Reclast (Zoledronic Acid) for Osteoporosis

What Members Say Top Tips Side Effects FAQs

Reclast (zoledronic acid) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat osteoporosis in women after menopause. It is also approved to increase bone mass in men with osteoporosis.

What Members Say

MHT logo These insights are based on 2,568 comments about Reclast from MyOsteoTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Once-yearly intravenous (IV) dosing feels simpler than taking osteoporosis medicine more often.
Bone density often improves or stays stable on follow-up DEXA scans.
Side effects often lessen with later yearly infusions.

Considerations:

Kidney function and hydration need attention before treatment, especially with older age.
Eye inflammation or vision changes can occur and need prompt medical attention.
Jaw problems and dental work need discussion before treatment and during follow-up.

How Reclast Works and How It’s Taken

Reclast is a type of medicine called a bisphosphonate. It slows the activity of cells called osteoclasts, which break down bone. This helps reduce bone loss.

In women with osteoporosis after menopause, Reclast has been shown to lower the risk of hip, spine, and other osteoporosis-related fractures.

Doctors prescribe Reclast when treatment is needed to:

Treat or prevent osteoporosis in women after menopause
Increase bone mass in men with osteoporosis
Treat or prevent osteoporosis caused by glucocorticoid medicines in certain men and women

Reclast is given into a vein as an intravenous infusion. The infusion must last at least 15 minutes.

Before receiving Reclast, drink at least two glasses of fluid, such as water, within a few hours before the infusion, as directed by your doctor. You may eat before your treatment.

Typical Dosing for Osteoporosis

The recommended dose and schedule depend on why Reclast is being used.

Treatment of osteoporosis in women after menopause — 5 milligrams once a year.
Prevention of osteoporosis in women after menopause — 5 milligrams once every two years.
Osteoporosis in men — 5 milligrams once a year.
Treatment or prevention of osteoporosis caused by glucocorticoid medicines — 5 milligrams once a year.

If dietary intake is not enough, an average of at least 1,200 milligrams of calcium and 800 to 1,000 international units of vitamin D each day is recommended.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Reclast

MHT logo These insights are based on 2,568 comments about Reclast from MyOsteoTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Members who use Reclast often say it helps to prepare for the infusion, know that short-term flu-like side effects can happen, and keep your doctor updated about anything unusual or severe. Many members also describe pairing treatment with follow-up scans, supplements, and regular exercise as part of their overall bone health plan.

1

Drink plenty of water around infusion day.
“My endocrinologist told me to hydrate before the infusion. I drank plenty of water the day before, before my appointment, and during the infusion.”
2

Keep track of side effects and tell your doctor.
“I had blurry vision day after. Dr. gave me steroid eye drops. Said inflammation in my eyes. Still have some blurred vision.”
3

Talk to your doctor about dental work before treatment.
“Before my Reclast infusion, I talked with my dentist and had my mouth and teeth checked. It helped me make sure any dental concerns were addressed before treatment.”

Connect with others who understand life with osteoporosis. Join MyOsteoTeam for free.

Reclast Side Effects

In clinical studies of Reclast, the most common side effects occurred in about 11 percent to 24 percent of people. These included:

Pyrexia (fever)
Joint pain
Muscle pain
Headache
Pain in the arms or legs

Serious Side Effects and Warnings

Reclast can cause serious side effects that may require immediate medical attention. These include:

Hypocalcemia (low calcium levels in the blood) — This can cause muscle cramps or spasms, or numbness and tingling.
Severe kidney problems — These can include acute kidney failure.
Osteonecrosis of the jaw — This jawbone damage can cause jaw pain, swelling, or a sore in the mouth that does not heal.
Atypical femur fractures — These unusual thigh bone fractures can cause new or unusual hip, groin, or thigh pain.
Severe bone, joint, or muscle pain — This pain can be severe and sometimes disabling.
Uveitis or iritis (eye inflammation) — This can cause eye pain, redness, or vision changes.
Atrial fibrillation (an irregular heartbeat) — This may cause palpitations, dizziness, or shortness of breath.
Severe allergic reactions — These can include anaphylaxis, angioedema, or severe skin reactions such as Stevens-Johnson syndrome.
Bronchoconstriction and asthma exacerbations — Tightening of the airways can cause wheezing or trouble breathing.

Get medical help right away if you think you are having a serious reaction.

What To Know Before Taking Reclast

Before starting Reclast, your doctor will examine your mouth and teeth. Before each dose, your doctor will check your kidney function with a blood test and calculate your creatinine clearance.

Tell your doctor if you are allergic to zoledronic acid or any ingredient in Reclast.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Be sure to tell your doctor if you take:

Certain antibiotics called aminoglycosides
Diuretics, sometimes called water pills
Nonsteroidal anti-inflammatory drugs (NSAIDs)

Also tell your doctor if you:

Have low calcium levels in your blood
Have kidney problems
Have had thyroid or parathyroid surgery
Have trouble absorbing minerals from your stomach or intestines
Have had part of your intestine removed
Have asthma caused by aspirin
Plan to have dental surgery or a tooth removed

Do not take Reclast if you:

Have low calcium levels in your blood
Have creatinine clearance below 35 milliliters per minute
Have acute kidney impairment
Are allergic to zoledronic acid or any ingredient in Reclast

Reclast is also FDA-approved to treat certain men and women with Paget’s disease of bone.

If you miss a dose of Reclast, call your doctor or healthcare provider to schedule your next dose.

Reclast should not be used during pregnancy. If you are pregnant, plan to become pregnant, are breastfeeding, or plan to breastfeed, talk with your doctor before receiving Reclast.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Reclast for osteoporosis?

In a three-year study of women with osteoporosis after menopause, Reclast lowered the risk of several types of fractures. New spine fractures occurred in 3.3 percent of women who received Reclast compared with 10.9 percent who received placebo (an inactive treatment). This was a 70 percent relative reduction.

Hip fractures occurred in 1.4 percent of women who received Reclast compared with 2.5 percent who received placebo. This was a 41 percent relative reduction. Any clinical fracture occurred in 8.4 percent of people who received Reclast compared with 12.8 percent who received placebo.

Over three years, Reclast also increased bone mineral density by 6.7 percent at the lower spine, 6.0 percent at the total hip, and 5.1 percent at the femoral neck compared with placebo. In another study of people with osteoporosis who had recently had a low-trauma hip fracture, 8.6 percent of people who received Reclast had a clinical fracture compared with 13.9 percent of people who received placebo at 24 months.

How long does Reclast take to work for osteoporosis?

In the main osteoporosis study, fewer new spine fractures were seen within the first year. At year 1, 1.5 percent of women who received Reclast had at least one new spine fracture compared with 3.7 percent who received placebo. Bone mineral density was also higher with Reclast than placebo at 12, 24, and 36 months.

The prescribing information does not give one exact time when every person will experience a benefit.

Does Reclast interact with other medicines?

Yes. Reclast can interact with some medicines.

Aminoglycoside antibiotics — These may increase the risk of low calcium levels in the blood for a longer period.
Loop diuretics (“water pills”) — These may also increase the risk of low blood calcium.
Medicines that can affect the kidneys — Reclast should be used with caution with potentially kidney-harming medicines, including NSAIDs.
Medicines mainly removed by the kidneys — If kidney function is reduced, levels of these medicines may increase.

Tell your doctor about all prescription medicines, over-the-counter medicines, vitamins, and herbal supplements you take before receiving Reclast.