natgillin/translations-raw huggingface dataset:
Zoledronic acid is not recommended for patients presenting with severe renal impairment prior to initiation of therapy, which is defined for this population as CLcr < 30 ml/min.
Zoledronatna kiselina ne preporučuje se u bolesnika koji prije početka liječenja imaju teško oštećenje funkcije bubrega, koje se u ove populacije definira kao klirens kreatinina < 30 ml/min.
• Other medicines that also contain zoledronic acid and are used to treat osteoporosis and other non-cancer diseases of the bone, or any other bisphosphonate, since the combined effects of these medicines taken together with Zoledronic Acid Accord are unknown.
• druge lijekove koji također sadrže zoledronatnu kiselinu i koriste se za liječenje osteoporoze i drugih bolesti kostiju koje nisu uzrokovane rakom ili bilo koji drugi bisfosfonat, budući da kombinirani učinci ovih lijekova kad se uzimaju zajedno sa Zoledronatnom kiselinom Accord nisu poznati
Animal reproduction studies with zoledronic acid have shown reproductive toxicity (see section 5.3).
Ispitivanja zoledronatne kiseline na životinjama pokazala su da postoji reproduktivna toksičnost (vidjeti dio 5.3).
The European Medicines Agency has waived the obligation to submit the results of studies with the reference product containing zoledronic acid in all subsets of the paediatric population in the treatment of tumour-induced hypercalcaemia and prevention of skeletal-related events in patients with advanced malignancies involving bone (see section 4.2 for information on paediatric use).
Europska agencija za lijekove je izuzela obvezu podnošenja rezultata ispitivanja referentnog lijeka koji sadrži zoledronatnu kiselinu u svim podskupinama pedijatrijske populacije u liječenju hiperkalcemije izazvane tumorom i sprječavanju događaja povezanih s koštanim sustavom u bolesnika s uznapredovalom zloćudnom bolešću koja zahvaća kosti (vidjeti dio 4.2 za informacije o pedijatrijskoj primjeni).
Following initiation of therapy, serum creatinine should be measured prior to each dose of zoledronic acid and treatment should be withheld if renal function has deteriorated.
Nakon početka liječenja kreatinin u serumu treba mjeriti prije primjene svake doze zoledronatne kiseline, a liječenje treba obustaviti ako se funkcija bubrega pogorša.
CONDITIONS OR RESTRICTIONS WITH REGARD TO THE SAFE AND EFFECTIVE USE OF THE MEDICINAL PRODUCT
UVJETI ILI OGRANIČENJA VEZANI ZA SIGURNU I UČINKOVITU PRIMJENU LIJEKA
• Irregular heart rhythm (atrial fibrillation) has been seen in patients receiving zoledronic acid for postmenopausal osteoporosis.
• nepravilan srčani ritam (fibrilacija atrija) opažen je u bolesnica koje su primale zoledronatnu kiselinu zbog postmenopauzalne osteoporoze.
Within three days after zoledronic acid administration, an acute phase reaction has commonly been reported, with symptoms including bone pain, fever, fatigue, arthralgia, myalgia, rigors and arthritis with subsequent joint swelling; these symptoms usually resolve within a few days (see description of selected adverse reactions).
Tijekom tri dana nakon primjene zoledronatne kiseline često je zabilježena reakcija akutne faze sa simptomima koji uključuju bol u kostima, vrućicu, umor, artralgiju, mialgiju, tresavicu i artritis s posljedičnim oticanjem zglobova; ti se simptomi obično povuku u roku od nekoliko dana (vidjeti opis odabranih nuspojava).
The recommended dose in hypercalcaemia (albumin-corrected serum calcium ≥12.0 mg/dl or 3.0 mmol/l) is a single dose of 4 mg zoledronic acid.
Preporučena doza kod hiperkalcemije (serumski kalcij korigiran za albumin ≥ 12,0 mg/dl ili 3,0 mmol/l) je jednokratna doza od 4 mg zoledronatne kiseline.
Additionally, there have been sporadic reports of osteonecrosis of other sites, including the hip and femur, reported predominantly in adult cancer patients treated with Zoledronic Acid .
Dodatno, bilo je sporadičnih prijava osteonekroze drugih anatomskih mjesta, uključujući kuk i bedrenu kost, koje su bile prijavljene pretežno u odraslih bolesnika oboljelih od raka liječenih Zoledronatnu kiselina.
