Aclasta (Reclast®, Zometa®)

Warning:  Aclasta is associated with kidney damage and kidney failure. The risk is higher in patients who already have some kind of kidney dysfunction or renal impairment. Therefore, there are warnings for Aclasta from the FDA that the medication should not be used by people with a history of serious kidney or renal problems.  In the general population, there is a slight risk of kidney failure.

Indications: Zoledronic acid, sold under the name Aclasta, is one of the bisphosphonates that is used to assist in the prevention and treatment of osteoporosis.  Osteoporosis is when the bones thin and become weakened and even brittle.  This means that they are more prone to breaking, and seems to be more common in women than in men.  This treatment is prescribed primarily for women with osteoporosis who are past the age of menopause, but also can be prescribed for men who have osteoporosis, and for people taking glucocorticoids.  Glucocorticoids often contribute to osteoporosis issues.  Paget’s disease can also be treated with this medication.  This is when the bones are soft and weak.

Often, Zoledronic acid is used in conjunction with chemotherapy because the cancer often creates bone damage as it travels to the bones.  This medication helps to make the bones become thicker and to slow down the loss of calcium by the bones.

Dosage: Aclasta is only to be administered by a licensed medical professional.  It is usually in liquid form and is injected directly into the veins.  It takes approximately fifteen minutes for the injection.  There are different dosages depending on the reason for the medication.  For instance, if the treatment is to help bones that are being infiltrated by cancer, the treatment may be one injection every three or four weeks.  If your medical professional is treating your bone calcium levels, one dosage may be sufficient.  If the treatment is to help with glucocorticoids, it is usually done once per year.  Treatment of osteoporosis often means one injection every two years.  As you can see, dosages vary depending on the reason for treatment.  It is important to drink at least two glasses of water before getting an injection.

Overdose: Overdosing  Aclasta may cause serious or irreversible kidney problems. Contact your doctor immediately if you believe you have been overdosed or you are having these symptoms:

  • 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

Interactions: Several different medications are known to have adverse interactions with Zoledronic Acid, including NSAIDS such as Naproxen, aminoglycoside antibiotics, and others, so it is extremely important to let your physician know about all of the medications you are taking before you agree to this treatment.

Contraindications : This medication should not be taken by patients who have kidney disease. Blood tests should be administered prior to each dose if there is any indication of kidney or renal issues.  If the creatinine clearance is too low, Aclasta should not be administered.

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

  • intense thirst
  • diarrhea
  • bone or joint pain
  • swollen legs
  • fatigue
  • white vaginal discharge
  • hair loss
  • heartburn
  • fever
  • headaches
  • loss of appetite
  • weight loss
  • 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
  • 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


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