Reclast is the version of Zolendronate used for Osteoporosis treatment. I do not do cancer treatment, so I will not discuss Zometa here other than to say that it is used successfully to slow or stop the spread of metastatic cancer which has spread to bone. All warnings about Reclast apply to Zometa.
Reclast is given once a year by a 20-30 minute long infusion. You need to be lying down for the infusion. You need to be monitored for a full hour. This needs to be done at an infusion center.
Reclast is excreted by the kidneys. Therefore you must drink lots of water on the day of your infusion and for several days thereafter. Getting dehydrated in the first few days after Reclast can be dangerous to your kidneys. Remember also that your kidneys must be “normal” with a GFR of at least 35.
Reclast is very concentrated and very effective in stopping the osteoclast cells that eat away bone from releasing calcium from the bone. Therefore, Reclast can be dangerous without enough Calcium and Vitamin D every day for the first few weeks after a dose.
About 1/3 of patients who have never had a bisphosphonate have 3-5 days of mild flu-like symptoms after their first dose of Reclast. These symptoms are milder and only half as likely to occur with the second dose, and down by half again with the third dose. These symptoms respond to drinking lots of water and taking Tylenol or other OTC meds.
Jay Ginther, MD
2008 / Revised May 2011