From the Guidelines
Common side effects of Reclast (zoledronic acid) include flu-like symptoms, gastrointestinal issues, pain, fatigue, and dizziness, which are typically temporary and manageable. These side effects can be minimized by drinking plenty of fluids, taking acetaminophen or ibuprofen for discomfort, ensuring adequate calcium and vitamin D intake, and maintaining good dental hygiene 1. Some patients may also experience low blood calcium levels (hypocalcemia), especially if they don't take calcium and vitamin D supplements as directed 1. Less commonly, patients might experience eye inflammation, kidney problems, or osteonecrosis of the jaw (particularly in those with poor dental health) 1. It is essential for patients to contact their healthcare provider if symptoms are severe or persistent. Key considerations for minimizing side effects include:
- Drinking plenty of fluids before and after treatment
- Taking acetaminophen or ibuprofen for discomfort
- Ensuring adequate calcium and vitamin D intake
- Maintaining good dental hygiene
- Monitoring renal function and serum calcium levels, especially in patients receiving intravenous bisphosphonates 1. Overall, while Reclast can cause various side effects, most are temporary and manageable with proper care and monitoring.
From the FDA Drug Label
Advise patients that the most common side effects of zoledronic acid injection are nausea, fatigue, anemia, bone pain, constipation, fever, vomiting, and dyspnea. The common side effects of Reclast are:
- Nausea
- Fatigue
- Anemia
- Bone pain
- Constipation
- Fever
- Vomiting
- Dyspnea 2
From the Research
Common Side Effects of Reclast
The common side effects of Reclast, also known as zoledronic acid, include:
- Acute kidney impairment, which can occur even in patients without a history of cancer or preexisting kidney impairment 3
- Hypocalcemia and hypophosphatemia, which can be severe and symptomatic 4
- Renal dysfunction, which can be a potential risk factor for patients with higher Charlson Comorbidity Index (CCI) or smoking history 5
- Osteonecrosis of the jaw, which is a rare but potentially life-threatening side effect 6
- Acute phase response, which can cause transient fever, myalgia, and bone pain 6
- Muscle twitching, spasms, and tingling, which can occur suddenly after infusion 7
- Trismus, which can be a severe side effect 7
Risk Factors for Side Effects
Certain risk factors can increase the likelihood of side effects from Reclast, including:
- Higher age 5
- Higher Charlson Comorbidity Index (CCI) 5
- Smoking history 5
- Combination of hypertension or diabetes mellitus 5
- Worse renal function indicators 5
- Baseline estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m2 5
Monitoring and Prevention
To minimize the risk of side effects, it is essential to: