Smart Leaf Press

Reclast ; Once a Year Treatment for Osteoporosis

11/9/09


Osteoporosis affects more than ten million women in the United States. Given that the condition affects such a large portion of our population, drug companies are racing to come up with newer, better therapies for the osteoporosis including drugs that cost less and have fewer side effects. Their race to capture a piece of the market means more innovative therapies for us, the consumer. For example, first came  the once daily osteoporosis pills and then nasal sprays. Then came the once weekly osteoporosis pill. Then a pill that could be taken every other week was approved. Finally, the most recent development was the approval of an intravenous (IV) infusion that could be given once every 3 months.  Now, a once-yearly (yes ‘yearly’) IV treatment is being made available for the treatment of osteoporosis.  This once yearly IV treatment for osteoporosis is called Reclast and is sold by prescription.
 
How Is Reclast Given?
 
Reclast (zoledronic acid) is given once a year as an IV infusion in the doctor’s office. After starting a temporary IV line, the doctor will administer the Reclast solution over about 15 minutes. 
 

What About Side Effects?
 
Reclast has few side effects, however, patients who receive Reclast should have their blood calcium and phosphorus levels monitored by their doctor at regular intervals. Additional supplementation of these elements may be necessary. In fact, it is recommended that women who take Reclast for osteoporosis consume 1200mg elemental calcium and 400 to 800IU of vitamin D daily.
 
Prior to receiving a dose of Reclast, you should make sure you are properly hydrated to prevent problems with your kidneys. Some women may also experience temporary side effects right after the dose such as fever, muscle aches and headache. Taking acetaminophen or ibuprofen after the dose may help. Check with your doctor to see if it would be ok for you to take acetaminophen or ibuprofen should you need to. 
 
Other drugs in the same class as Reclast have been associated with a weakening of the jaw bone and a subsequent increased risk of serious deterioration of the jaw bone. This risk is more prevalent if the bone is exposed to trauma. For this reason, women should finish any major dental work before receiving a dose of Reclast®.    
 
Lastly, recent trials have found a correlation between other drugs in the same class as Reclast and an increased risk for a heart condition called atrial fibrillation. Although Reclast itself has not been directly shown to have this correlation, one should keep in mind that the possibility exists that Reclast may also share this side effect. Talk to your doctor if you have a history of heart arrhythmias before taking Reclast. If you notice any abnormal palpitations or shortness of breath while taking Reclast, let your doctor know immediately. 

 
What Does It Cost?
 
Reclast is significantly less expensive than its IV competitor (Boniva) that is given once every 3 months. A one year supply of Reclast will cost somewhere around $1300 versus a one year supply of Boniva which will run about twice that. If you are covered under insurance, it is important to keep in mind that your insurance company may not cover the therapy and may require you to try less expensive therapies first (such as pills). 
 
The Bottom Line
 
When it comes to osteoporosis, prevention is the key. However, many of us will end up needing to treat our osteoporosis at some point in our lives. IV infusions that occur once yearly or once every three months have not been shown to be any more effective than traditional osteoporosis treatments such as pills taken once weekly. Many women also find these IV infusions to be more convenient. Convenience can come at a price, however. In other words, these IV treatments are generally more expensive than good, old fashioned pills. If convenience would help you make sure you didn’t miss a dose of your therapy, you may opt for the once yearly or once every three month IV infusion. If you are perfectly content to take your osteoporosis pills once a week, then by all means, please do. The availability of different therapy options is simply meant to make treating osteoporosis easier than ever. 
 


Author: Christi Larson, Pharm. D.


Dr. Larson is a Clinical Infusion Pharmacist and author of Empowered Medicine; A Guide for Consumers . Get your copy of this one-of-a-kind medication reference and find out if YOUR doctor is following the guidelines.

 

 

 

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