The onset time is ≤ 3 days post-zoledronic acid infusion, and the reaction is also referred to using the terms “flu-like” or “post-dose” symptoms.
Vrijeme nastupa je ≤3 dana nakon infuzije Zomete, a reakcija se još zove “sindrom sličan gripi” ili simptomi “nakon doziranja”.
Hypophosphataemia 1 Adverse events occurring with frequencies < 5% were medically assessed and it was shown that these cases are consistent with the well established safety profile of zoledronic acid (see section 4.8)
hipofosfatemija 1 Nuspojave koje nastaju učestalošću < 5% bile su medicinski procijenjene i pokazalo se da su u skladu s dobro utvrđenim sigurnosnim profilom zoledronatne kiseline (vidjeti dio 4.8).
Hypersensitivity reaction
reakcija preosjetljivosti
Intravenous use after dilution.
Primjena u venu nakon razrjeđenja.
In clinical studies, zoledronic acid has been administered concomitantly with commonly used anticancer agents, diuretics, antibiotics and analgesics without clinically apparent interactions occurring.
U kliničkim se ispitivanjima zoledronatna kiselina primjenjivala istodobno s često davanim antitumorskim lijekovima, diureticima, antibioticima i analgeticima bez klinički vidljivih interakcija.
Intravenously administered zoledronic acid is eliminated by a triphasic process: rapid biphasic disappearance from the systemic circulation, with half-lives of t½α 0.24 and t½β 1.87 hours, followed by a long elimination phase with a terminal elimination half-life of t½γ 146 hours.
Intravenski primijenjena zoledronatna kiselina eliminira se procesom u tri faze: brzim bifazičnim nestankom iz sistemskog krvotoka, uz poluvijek t1/2α od 0,24 sata i t1/2β od 1,87 sati, za kojim slijedi dugotrajna faza eliminacije uz terminalni poluvijek eliminacije t1/2γ od 146 sati.
The imbalance observed in this trial has not been observed in other trials with zoledronic acid, including those with zoledronic acid 4 mg every 3-4 weeks in oncology patients.
Opažena neravnoteža u ovom ispitivanju nije bila primijećena u drugim ispitivanjima zoledronatne kiseline, uključujući ispitivanja zoledronatne kiseline u dozi od 4 mg primijenjene svaka 3-4 tjedna u onkoloških bolesnika.
5-ml plastic vial made of clear, cycloolefine copolymer with chlorobutyl rubber stopper and aluminium cap with flip-off component.
Plastična bočica od 5 ml izrađena od prozirnog cikloolefinskog kopolimera s čepom od klorobutilne gume i aluminijskim poklopcem s „flip-off“ dijelom.
During bisphosphonate treatment patients should be advised to report any thigh, hip or groin pain and any patient presenting with such symptoms should be evaluated for an incomplete femur fracture.
Bolesnicima treba savjetovati da tijekom liječenja bisfosfonatima prijave svaki bol u natkoljenici, kuku ili preponama, i svakog bolesnika s takvim simptomima treba pregledati na nepotpuni prijelom bedrene kosti.
In the clinical programme patients aged 1 to < 3 years received 0.025 mg/kg zoledronic acid (up to a maximum single dose of 0.35 mg) every 3 months and patients aged 3 to 17 years received 0.05 mg/kg zoledronic acid (up to a maximum single dose of 0.83 mg) every 3 months.
Bolesnici uključeni u klinički program u dobi od 1 do < 3 godine primali su 0,025 mg/kg zoledronatne kiseline (do najveće jednokratne doze od 0,35 mg) svaka 3 mjeseca, a bolesnici u dobi od 3 do 17 godina primali su 0,05 mg/kg zoledronatne kiseline (do najviše jednokratne doze od 0,83 mg) svaka 3 mjeseca.
• if you are allergic to zoledronic acid, another bisphosphonate (the group of substances to which Zoledronic Acid Accord belongs), or any of the other ingredients of this medicine
• ako ste alergični (preosjetljivi) na zoledronatnu kiselinu, drugi bisfosfonat (skupina tvari kojoj pripada Zoledronatna kiselina Accord) ili neki drugi sastojak ovog lijeka (naveden u dijelu 6).
• The active substance is zoledronic acid.
