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Reclast (Zometa®, Aclasta)

Warning: Reclast (Zoledronic acid) is associated with the risk of kidney (renal) failure. Although rare, serious kidney failure has been associated with the use of Reclast in patients with a history of or risk factors for kidney problem. Cases of acute renal failure requiring dialysis or having a fatal outcome following Reclast use have been reported to FDA. Tell your health care provider if you have any history of kidney disease before undergoing the treatment.

Indications: This drug is for the treatment of a specific bone disease (Paget’s disease) and osteoporosis in men, and in women after menopause. It also may be used in people that need to take corticosteroids over a long period of time to prevent osteoporosis. It works by slowing bone loss and keeping bones strong. It also reduces the chance for broken bones. This medication belongs to a class known as bisphosphonates.

Reclast is used to treat hypercalcemia (high blood calcium) caused by cancer with or without metastases. The drug is also used as prevention of complications (fracture of a bone, or bone pain that requires surgery or radiotherapy) due to the spread of cancer to bones (bone metastases) from different types of tumors. 

Along with the medication, you may be recommended to take calcium supplement and a multivitamin containing vitamin D to prevent bone damage. Reclast may be recommended for other medical conditions that are not mentioned in this article; talk to your doctor or pharmacist for more information.  

Dosage:  Reclast is given intravenously slowly over 15 minutes, by a healthcare professional. The dose you are given depends on your body size, medical condition and response to therapy. The maximum dose for adults is 5 milligrams.

Eat and drink normally on the day of treatment. Drink 2 full glasses of fluid before treatment, unless otherwise prescribed by your doctor. It is important to take in plenty of fluids while taking this drug.

Your doctor may want you to take calcium and vitamin D supplements while taking this medication. If you suffer from Paget’s disease you should take these 2 weeks after your treatment. Vitamin D and calcium are important to take to prevent low levels of calcium in the blood. Tell your doctor immediately if you suffer from any signs of low calcium, such as numbing/tingling (especially in the mouth/lips), and muscle spasms.

For medication of Paget’s disease Reclast is given once and then repeated depending on your symptoms. For osteoporosis it is given once a year.

Overdose:  Reclast must be given exactly as directed by a health professional that has experience in chemotherapy drugs. In fact, not only zoledronic acid, but taking any medication in the right dose is the first step to better treatment. An overdose of Reclast may cause serious kidney problems. Contact your doctor immediately if you experience these warning signs of overdose:  

  • seizures  
  • confusion  
  • double vision  
  • shortness of breath  
  • sudden tightening of muscles  
  • muscle cramps or/and weakness  
  • fast, pounding, or irregular heartbeat
  • difficulty walking or/and speaking  
  • Numbness, burning, or tingling in fingers or toes.   

Contraindications: Before you start this medication tell your doctor if you are allergic to bisphosphonates such as alendronate or risedronate, or if you have any wheezing (trouble breathing) after taking aspirin, or of any known allergies that you have.

Before use tell your doctor of your medical history, including kidney problems, problems taking vitamin D or calcium, low calcium levels in the blood, recent or planned dental surgery, gut problems (malabsorbtion, surgery of the small intestine), treatment with zoledronic acid (for cancer), parathyroid/thyroid problems, and dehydration (severe loss of water).

Interactions: Keep a list of all medications you are taking. Your doctor and pharmacist should know of all possible interactions.

Some products are known to cause interactions with this medication, such as mineral supplements (e.g. calcium, magnesium, and phosphorous), water pills (diuretics such as bumetanide, furosemide, and hydrochlorothiazide).

You should also tell your doctor if you are taking any medications that can harm your kidneys, such as aminoglycoside antibiotics, amphotericin B, cyclosporine, nonsteroidal anti-inflammatory durgs, tacrolimus, and vancomycin.

Side effects:  In addition to attacking cancer cells, Reclast  also affects some normal cells and cause adverse effects in most patients. Most common Reclast side effects include

  • intense thirst
  • diarrhea
  • bone or joint pain
  • swollen legs
  • fatigue
  • white vaginal discharge
  • hair loss
  • heartburn
  • fever
  • headaches
  • loss of appetite
  • loss of weight
  • nausea and vomiting
  • difficulty falling asleep or staying asleep
  • white patches in the mouth
  • redness of the eye or excessive tearing
  • redness or swelling at the injection site
  • Numbness, burning, or tingling in fingers or toes 

If  the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor if you experience any of these symptoms: 

  • chest pain   
  • painful or swollen gums  
  • Poor healing of the gums 
  • loosening of the teeth  
  • sudden high blood pressure or irregular heartbeat  
  • numbness or the feeling of heaviness in the jaw  
  • signs of infections: rash, hives, itching, fever, sore throat   
  • swelling of the eyes, face, lips, tongue and/or throat  
  • swelling of the hands, arms, feet, ankles, and/or lower legs  
  • difficulty breathing or swallowing  
  • numbness or tingling around the mouth  
  • sudden tightening of muscles  
  • Unusual bruising or bleeding.   

 

References: 

http://www.pharma.us.novartis.com/product/pi/pdf/Reclast.pdf 

http://www.us.Reclast.com/info/cancer_bones/dental_health.jsp