Zoledronic acid, known by its brand name Reclast, is now approved by the FDA for the treatment of osteoporosis. Here is more information that may be useful in preparation for consultation with a physician about the medication.
Which osteoporosis patients are candidates for treatment with zoledronic acid?
Dr. Benjamin Lechner, a South Florida rheumatologist, often prescribes zoledronic acid for patients who have already tried other bisphosphonates, but who were forced to discontinue them because of gastrointestinal side effects. In particular, those whose bone loss is especially severe, leaving them at high risk of fracture if no medication is given, could benefit from zoledronic acid treatment. In addition, relatively younger women - in their late 50s or early 60s - whose bone densitometry readings already indicate serious trouble for their age might find this course of medication useful.
The once-yearly regimen of zoledronic acid is considered ideal for individuals who have difficulty with more frequent - weekly or monthly - compliance, such as those who suffer from memory loss. "People just get tired of taking their pills," says Dr. Lechner, who also serves as an associate professor on the University of Miami's medical school voluntary faculty. "The elderly patients, they've got so many medicines to take."
Because of the risk of atrial fibrillation, however, Dr. Lechner does not recommend zoledronic acid for patients who are especially frail or elderly. Furthermore, patients who require ongoing dental work may not be suitable candidates for treatment with zoledronic acid because of the possibility of osteonecrosis associated with bisphosphonates, especially those taken intravenously. Some patients expecting to undergo an extensive dental procedure may elect to delay the zoledronic acid infusion until after the work has been completed and the mouth and jaw have fully healed.
What about the cost of Reclast?
An annual treatment of zoledronic acid costs about $800, which is comparable to the price of other bisphosphonate medications totaled up over the course of a year. However, the FDA's recent approval does not necessarily guarantee immediate coverage by all insurance plans. "There's always that delay between good data in the literature and the carriers covering it," says Dr. Lechner, who adds that a patient may ask the physician to contact the insurance directly to request approval beforehand.
What other factors should I consider?
While your primary physician may be able to provide you more information about the drug and whether it might be right for you, bear in mind that zoledronic acid is most commonly administered by specialists such as rheumatologists and endocrinologists. With more medication options than ever to combat osteoporosis, it is essential to consult carefully with your physician to determine which drug, if any, might be right for you.
The various medications - bisphosphonates and others - each have their particular benefits and drawbacks, and the bone health of each individual is unique. "Ultimately, which one is the absolute best to use is patient specific," says Dr. Lechner.
Published On: August 22, 2007