• Djelatna tvar je zoledronatna kiselina.
Statistically significant differences are marked (*p< 0.05) for between treatment comparisons (4 mg zoledronic acid vs.
Označene su statistički značajne razlike (*p<0,05) između dvije terapije (zoledronatna kiselina u dozi od 4 mg nasuprot placebu)
• Zoledronic Acid Accord must only be given by healthcare professionals trained in administering bisphosphonates intravenously, i.e. through a vein.
• Zoledronatnu kiselinu Accord smije davati samo zdravstveni djelatnici iskusni u davanju bisfosfonata intravenskim putem, tj. u venu.
4.1 ml for 3.3 mg dose
- 4,1 ml za dozu od 3,3 mg
Median time to SRE (days)
Vrijeme u ispitivanju (tjedni)
Zoledronic acid 4 mg was also studied in a double-blind, randomised, placebo-controlled trial in 228 patients with documented bone metastases from breast cancer to evaluate the effect of 4 mg zoledronic acid on the skeletal related event (SRE) rate ratio, calculated as the total number of SRE events (excluding hypercalcaemia and adjusted for prior fracture), divided by the total risk period.
Zoledronatna kiselina od 4 mg također se ispitivala u dvostruko slijepom, randomiziranom, placebom kontroliranom ispitivanju u 228 bolesnika s potvrđenim koštanim metastazama karcinoma dojke da bi se procijenio učinak zoledronatne kiseline u dozi od 4 mg na omjer stope koštanih događaja izračunatog kao ukupni broj koštanih događaja (bez hiperkalcemije i prilagođen s obzirom na prethodne prijelome) podijeljen s ukupnim rizičnim razdobljem.
Zoledronic acid has been associated with reports of renal dysfunction.
Zoledronatna kiselina povezuje se s prijavama poremećaja funkcije bubrega.
MARKETING AUTHORISATION NUMBER(S) EU/1/13/834/001- 1vial pack EU/1/13/834/002- 4 vial pack EU/1/13/834/003- 10 vial pack
EU/1/13/834/001- pakiranje s 1 bočicom EU/1/13/834/002- pakiranje sa 4 bočice EU/1/13/834/003- pakiranje s 10 bočica
DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION Date of first authorisation: 16.01.2014
DATUM PRVOG ODOBRENJA/DATUM OBNOVE ODOBRENJA
The active substance in Zoledronic Acid Accord is zoledronic acid, which belongs to a group of substances called bisphosphonates.
Djelatna tvar u Zoledronatnoj kiselini Accord je zoledronatna kiselina, koja pripada skupini tvari koje se zovu bisfosfonati.
Zoledronic acid treatment should be resumed at the same dose as that given prior to treatment interruption.
Liječenje zoledronatnom kiselinom treba nastaviti istom dozom koja se davala prije prekida liječenja.
In patients with bone metastases presenting with mild to moderate renal impairment prior to initiation of therapy, which is defined for this population as CLcr 30-60 ml/min, the following zoledronic acid dose is recommended (see also section 4.4):
U bolesnika s metastazama u kostima koji prije početka liječenja imaju blago do umjereno oštećenje funkcije bubrega, koje se u ove populacije definira kao klirens kreatinina od 30 do 60 ml/min, preporučuje se sljedeća doza zoledronatne kiseline (vidjeti također dio 4.4):
Reduced levels of calcium in the blood (hypocalcaemia), sometimes leading to muscle cramps, dry skin, burning sensation, have been reported in patients treated with Zoledronic Acid Accord.
Smanjene razine kalcija u krvi (hipokalcemija), što ponekad dovodi do mišićnih grčeva, suhe kože, osjećaja peckanja, zabilježene su u bolesnika koji su liječeni Zoledronatnom kiselinom Accord.
The following are the important identified risks with zoledronic acid in the approved indications: Renal function impairment, osteonecrosis of the jaw, acute phase reaction, hypocalcaemia, atrial fibrillation, anaphylaxis, interstitial lung disease.
Utvrđeni su sljedeći važni rizici primanja zoledronatne kiseline u odobrenim indikacijama: oštećenje funkcije bubrega, osteonekroza čeljusti, reakcija akutne faze, hipokalcemija, fibrilacija atrija, anafilaksija, intersticijska bolest pluća.
