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