The Medical Letter on Drugs and Therapeutics
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A Once-Yearly IV Bisphosphonate for Osteoporosis

Zoledronic acid (Reclast – Novartis) is the first bisphosphonate approved by the FDA for once-yearly intravenous (IV) treatment of osteoporosis in postmenopausal women. Reclast is also approved for treatment of Paget’s disease. Another IV formulation of zoledronic acid (Zometa) is approved for treatment of hypercalcemia of malignancy, multiple myeloma and bone metastases from solid tumors.1

BISPHOSPHONATES — Zoledronic acid is the second bisphosphonate (ibandronate was the first) approved for IV treatment of osteoporosis. Oral bisphosphonates can cause heartburn, esophageal irritation and esophagitis. To ensure adequate absorption (at best <1% is absorbed) and avoid esophageal injury, they must be taken after an overnight fast, while in an upright position, along with 8 ounces of plain (not mineral) water. After taking the drug, the patient must take nothing by ... more      

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