Based on the review of both clinical trial and post-marketing cases, there is sufficient evidence to support an association between zoledronic acid therapy, the reported event of hypocalcaemia, and the secondary development of cardiac arrhythmia.
Na osnovu ocjenjivanja kliničkog ispitivanja i slučajeva nakon stavljanja lijeka na tržište postoji dovoljno dokaza koji ukazuju na povezanost između terapije zoledronatnom kiselinom, prijavljenih slučajeva hipokalcemije i posljedičnog razvoja srčane aritmije.
Caution is advised when Zolendronc Acid Accord is administered with medicinal products known to cause hypocalcaemia, as they may have a synergistic effect resulting in severe hypocalcaemia (see section 4.5).
Savjetuje se oprez kod primjene Zoledronatne kiseline Accord s lijekovima za koje je poznato da uzrokuju hipokalcemiju budući da mogu imati sinergistički učinak s posljedičnom teškom hipokalcemijom (vidjeti dio 4.5).
Excipients: mannitol (E421), sodium citrate and water for injections.
Pomoćne tvari: manitol (E421), natrijev citrat i voda za injekcije.
Convulsions, hypoaesthesia and tetany (secondary to hypocalcaemia)
konvulzije, hipoestezija, tetanija (uzrokovana hipokalcemijom)
Pain in extremities, arthralgia, musculoskeletal pain
bol u ekstremitetima, artralgija, mišićno-koštana bol
What Zoledronic Acid Accord looks like and contents of the pack Zoledronic Acid Accord is supplied as a liquid concentrate in a vial.
Kako Zoledronatna kiselina Accord izgleda i sadržaj pakiranja Zoledronatna kiselina Accord isporučuje se kao tekući koncentrat u bočici.
From a microbiological point of view, the diluted solution for infusion should be used immediately.
S mikrobiološkog stajališta, razrijeđena otopina za infuziju treba se odmah primijeniti.
Increases in serum creatinine also occur in some patients with chronic administration of zoledronic acid at recommended doses for prevention of skeletal related events, although less frequently.
U nekih bolesnika dolazi do povišenja kreatinina u serumu i kod kronične primjene zoledronatne kiseline u dozama koje se preporučuju za sprječavanje koštanih događaja, iako manje često.
3.8 ml for 3.0 mg dose
- 3,8 ml za dozu od 3,0 mg
Median time to relapse (re-increase of albumin-corrected serum calcium ≥ 2.9 mmol/l) was 30 to 40 days for patients treated with zoledronic acid versus 17 days for those treated with pamidronate 90 mg (p-values: 0.001 for 4 mg and 0.007 for 8 mg zoledronic acid).
Medijan vremena do relapsa (ponovnog povišenja kalcija u serumu korigiranog za albumin ≥ 2,9 mmol/l) iznosio je 30 do 40 dana u bolesnika liječenih zoledronatnom kiselinom za razliku od 17 dana u onih liječenih pamidronatom u dozi od 90 mg (p-vrijednosti: 0,001 za 4 mg i 0,007 za 8 mg zoledronatne kiseline).
In view of the potential impact of zoledronic acid on renal function, the lack of clinical safety data in patients with severe renal impairment (in clinical trials defined as serum creatinine ≥ 400 µmol/l or ≥ 4.5 mg/dl for patients with TIH and ≥ 265 µmol/l or ≥ 3.0 mg/dl for patients with cancer and bone metastases, respectively) at baseline and only limited pharmacokinetic data in patients with severe renal impairment at baseline (creatinine clearance < 30 ml/min), the use of zoledronic acid is not recommended in patients with severe renal impairment.
S obzirom na mogući utjecaj zoledronatne kiseline na funkciju bubrega, nedostatak kliničkih podataka o sigurnosti primjene u bolesnika s teškim oštećenjem funkcije bubrega (u kliničkim ispitivanjima definiranim kao kreatinin u serumu ≥ 400 μmol/l ili ≥ 4,5 mg/dl u bolesnika s hiperkalcemijom izazvanom tumorom, odnosno ≥ 265 μmol/l ili ≥ 3,0 mg/dl u bolesnika s rakom i metastazama u kostima) na početku liječenja i ograničene farmakokinetičke podatke u bolesnika s teškim oštećenjem funkcije bubrega (klirens kreatinina <30 ml/min) na početku liječenja, ne preporučuje se primjena zoledronatne kiseline u bolesnika s teškim oštećenjem funkcije bubrega.
• Difficulty in breathing with wheezing or coughing.
• otežano disanje uz piskanje u plućima ili kašljanje.
The safety margins relative to renal effects were narrow in the long-term repeat-dose parenteral animal studies but the cumulative no adverse event levels (NOAELs) in the single dose (1.6 mg/kg) and multiple dose studies of up to one month (0.06-0.6 mg/kg/day) did not indicate renal effects at doses equivalent to or exceeding the highest intended human therapeutic dose.
Dugotrajna ispitivanja ponovljene parenteralne doze u životinja pokazala su uzak raspon sigurnosti s obzirom na učinke na bubrege, ali najviša kumulativna doza koja ne uzrokuje oštećenje (NOAEL) u ispitivanjima jednostruke doze (1,6 mg/kg) i višestrukih doza u trajanju do jednog mjeseca (0,060,6 mg/kg na dan) nije imala učinke na bubrege pri dozama jednakima ili višima od najviše terapijske doze namijenjene ljudima.
Patients being treated with Zoledronic Acid Accord should not be treated with Aclasta or any other bisphosphonate concomitantly, since the combined effects of these agents are unknown.
Bolesnici koji se liječe Zoledronatnom kiselinom Accord ne smiju istodobno uzimati Aclastu ili bilo koji drugi bisfosfonat, budući da nisu poznati kombinirani učinci tih lijekova.
• To prepare an infusion solution containing 4 mg zoledronic acid, further dilute the Zoledronic Acid Accord concentrate (5ml) with 100 ml of calcium-free or other divalent cation-free infusion solution.
• Da biste pripremili otopinu za infuziju koja sadrži 4 mg zoledronatne kiseline, dodatno razrijedite koncentrat Zoledronatne kiseline Accord (5 ml) sa 100 ml otopine za infuziju koja ne sadrži kalcij niti druge dvovalentne katione.
Caution is advised when zoledronic acid is administered with anti-angiogenic medicinal products, as an increase in the incidence of ONJ has been observed in patients treated concomitantly with these medicinal products.
Savjetuje se oprez prilikom primjene zoledronatne kiseline sa antiangiogenim lijekovima budući da je zabilježena incidencija osteonekroze čeljusti u bolesnika istovremeno liječenih ovim lijekovima.
In the clinical trials, renal deterioration was defined as follows: For patients with normal baseline serum creatinine (< 1.4 mg/dl or < 124 µmol/l), an increase of 0.5 mg/dl or 44 µmol/l; For patients with abnormal baseline creatinine (> 1.4 mg/dl or > 124 µmol/l), an increase of 1.0 mg/dl or 88 µmol/l.
U kliničkim je ispitivanjima pogoršanje funkcije bubrega bilo definirano na sljedeći način: povišenje vrijednosti kreatinina za 0,5 mg/dl ili 44 μmol/l, u bolesnika s normalnom početnom vrijednošću kreatinina u serumu (< 1,4 mg/dl ili < 124 μmol/l), povišenje vrijednosti kreatinina za 1,0 mg/dl ili 88 μmol/l, u bolesnika s poremećenom početnom vrijednošću kreatinina (> 1,4 mg/dl ili > 124 μmol/l).
The pain score for zoledronic acid was consistently below baseline and pain reduction was accompanied by a trend in reduced analgesics score.
Rezultat na ljestvici bola za zoledronatnu kiselinu bio je dosljedno ispod početne razine, a smanjenje bola bilo je praćeno trendom smanjenja bodova za analgetike.
The following adverse reactions, listed in Table 1, have been accumulated from clinical studies and post-marketing reports following predominantly chronic treatment with 4 mg zoledronic acid:
Sljedeće nuspojave navedene u tablici 1 prikupljene su iz kliničkih ispitivanja i prijava nakon stavljanja lijeka u promet, uglavnom kod kroničnog liječenja zoledronatnom kiselinom u dozi od 4 mg:
To assess the effects of 4 mg zoledronic acid versus pamidronate 90 mg, the results of two pivotal multicentre studies in patients with TIH were combined in a pre-planned analysis.
Da bi se procijenili učinci zoledronatne kiseline u dozi od 4 mg u usporedbi s 90 mg pamidronata, u unaprijed planiranoj analizi kombinirali su se rezultati dva glavna multicentrična ispitivanja u bolesnika s hiperkalcemijom izazvanom tumorom.
