loss of strength
- lower back or side pain
- 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
- shaking of the hands, arms, feet, legs, or face
- skin rash, cracks in the skin at the corners of the mouth, or soreness or redness around the fingernails and toenails
- 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
Less Common
- Feeling of constant movement of self or surroundings
- muscle cramps in the hands, arms, feet, legs, or face
- muscle spasms
- 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 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
- weight gain
Some side effects of zoledronic acid 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
- 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
- cracked lips
- cracked, dry, or scaly skin
- difficulty with swallowing
- discouragement
- dry mouth
- ear congestion
- feeling sad or empty
- frequent urge to urinate
- hair loss or thinning hair
- 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
- swelling or inflammation of the mouth
- thirst
- trouble concentrating
- trouble sleeping
- unusually cold, shivering
- vomiting
Less Common
- Acid or sour stomach
- 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
For Healthcare Professionals
Applies to zoledronic acid: intravenous powder for injection, intravenous solution
General
In general, side effects have been mild and transient and similar to other bisphosphonates.
Acute phase reactions have occurred within three days after administration of this drug with symptoms of pyrexia, fatigue, bone pain and/or arthralgias, myalgias, chills, and influenza-like illness. Symptoms usually resolve within three days of onset, but resolution can take up to 7 to 14 days, and some symptoms have persisted for a longer duration.[Ref]
Cardiovascular
In the postmenopausal osteoporosis trial, adjudicated serious adverse events of atrial fibrillation in the zoledronic acid (the active ingredient contained in Zometa) treatment group occurred in 1.3% of patients (50 out of 3862) compared to 0.4% (17 out of 3852) in the placebo group. The overall incidence of all atrial fibrillation adverse events in the zoledronic acid treatment group was, reported in 2.5% of patients (96 out of 3862) in the Reclast group vs. 1.9% of patients (75 out of 3852) in the placebo group.[Ref]
Very common (10% or more): Hypotension (10.5%)
Common (1% to 10%): Atrial fibrillation
Uncommon (0.1% to 1%): Palpitations, flushing, hypotension, hypotension leading to syncope or circulatory collapse
Rare (less than 0.1%): Bradycardia
Very rare (less than 0.01%): Cardiac arrhythmia (secondary to hypocalcemia)
Postmarketing reports: Atrial fibrillation, hypertension, bradycardia, and hypotension[Ref]
Dermatologic
Very common (10% or more): Alopecia (12%) and dermatitis (11%)
Uncommon (0.1% to 1%): Pruritus, hyperhidrosis, rash (including erythematous and macular rash), increased sweating
Frequency not reported: Stevens-Johnson syndrome, epidermal necrolysis
Postmarketing reports: Increased sweating and urticaria[Ref]
Gastrointestinal
Very common (10% or more): Nausea (29.1% to 46%), vomiting (14% to 32%), constipation (26.7% to 31%), diarrhea (17.4% to 24%), abdominal pain (14% to 16.3%), dyspepsia (10%)
Common (1% to 10%): Stomatitis, sore throat, dysphagia
Uncommon (0.1% to 1%): Gastroesophageal reflux disease, esophagitis, toothache, gastritis
Postmarketing reports: Dry mouth[Ref]
Genitourinary
Very common (10% or more): Urinary tract infection (14%)[Ref]
Hematologic
Is Cracking Your Joints Bad
Very common (10% or more): Anemia (22.1% to 33%) and neutropenia (12%)
Common (1% to 10%): Granulocytopenia, thrombocytopenia and pancytopenia
Uncommon (0.1% to 1%): Leukopenia[Ref]
Metabolic
Very common (10% or more): Hypophosphatemia (12.8%), hypokalemia (11.6%), hypomagnesemia (10.5%),
Common (1% to 10%): Dehydration, hypocalcemia
Uncommon (0.1% to 1%): Anorexia, decrease appetite
Rare (less than 0.1%): Hyperkalemia, hypernatremia[Ref]
Grade 3 and 4 laboratory abnormalities have included hypophosphatemia (51.4%, grade 3; 1.4%, grade 4) and hypocalcemia (1.2%, grade 3).[Ref]
Musculoskeletal
Very common (10% or more): Bone pain (55%), myalgia (23%), arthralgia (21%), back pain (15%), and limb pain (14%)
Common (1% to 10%): Myalgia, arthralgia, generalized pain, pain in extremity
Uncommon (0.1% to 1%): Muscle cramps, osteonecrosis of the jaw (ONJ), neck pain, musculoskeletal stiffness, joint swelling, muscle spasms, shoulder pain, musculoskeletal chest pain, musculoskeletal pain, joint stiffness, arthritis, muscular weakness
Rare (less than 0.1%): Atypical subtrochanteric and diaphyseal femoral fractures (bisphosphonate class adverse reaction)
Postmarketing reports: Muscle cramps; osteonecrosis of the jaw, hip, and femur have been reported predominantly in cancer patients treated with intravenous bisphosphonates (many of these patients were also receiving chemotherapy and corticosteroids which may be a risk factor for ONJ).[Ref]
