Reclast (zoledronicacid) or Prolia (denosumab) are both injectable medications that a healthcare provider must give.
Both medications are approved by the Food and Drug Administration (FDA) totreat osteoporosis.
Reclast is also approved to prevent osteoporosis and treatPaget’s disease.
Getty Images / BSIP
Although the two drugs are similar in form and use, they possess notable differences.
Mainly, Reclast and Prolia belong to different drug classes.
Reclast is a bisphosphonate, and Prolia is amonoclonal antibody.
Reclast and Prolia injections also differ in their routes of administration and dosing frequency.
Getty Images / BSIP
What Is Reclast?
Generic Alternative
Reclast is also available in a generic version called zoledronic acid.
Generic Reclast also comes as an injection given as an IV infusion.
How It Works
Reclast works directly on the bones.
It blocks the action of a protein that helps break down and remove bone cells.
By doing so, Reclast prevents bones from breaking down and becoming weak.
Reclast attaches firmly to bone cells.
Because of this, its effects last longer than many other bisphosphonates.
This is called an off-label use.
Reclast is sometimes used off-label to help prevent bone loss in people taking specific treatments forbreast cancer.
What Is Prolia?
Some biologics have biosimilar versions, however.
These versions are similar to the reference product but not exactly alike.
Prolia is not available as a biosimilar.
Monoclonal antibodies, such as Prolia, work differently than bisphosphonates and other osteoporosis treatments.
Prolia prevents your body from making osteoclasts, the cells that break down and remove bone cells.
Blocking osteoclasts from removing bone cells allows bones to grow thicker and more robust.
Receiving Reclast
Your healthcare provider will give your Reclast dose by IV infusion.
For Reclast, the injection should be given for at least 15 minutes.
It’s important to keep your appointment to receive your Reclast dose.
If you have to miss an appointment, call your healthcare provider to reschedule.
You may eat as usual before your Reclast treatment.
This is to help lower your risk of having kidney problems from Reclast.
Reclast can causelow blood calcium levels.
Your healthcare provider will likely check yourcalcium levelbefore starting Reclast treatment.
Receiving Prolia
Like Reclast, Prolia is also given by a healthcare provider.
Your healthcare provider may inject this in your upper arm, thigh, or abdomen.
Be sure to keep your appointments to receive your Prolia injections.
If you miss an appointment, call your healthcare provider to reschedule as soon as possible.
If you reschedule, you may need to adjust future appointments to allow six months between doses.
Prolia may also cause low blood calcium level.
You’ll continue taking these supplements during your treatment to help prevent low blood calcium levels from Prolia.
Drug interactions can potentially affect a medication’s efficacy, safety, and long-term tolerability.
Reclast
Reclast may interact with some medications.
These include:
Keep in mind that Reclast contains the active ingredient zoledronic acid.
This is the same active ingredient in Zometa, a medication for specific cancer treatments.
If you’re receiving treatment with Zometa, your healthcare provider will not prescribe Reclast for you.
Prolia
There are no known interactions for Prolia.
However, new interactions may be discovered as new drugs are developed.
Also, let them know if you are starting any new medications.
In addition, using Reclast may cause severekidney problems.
If you already have kidney problems, check with a healthcare provider before starting Prolia treatment.
However, there are other things you could do to help with your treatment and prevent further bone loss.
Examples include:
Summary
Reclast and Prolia are both osteoporosis treatments with some similarities and differences.
Reclast is a bisphosphonate with the active ingredient zoledronic acid.
Prolia is a monoclonal antibody with the active ingredient denosumab.
Prolia is also approved to help increase bone mass in males with osteoporosis and adults receiving specific cancer treatments.
A healthcare provider must give both drugs.
Reclast is typically administered once per year by an IV infusion.
Meanwhile, once every six months, Prolia is injected under your skin.
Talking with your healthcare provider about your health history before starting treatment with Reclast or Prolia is important.
This information will help them decide whether either of these medications is safe for you to use.
Prolia may also be stored at a healthcare facility, or you may receive it from a specialty pharmacy.
Do not freeze Prolia.
You should store Prolia out of sight and out of reach of children and pets.
About 30% to 50% of people with RA develop osteoporosis.
With RA, your immune system attacks the joints in your body.
Many factors can contribute to increased bone loss with RA.
These include inflammation brought on by RA and long-term treatment with corticosteroids.
Someone taking Reclast will typically meet with their healthcare provider once per year to receive their dose.
For someone taking Prolia, they would meet once every six months.
DailyMed.Label: Reclast- zoledronic acid injection, solution.
DailyMed.Label: Prolia- denosumab injection.
2016;9:6029-6036. doi:10.2147/OTT.S115058
American College of Rheumatology.Denosumab (prolia).
Food and Drug Administration.Biosimilars.
Polyzos SA, Makras P, Tournis S, Anastasilakis AD.Off-label uses of denosumab in metabolic bone diseases.Bone.
2021;5(3):rkab099.
2017;5:17021. doi:10.1038/boneres.2017.21
Food and Drug Administration.Zometa (zoledronic acid) injection, for intravenous use.
American Kidney Fund.Stages of kidney disease (CKD).
Ashai S, Harvey NC.Rheumatoid arthritis and bone health.Clin Med (Lond).
2021;13(8):e17519.
