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Reclast

Generic Name: zoledronic acid (ZOE le DRON ik AS id)
Brand Names: Reclast, Zometa

What is Reclast?

Reclast (zoledronic acid) (sometimes called zoledronate) is a bisphosphonate medicine that alters bone formation and breakdown in the body. This can slow bone loss and may help prevent bone fractures.

Reclast is used in men and women to treat or prevent osteoporosis caused by menopause or by taking steroids. Reclast is also used to increase bone mass in men who have osteoporosis, and to treat Paget's disease of bone in men and women.

Zometa is another brand of zoledronic acid used to treat high blood levels of calcium caused by cancer and multiple myeloma.

You should not use Reclast and Zometa at the same time.

Important information

Reclast may harm an unborn baby. Avoid getting pregnant while using this medicine and tell your doctor if you become pregnant.

Reclast can cause serious kidney problems, especially if you are dehydrated, if you take diuretic medicine, or if you already have kidney disease. Call your doctor if you urinate less than usual, if you have swelling in your feet or ankles, or if you feel tired or short of breath.

Also call your doctor if you have muscle spasms, numbness or tingling (in hands and feet or around the mouth), new or unusual hip pain, or severe pain in your joints, bones, or muscles.

Your doctor may recommend you have a dental exam for preventive tooth and gum care before you start your treatment with zoledronic acid. This is especially important if you have cancer, if you are undergoing chemotherapy or using steroids, or if you have poor dental health.

Some people using medicines similar to Reclast have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms of this condition may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums. You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and pre-existing dental problems.

Before taking this medicine

You should not be treated with Reclast if you are allergic to zoledronic acid.

You also should not receive Reclast if you have:

  • low levels of calcium in your blood (hypocalcemia); or

  • severe kidney disease.

You should not be treated with this medicine if are currently using any other bisphosphonate (such as alendronate, etidronate, ibandronate, pamidronate, risedronate, or tiludronate).

To make sure Reclast is safe for you, tell your doctor if you have ever had:

  • kidney disease;

  • hypocalcemia;

  • thyroid or parathyroid surgery;

  • surgery to remove part of your intestine;

  • asthma caused by taking aspirin;

  • any condition that makes it hard for your body to absorb nutrients from food (malabsorption); or

  • a dental problem (you may need a dental exam before you receive Reclast).

Reclast can cause serious kidney problems, especially if you are dehydrated, if you take diuretic medicine, or if you already have kidney disease.

In rare cases, this medicine may cause bone loss (osteonecrosis) in the jaw. Symptoms include jaw pain or numbness, red or swollen gums, loose teeth, or slow healing after dental work. The longer you use Reclast, the more likely you are to develop this condition.

Osteonecrosis of the jaw may be more likely if you have cancer or received chemotherapy, radiation, or steroids. Other risk factors include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.

Zoledronic acid may harm an unborn baby. Use effective birth control to prevent pregnancy while you are using this medicine. Tell your doctor if you become pregnant. You may also need to use birth control for several weeks after you last received Reclast. This medicine can have long-lasting effects on your body.

Zoledronic acid can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How is Reclast given?

Reclast is injected into a vein through an IV. A healthcare provider will give you this injection.

Reclast is sometimes given as a single dose only one time. It may also be given once every 1 or 2 years. How often you receive Reclast will depend on why you are using this medicine. Follow your doctor's instructions.

Drink at least 2 glasses of water within a few hours before your injection to keep from getting dehydrated.

You may need frequent medical tests to help your doctor determine how long to treat you with Reclast. Your kidney function may also need to be checked.

Pay special attention to your dental hygiene while using Reclast. Brush and floss your teeth regularly. If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using zoledronic acid.

Reclast is only part of a complete program of treatment that may also include diet changes and taking calcium and vitamin supplements. Follow your doctor's instructions very closely.

Your doctor will determine how long to treat you with this medicine. Reclast is often given for only 3 to 5 years.

Reclast dosing information

Usual Adult Dose for Paget's Disease:

5 mg IV infusion, at a constant infusion rate, over no less than 15 minutes

Calcium and vitamin D supplementation:
-Calcium: 750 mg elemental calcium orally twice a day, or 500 mg orally three times a day
-Vitamin D: 800 international units orally daily, especially in the 2 weeks following drug administration

Comments: Retreatment may be considered in patients who have relapsed, based on increases in serum alkaline phosphatase or failure to achieve normalization of serum alkaline phosphatase.

Uses: Paget's disease of bone with elevations in serum alkaline phosphatase of two times or higher than upper limit of age- specific normal reference range

Usual Adult Dose for Osteoporosis:

5 mg IV infusion over no less than 15 minutes, once a year

Comments: An average of at least 1200 mg calcium and 800 to 1000 international units vitamin D daily is recommended.

Uses:
-Osteoporosis in postmenopausal women, diagnosed by bone mineral density or prevalent vertebral fracture (this drug reduces the incidence of fractures).
-To increase bone mass in men with osteoporosis.
-Treatment of glucocorticoid-induced osteoporosis in men and women who are either initiating or continuing systemic glucocorticoids in a daily dosage equivalent to 7.5 mg or greater of prednisone and are expected to remain on glucocorticoids for at least 12 months.

Usual Adult Dose for Prevention of Osteoporosis:

5 mg IV infusion over no less than 15 minutes, every 2 years

Uses:
-Prevention of osteoporosis in postmenopausal women.
-Prevention of glucocorticoid-induced osteoporosis in men and women who are either initiating or continuing systemic glucocorticoids in a daily dosage equivalent to 7.5 mg or greater of prednisone and are expected to remain on glucocorticoids for at least 12 months.

Dosage Information (comprehensive)

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Reclast injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving Reclast?

Avoid smoking, or try to quit. Smoking can reduce your bone mineral density, making fractures more likely.

Avoid drinking large amounts of alcohol. Heavy drinking can also cause bone loss.

Reclast side effects

Get emergency medical help if you have signs of an allergic reaction to Reclast: hives; wheezing, chest tightness, trouble breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • new or unusual pain in your thigh or hip;

  • jaw pain, numbness, or swelling;

  • kidney problems - little or no urination, swelling in your feet or ankles, feeling tired or short of breath;

  • severe joint, bone, or muscle pain; or

  • low calcium levels - muscle spasms or contractions, numbness or tingly feeling (around your mouth, or in your fingers and toes).

Serious side effects on the kidneys may be more likely in older adults.

Common Reclast side effects may include:

  • nausea, vomiting, diarrhea, constipation;

  • bone pain, muscle or joint pain;

  • fever or other flu symptoms;

  • pain in your arms or legs;

  • red or puffy eyes;

  • headache, tiredness; or

  • trouble breathing.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects (complete list)

What other drugs will affect Reclast?

Zoledronic acid can harm your kidneys. This effect is increased when you also use certain other medicines, including: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, medicine to prevent organ transplant rejection, injectable osteoporosis medication, and some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).

Other drugs may interact with zoledronic acid, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about Reclast.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Reclast only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2017 Cerner Multum, Inc. Version: 16.01.

Date modified: December 07, 2017
Last reviewed: November 08, 2017

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