During post-marketing experience the following reactions have been reported (frequency rare): Atypical subtrochanteric and diaphyseal femoral fractures (bisphosphonate class adverse reaction).
U razdoblju nakon stavljanja lijeka u promet zabilježene su sljedeće reakcije (rijetke učestalosti): atipični suptrohanterični prijelomi i prijelomi dijafize bedrene kosti (nuspojava skupine bisfosfonata).
In most cases no specific treatment is required and the symptoms disappear after a short time (couple of hours or days).
zimice i bolova u kostima, zglobovima i/ili mišićima; u većini slučajeva nije potrebno posebno liječenje, i simptomi nestaju nakon kratkog vremena (nekoliko sati ili dana).
* Includes vertebral and non-vertebral fractures ** Accounts for all skeletal events, the total number as well as time to each event during the trial NR-Not Reached
** Odnosi se na sve koštane događaje, njihov ukupni broj i vrijeme do svakog pojedinog događaja tijekom ispitivanja.
In Phase I dose finding studies in patients with mild to moderate tumour-induced hypercalcaemia (TIH), effective doses tested were in the range of approximately 1.2-2.5 mg.
U ispitivanjima faze I, određivanja doze u bolesnika s blagom do umjerenom hiperkalcemijom izazvanom tumorom, djelotvorne ispitivane doze kretale su se u rasponu od približno 1,2 do 2,5 mg.
Blurred vision, scleritis and orbital inflammation
zamagljen vid, skleritis i upala orbite
Proportion of patients with SREs (%) p-value
Udio bolesnika s koštanim događajem (%) p-vrijednost Medijan
Patients must be maintained well hydrated prior to and following administration of zoledronic acid.
Bolesnici moraju biti dobro hidrirani prije i nakon primjene zoledronatne kiseline.
In a pooled analysis of safety data from zoledronic acid registration trials for the prevention of skeletal-related events in patients with advanced malignancies involving bone, the frequency of renal impairment adverse events suspected to be related to zoledronic acid (adverse reactions) was as follows: multiple myeloma (3.2%), prostate cancer (3.1%), breast cancer (4.3%), lung and other solid tumours (3.2%).
U analizi objedinjenih podataka o sigurnosti primjene zoledronatne kiseline iz registracijskih ispitivanja za sprječavanje koštanih događaja u bolesnika s uznapredovalom zloćudnom bolešću koja je zahvatila kosti, sumnjalo se da je učestalost nuspojave oštećenja funkcije bubrega povezana sa zoledronatnom kiselinom (nuspojava) na sljedeći način: multipli mijelom (3,2%), karcinom prostate (3,1%), karcinom dojke (4,3%), karcinom pluća i drugi solidni tumori (3,2%).
Cases of osteonecrosis of the jaw have been reported, predominantly in cancer patients treated with medicinal products that inhibit bone resorption, such as zoledronic acid (see section 4.4).
Slučajevi osteonekroze čeljusti pretežno su zabilježeni u onkoloških bolesnika liječenih lijekovima koji inhibiraju resorpciju kosti, kao što je zoledronatna kiselina (vidjeti dio 4.4).
Asthenia, peripheral oedema, injection site reactions (including pain, irritation, swelling, induration), chest pain, weight increase, anaphylactic reaction/shock, urticaria
astenija, periferni edemi, reakcije na mjestu primjene injekcije (uključujući bol, iritaciju, oteklinu i otvrdnuće), bol u prsištu, povećanje tjelesne težine, anafilaktična reakcija/šok, urtikarija
• Skin reactions (redness and swelling) at the infusion site, rash, itching.
• kožne reakcije (crvenilo i oticanje) na mjestu primjene infuzije, osip, svrbež
Zoledronic acid is contraindicated in breast-feeding women (see section 4.3).
Zoledronatna kiselina kontraindicirana je tijekom dojenja (vidjeti dio 4.3).
• As a consequence of low calcium values: irregular heart beat (cardiac arrhythmia; secondary to hypocalcaemia).
• kao posljedica niskih razina kalcija: nepravilni otkucaji srca (srčana aritmija, uslijed hipokalcemije).
Do not receive Zoledronic Acid Accord:
Ne smijete primati Zoledronatnu kiselinu Accord: