Reclast

Reclast is a drug used for the treatment of Paget's disease of the bone, as well as osteoporosis in certain people. It is a bisphosphonate and works by binding to cells in bones, slowing down the rate at which they break down. It can also help the body to rebuild bone at a more normal rate. Reclast comes in injectable form and is administered by your healthcare provider. Side effects include flu-like symptoms, dizziness, and headaches.

What Is Reclast?

Reclast (zoledronic acid) is a prescription medication used for the following purposes:
 
  • Treating Paget's disease of the bone
  • Preventing and treating osteoporosis in postmenopausal women
  • Treating osteoporosis treatment in men
  • Preventing and treating osteoporosis due to glucocorticoid steroid medications (such as prednisone).
 
For osteoporosis prevention and treatment, the medication is taken as a single dose per year, given by IV (intravenously).
  
(Click Reclast Uses for more information, including possible off-label uses.)
 

Who Makes Reclast?

It is made by Novartis Pharmaceuticals.
 

How Does It Work?

Reclast belongs to a group of medications known as bisphosphonates. The drug binds to certain cells in bones and slows down the rate at which they break down, which helps to strengthen bone in people with osteoporosis. Reclast works similarly for people with Paget's disease of the bone, a condition involving rapid breakdown of bone combined with abnormal reformation of bone. The abnormally reformed bone is weaker than normal bone. Bisphosphonates such as Reclast can help slow the breakdown of bone, which helps the body to build bone more normally.
 

Effects of Reclast

One way to assess the severity of Paget's disease is by measuring the level of alkaline phosphate in the blood. In studies, Reclast was shown to decrease alkaline phosphate levels, which indicates that it helps to improve Paget's disease. Studies compared a single dose of Reclast with daily doses of Actonel® (risedronate) 30 mg, a similar medication used to treat Paget's disease. Up to 89 percent of people who took Reclast achieved normal alkaline phosphate levels, compared to just 58 percent of those taking Actonel. In addition, Reclast seemed to work more quickly than Actonel.
 
Reclast has also been studied for osteoporosis in postmenopausal women. Studies showed that one dose of Reclast per year reduces the risk of vertebral (spine) fractures, hip fractures, and fractures in general, compared to a placebo injection (an injection with no active ingredient). Both groups of women were also given vitamin D and calcium supplements. These studies also showed that Reclast can prevent the loss of height that can occur in people with osteoporosis.
 
Studies have also shown that Reclast can increase bone mineral density in postmenopausal women with low bone mass (that are at a high risk for developing osteoporosis).
 
Additionally, studies have shown that Reclast can increase bone mineral density in men with osteoporosis. Also, one study compared Reclast with oral bisphosphonate medication for treating and preventing osteoporosis due to glucocorticoid steroids (such as prednisone). This study showed that Reclast was superior for increasing bone mineral density.
 

When and How to Take Reclast

General considerations for when and how to take the medication include the following:
 
  • It comes in injectable form. For high blood calcium or Paget's disease, your healthcare provider will give Reclast as a single dose (although in some situations, re-treatment with Reclast may be necessary). For osteoporosis treatment, Reclast is given once yearly; for osteoporosis prevention, it is given once every two years.  

 

  • It is important that you are well hydrated before receiving your Reclast dose in order to protect your kidneys. Make sure to drink enough fluids in the days before you are to receive the injection.
     
  • You need to make sure that you get enough calcium and vitamin D after your Reclast dose. The medication cannot adequately build bone without calcium and vitamin D, and calcium and vitamin D help to prevent the low blood calcium that can be caused by Reclast. This is especially important during the two weeks after your dose.
     
  • In some cases of Paget's disease, your healthcare provider may recommend that you be re-treated with Reclast, although this type of use has not been studied.
     

Dosing Information

The dosage your healthcare provider recommends will vary depending on the condition being treated. As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
 
(Click Reclast Dosage for more information.)
 

Side Effects

As with any medicine, side effects are possible. However, not everyone who takes the drug will experience side effects. In fact, most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
 
Common side effects of Reclast include, but are not limited to:
 
  • Flu-like symptoms (such as fever and chills)
  • Headaches
  • Dizziness
  • Nausea
  • Joint pain or bone pain.
     
(Click Reclast Side Effects to learn more, including potentially serious side effects that you should report immediately to your healthcare provider.)
 

Drug Interactions

Reclast can potentially interact with a number of different medications (see Reclast Drug Interactions).
 

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking this medication if you have:
 
  • Low blood calcium (hypocalcemia)
  • Kidney disease, including kidney failure (renal failure)
  • Hypoparathyroidism
  • A history of thyroid or parathyroid surgery
  • Problems absorbing vitamins and minerals from your diet
  • Any allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
Make sure to tell your healthcare provider about all medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 
(Click Reclast Warnings and Precautions to learn more, including information on who should not take the drug.)
 

What If I Take an Overdose?

People who are given too much of the medication may have overdose symptoms that could include:
 
  • Low blood calcium (hypocalcemia)
  • Low blood magnesium (hypomagnesemia)
  • Low blood phosphate (hypophosphatemia).
     
If you happen to overdose, seek immediate medical attention.
 
(Click Reclast Overdose for more information.)
 

Strengths

Reclast is available in one strength -- Reclast 5 mg per 100 mL injection.
 

Generic Reclast

At this time, the drug is not available in generic form (see Generic Reclast).
 
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;
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