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Aclasta (Zoledronic Acid): The Once-Yearly Infusion for Osteoporosis

MEDICAL INFORMATION: This information is for educational purposes only and is intended for healthcare professionals and informed patients. Aclasta® is a prescription medication that must be administered by a qualified healthcare provider in a clinical setting. It is NOT for self-administration.

Aclasta® (Zoledronic Acid) 5 mg/100 ml IV Infusion

Summary

Aclasta® is a high-potency, intravenous (IV) bisphosphonate medication containing Zoledronic Acid. It is primarily used for the treatment of osteoporosis, where it works to increase bone density and significantly reduce the risk of fractures. A key feature of Aclasta is its long-acting formulation, allowing for administration as a single IV infusion just once a year. It is also used to treat Paget's disease of bone and to prevent new fractures after a hip fracture.

Manufacturer

Sandoz (a Novartis division).

Category & Active Ingredient

  • Category: Bisphosphonate; Bone Resorption Inhibitor.
  • Active Ingredient: Zoledronic Acid 5 mg per 100 ml vial.

Available Forms

Aclasta is available as a ready-to-use solution for intravenous infusion in a 100 ml vial.

Mechanism of Action

Zoledronic acid works by inhibiting osteoclasts, the cells responsible for breaking down bone tissue. By slowing down this bone loss process, it allows the bone-building cells (osteoblasts) to work more effectively, leading to a net increase in bone mass and strength.

Indications for Aclasta®

  • Treatment of Osteoporosis in postmenopausal women and in men.
  • