IV Reclast and Zometa are Zolendronate Part 1

May 2, 2011 4 Comments

Reclast and Zometa are both Zolendronate, a bisphosphonate antiresorptive.  Because they are given as a shot into a vein (IV) they have no heartburn, GERD, esophagus or stomach issues.  This makes Zolendronate an antiresorptive which can be used if you have GERD.

Reclast is used for Osteoporosis treatment.  Reclast is given once a year.  Zometa is used in cancer patients in higher total doses twice a year, especially those whose cancer has spread to bone as metastatic cancer.

Reclast is given once every year.  It is 12 times as much drug as a monthly dose.  Zometa is 10 times as much drug as a monthly dose and given twice a year.  These higher doses mean that you must have normal kidney function for these drugs to be safe.  Reclast requires a GFR of at least 35.  Zometa requires a higher GFR.  As long as your kidneys are functioning at least this well, the drugs are safe.  Many individuals over 80 and some who are younger no longer have kidney function this good.

Reclast has been used in a few patients with rare cases of Osteonecrosis of the Jaw (ONJ) and Atypical Fractures of the Femur.  Zometa is a higher dose and used in patients more likely to have these problems.  Therefore Zometa has been used in the most patients with these problems.  Even so, there is not yet any conclusive evidence that Reclast, Zometa, or any other Antiresorptive or Bisphosphonate, causes these conditions.

Reclast/Zometa (Zolendronate) is a Bisphosphonate and has the same safety and effectiveness issues as others in this class except for the GI issues.  Read about these issues in the sections about Antiresorptives, Bisphosphonates, and IV Bisphosphonates.

Jay Ginther, MD                                              

2008 / Revised May 2011

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  • ann w

    is there a maximum number of doses you can have the reclast? I was told once a year for five years, but I don’t know what would happen after that?

    • Reclast is a bisphosphonate (like Fosamax, Actonel, Boniva, and their generics) and builds up in the bone
      After 3-5 years of Reclast there should be enough built up to go on “Holiday” for 2-5 years – you should be checked regularly to determine how long you as an individual can go before more medication is needed
      There are no fixed guidelines because everyone is a little different

  • berna

    r u taking funds from novartis. first u can not write an infusion as shot.and becareful what u suggest people when u have a title of dr.

    • Dr. Ginther

      I do not receive any money or other compensation from Novartis.
      I am attempting to provide easily understood information to those who seek it.
      I hope it is clear that each person needs to weigh the risks and benefits of their own personal situation and discuss it with their own physician.
      I make no recommendations about therapy except to my own patients.
      Currently about half of my patients are being treated without any pharmaceuticals.
      They do get enough calcium and vitamin D and will be rechecked.

      Jay Ginther, MD

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