Cases of osteonecrosis (primarily of the jaws) have been reported, predominantly in cancer patients taking this drug. Many of these patients had signs of local infection including osteomyelitis, and the majority of the reports refer to cancer patients following tooth extractions or other dental surgeries. Osteonecrosis of the jaws has multiple documented risk factors including a diagnosis of cancer, concomitant therapies (e.g. chemotherapy, radiotherapy, corticosteroids) and co-morbid conditions (e.g. anemia, coagulopathies, infection, pre-existing oral disease).[Ref]
Nervous system
Very common (10% or more): Headache (19%), dizziness (18%), paresthesia (15%), hypoesthesia (12%)
Common (1% to 10%): Somnolence
Uncommon (0.1% to 1%): Paraesthesia, taste disturbance, hyperesthesia, tremor, somnolence, syncope, dysgeusia, lethargy
Very rare (less than 0.01%): Seizures, numbness and tetany (secondary to hypocalcemia)
Frequency not reported: Neurological events due to hypokalemia (e.g., seizures, numbness, tetany)
Postmarketing reports: Taste disturbance, hyperesthesia, tremor[Ref]
Other
Very common (10% or more): Fever (44.2%), moniliasis (11.6%)
Common (1% to 10%): Nonspecific infections, asthenia, mucositis, chest pain, leg edema
Uncommon (0.1% to 1%): Vertigo
Postmarketing reports: Flu-like syndrome, pyrexia, fatigue, malaise; osteonecrosis of the external auditory canal have been reported predominantly in cancer patients treated with intravenous bisphosphonates (many of these patients were also receiving chemotherapy and corticosteroids which may be a risk factor for ONJ).[Ref]
Fever is the most common adverse effect associated with zoledronic acid infusion.
Flu-like syndromes including fever, chills, bone pain, and/or arthralgias and myalgias have also occasionally been reported. These symptoms generally did not require treatment and resolved within 24 to 48 hours.[Ref]
Psychiatric
Very common (10% or more): Insomnia (15.1%), anxiety (14%), depression (14%), agitation (12.8%)
Common (1% to 10%): Confusion[Ref]
Renal
The following factors have been associated with an increased risk: Pre-existing renal dysfunction, dehydration, multiple cycles of zoledronic acid (the active ingredient contained in Zometa) or other bisphosphonates, concomitant use of nephrotoxic medicines and use of a shorter infusion time than what is recommended.
The frequency of renal impairment adverse events suspected to be related to this drug was as follows: Multiple myeloma (3.2%), prostate cancer (3.1%), breast cancer (4.3%), lung and other solid tumors (3.2%). Renal deterioration, progression to renal failure and dialysis have been reported in patients after the initial dose or a single dose of 4 mg zoledronic acid.[Ref]
Very common (10% or more): Renal toxicity (deterioration of renal function or renal failure),
Common (1% to 10%): Grade 3 increases (more than 3 times upper limit of normal) in serum creatinine in 2.3% of patients, blood urea increased
Uncommon (0.1% to 1%): Acute renal failure, hematuria, proteinuria, pollakiuria
Postmarketing reports: Hematuria, proteinuria, hyperkalemia, hypernatremia[Ref]
Respiratory
Very common (10% or more): Dyspnea (22.1% to 27%), coughing (11.6% to 22%), upper respiratory infection (10%)
Uncommon (0.1% to 1%): Pleural effusion
Rare (less than 0.1%): Interstitial lung disease
Postmarketing reports: Bronchoconstriction and asthma exacerbations[Ref]
Ocular
Common (1% to 10%): Conjunctivitis, ocular hyperemia
Uncommon (0.1% to 1%): Blurred vision, scleritis, orbital inflammation, eye pain
Very rare (less than 0.01%): Uveitis, episcleritis, iritis
Frequency not reported: Scleritis
Postmarketing reports: Uveitis, scleritis, episcleritis, conjunctivitis, iritis, and orbital inflammation including orbital edema[Ref]
Excessive Cracking Of Joints
Hypersensitivity
Uncommon (0.1% to 1%): Hypersensitivity reaction including bronchoconstriction, urticaria, angioedema, anaphylactic reaction/shock[Ref]
Local
All Joints Cracking Constantly
Uncommon (0.1% to 1%): Injection site reactions (including pain, irritation, swelling, induration)
Postmarketing reports: Itching and pain at the injection site[Ref]
Immunologic
Rare (less than 0.1%): Angioneurotic edema[Ref]
Oncologic
Frequency not reported: Aggravation of malignant neoplasm and progression of cancer[Ref]
References
1. Pharmaceutical Society of Australia 'APPGuide online. Australian prescription products guide online. Available from: URL: http://www.appco.com.au/appguide/default.asp.' ([2006]):
2. Cerner Multum, Inc. 'UK Summary of Product Characteristics.' O 0
3. 'Product Information. Zometa (zoledronic acid).' Novartis Pharmaceuticals, East Hanover, NJ.
4. Cerner Multum, Inc. 'Australian Product Information.' O 0
5. Markowitz GS, Fine PL, Stack JI, et al. 'Toxic acute tubular necrosis following treatment with zoledronate (Zometa).' Kidney Int 64 (2003): 281-289
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.
Related questions
More about Zometa (zoledronic acid)
- During Pregnancy or Breastfeeding
Consumer resources
Other brands:Reclast, Aclasta