Aclasta (Reclast; Zoledronate) is a bisphosphonate medicine used to treat and prevent thinning of the bones (osteoporosis) and to treat a condition called Paget’s disease.
Aclasta is given once a year by an intravenous (IV) infusion. Infusions take about 15 minutes and must be done at a specialized clinic by a nurse or doctor.
Its important to take calcium & vitamin D while taking Aclasta to help build the bones. Doctors who prescribe Aclasta will advise their patients on the right amount of calcium and vitamin D to take.
Important Tests and Risks
Bone Mineral Density (BMD) Test
People taking Aclasta should undergo Bone Mineral Density (BMD) tests so their doctor can monitor their body’s response to the medication. This test is usually done once every 1 to 3 years.
Risk of Pain in the Jaw
Biphosphonate medicines like Aclasta have been associated with a very rare problem with the jaw called osteonecrosis.
This problem is sometimes seen after dental work. Patients should let their doctor know if they develop sudden pain in the jaw.
Alcohol is known to increase fracture risk by decreasing bone mineral density and promoting osteoporosis.
People taking Aclasta should stop drinking alcohol, or at least reduce the amount of alcohol that they drink.
How Aclasta Works
The body features an ongoing process called bone remodelling where bones are constantly broken down (called bone resorption) and built back up.
Bones are broken down by a type of cell called osteoclasts and are built back up by a type of cell called osteoblasts.
In patients with Paget’s disease and osteoporosis, too much bone is being broken down too quickly.
All bisphosphonate medications, including Aclasta, bind to the surface of bones and slow down the bone resorption process. This works because it is toxic to the osteoclasts that break down bone.
When Aclasta slows down the resorption process, it gives the body more time to build up and strengthen the bones.
People taking Aclasta should talk to their doctor if they are concerned about any side effects.
Potential side effects of this medication include:
- Fever & flu-like symptoms – After receiving Aclasta, some patients have developed a fever and flu-like symptoms including “feeling out of sorts”, chills, fatigue, and weakness. These symptoms are usually mild to moderate and go away after a few days.
- Pain in the Jaw (osteonecrosis) – Medicines like Aclasta have been associated with a very rare problem with the jaw called osteonecrosis. This problem has been seen after dental work. Patients should let their doctor know if they develop sudden pain in the jaw.
- Nausea & diarrhea – Aclasta can cause nausea, vomiting, and diarrhea
- Headache & dizziness – Aclasta can rarely cause a headache or dizziness
- Muscle & bone pain – Aclasta can cause bone, muscle, or joint pain. This can be severe but is rare.
- Heart problems – Aclasta has been associated with abnormal heart rhythms (atrial fibrillation). Patients should tell their doctor if they have a heart rhythm problem.
Who Shouldn’t Take Aclasta
People who should NOT be taking Aclasta include those who are:
- Allergic to Aclasta or any ingredient in this medicine
- Allergic to other biphosphonate medications
- Pregnant or breast-feeding
- Experiencing decreased kidney function
Anyone who becomes pregnant while taking Aclasta should notify their doctor immediately.
When to Call a Doctor
People taking Aclasta should call a doctor if they feel sick and want to stop, or if they are concerned about any side effects.
People who feel sick after receiving an infusion should contact their doctor. Other reasons to call a doctor while taking Aclasta include:
- Stomach pain or trouble swallowing
- Pregnant or planning pregnancy
- New severe pain in the jaw
- About to have surgery
Watch Dr. Andy Thompson, a Canadian rheumatologist, introduce Aclasta.