zoledronic acid, Reclast
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: zoledronic acid
BRAND NAME: Reclast
DRUG CLASS AND MECHANISM: Zoledronic acid is an injectable drug belonging to a class of drugs called bisphosphonates that strengthen bone and are used primarily to treat osteoporosis. Zoledronic acid also is the active drug in Zometa, which is used for treating cancer. The bisphosphonate class includes etidronate (Didronel), pamidronate (Aredia), risedronate (Actonel), ibandronate (Boniva), and tiludronate (Skelid). Bone is in a constant state of remodeling. New bone is laid down by cells called osteoblasts while old bone is removed by cells called osteoclasts. Bisphosphonates strengthen bone by inhibiting bone removal (resorption) by osteoclasts. After menopause, there is an increased rate of bone loss leading to osteoporosis. Bisphosphonates increase bone density and decrease bone fractures. The FDA approved Reclast in August 2007.
GENERIC AVAILABLE: No
PREPARATIONS: Solution: 5 mg/100 ml
STORAGE: Unopened bottles should be kept at room temperature 15-30 C (59-86 F). Opened bottles of solution are stable for 24 hours at 2-8 C (36-46 F).
PRESCRIBED FOR: Zoledronic acid is used for treatment of osteoporosis in men and postmenopausal women as well as Paget's disease. It also is used to prevent osteoporosis in postmenopausal women and treatment of steroid-induced osteoporosis.
DRUG INTERACTIONS: Combining zoledronic acid with aminoglycoside antibiotics such as gentamycin or loop diuretics such as furosemide (Lasix) or bumetanide (Bumex) may lead to reduced calcium in blood. Zoledronic acid should be used with caution in patients who are taking drugs that affect kidney function because zoledronic acid has been associated with reduced kidney function. Since Reclast contains the same active ingredient as Zometa (zoledronic acid), patients treated with Zometa should not receive Reclast.
NURSING MOTHERS: It is not known whether zoledronic acid is excreted in human milk. Since many drugs are excreted in human milk, and zoledronic acid binds to bone long-term, zoledronic acid should not be administered to nursing women.
SIDE EFFECTS: The most common adverse reactions of zoledronic acid are fever, muscle pain, headache, and pain in hands and feet. Severe bone, joint, and muscle pain may occur. Low calcium levels may occur if calcium and vitamin D intake is not adequate. Reduced kidney function after administration of zoledronic acid has occurred. Patients may experience jaw problems (osteonecrosis of the jaw) associated with delayed healing and infection after tooth extraction. Bone, joint, and muscle pain also occur and low-trauma femoral fractures have been reported. Rare cases of severe allergic reactions involving shock, swelling of tongue, throat, and closure of airways have been reported.
Reference: FDA Prescribing Information
Last Editorial Review: 3/21/2012
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