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Aclasta (Reclast, Zometa)

by Mathew Marshall
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Aclasta (Reclast, Zometa)

Warning: The FDA has issued a warning that aclasta has a slight risk of kidney failure.

For patients who have a medical history of kidney issues or renal problems, precautions must be taken.

Indications: This medicine, Aclasta (zoledronic acid) is considered a bisphosphonate and is used to help prevent as well as to treat osteoporosis. When bones become weak and thin out, they can break more easily and this often occurs in females who are past the menopause phase.  Aclasta can also be used to treat men who have osteoporosis.  Additionally, this medicine is often used in people who are taking glucocorticoids which have a tendency toward causing osteoporosis.  A condition where bones are weak and soft, Paget’s disease, can also be treated with this medicine.  This medicine is frequently used with chemotherapy for cancer in order to treat bone damage from cancer that has either traveled to the bones or that started in the white blood cells.

Zoledronic acid slows the breakdown of the bones, which in turn increases the thickness of the bones and helps to slow the amount of calcium the bones release into the bloodstream.


 Dosage: Aclasta is a liquid that is usually delivered by a medical professional through injection into the veins.  It takes about fifteen minutes for the entire injection to occur.  There is usually one dose given if the calcium levels in the blood are being treated, but if the patient’s calcium levels in the blood do not drop to a more normal level, an additional injection may be administered after a week has passed.

If the treatment is for cancer that has infiltrated the bones, treatments are usually given every three or four weeks. If it is in conjunction with glucocorticoids, one dose per year is usually recommended. When the treatment is for osteoporosis, the dosage is once in two years.

It is important to drink at least 16 ounces of water prior to receiving your Aclasta injection.

Overdose: Aclasta must be given exactly as directed by a health professional that has experience in chemotherapy drugs. In fact, not only zoledronic acid, but taking any medication in the right dose is the first step to better treatment. An overdose of Aclasta may cause serious kidney problems. Contact your doctor immediately if you experience these warning signs of overdose:

  • 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.

Missing dose: Avoid missing a dose; undergo the therapy exactly as recommended by your doctor.

This image has an empty alt attribute; its file name is 6562020.jpgBy taking Aclasta on time and completely is the best way to get good results from it. Therefore, be present at each appointment to take all the prescribed doses. If for some reasons you cannot go to the hospital for the treatment, contact your oncologist before the date schedule for the injection. If in spite of your efforts you miss an appointment, call your doctor as soon as possible.

Contraindication: Aclasta is a medicine that should not be prescribed to patients with severe renal problems.  If the blood test that is given indicates that the creatinine clearance is less than 35 mL/min, zoledronic acid should not be prescribed.

Taking Aclasta requires particular attention in patients suffering from these medical conditions:

  • hypocalcemia– abnormally low serum calcium levels in the blood.
  • hypomagnesemia– abnormally low level of magnesium in the blood
  • hypophosphatemia– abnormally low level of phosphorus in the blood
  • dehydration
  • kidney failure or other severe kidney damage
  • liver failure
  • heart failure
  • Recentdental surgery – the therapy can cause serious problems with the jaws.

Interactions:  As mentioned, zoledronic acid is helpful to patients who are taking glucocorticoids.  There are a number of medications that are indicated for interactions including aminoglycoside antibiotics, non-steroidal anti-inflammatory drugs, cancer chemotherapy medications and others, so it is very important to discuss all medications you may be taking before agreeing to use this medicine.

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
  • loss of weight
  • 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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