Calcium and bisphosphonates

There’s been some question about whether people with MM should use calcium supplements when being treated with bisphosphonates (Zometa/Aredia). Most MM patients receive one or the other by IV every 4 weeks or so. ZOMETA (zoledronic acid) is a treatment for hypercalcemia of malignancy (HCM) and for the treatment of bone metastases across a broad range of tumor types. These tumors include multiple myeloma, prostate cancer, breast cancer, lung cancer, renal cancer and other solid tumors.

Because MM breaks down our bones and releases calcium into the blood stream, some people think we need to stay away from calcium supplements. I asked my doctor about this and here is his reply:

     Some people who receive Zometa develop bony
     aches for a few days afterwards, and can also have muscle irritability
     and spasms. This is probably due to the ability of Zometa to decrease
     calcium levels, making nerve fibers and muscle more irritable, and hence
     the recommendation for calcium and vitamin D supplementation. Generally
     an over-the-counter supplement like Caltrate 600 + D (with 600 mg of
     calcium and 200 IU of vitamin D), one tablet a day, or its equivalent,
     is sufficient. 

I’ll start taking the supplement this week. My next infusion is Wednesday at 10:30 am.