Reclast

Reclast is the brand name for zoledronic acid, a nitrogen-containing bisphosphonate used to treat bone disorders by reducing bone resorption. It is administered as an intravenous infusion in a clinical setting. Zoledronic acid binds to bone mineral and inhibits osteoclast-mediated bone resorption, leading to increased bone mineral density and a lower risk of fractures.

Indications include treatment of osteoporosis in postmenopausal women and men at high fracture risk, prevention of glucocorticoid-induced osteoporosis, and treatment of Paget’s disease of bone in adults. The drug may be used on a yearly basis for osteoporosis and typically as a single 5 mg infusion for Paget’s disease; retreatment decisions depend on response and guidelines.

Administration and dosing: For osteoporosis, Reclast is given as a 5 mg IV infusion over about 15 minutes once yearly. Before infusion, assess and correct electrolyte imbalances, especially calcium, phosphate, magnesium, and vitamin D status, and ensure adequate calcium and vitamin D intake. Renal function should be evaluated; use is not recommended in severe renal impairment (creatinine clearance below 35 mL/min). Hydration is advised, and patients should be monitored for infusion-related reactions.

Adverse effects and safety: Common post-infusion symptoms include fever, flu-like symptoms, fatigue, and musculoskeletal pain. Hypocalcemia can occur, particularly in those with vitamin D deficiency or low calcium intake. Rare but serious risks include osteonecrosis of the jaw and atypical femoral fractures, especially with long-term use. Dental health should be reviewed prior to starting therapy. Contraindications include hypocalcemia, pregnancy, and significant renal impairment; cautions include restoring mineral balance and avoiding concurrent administration of calcium or other minerals close to the infusion.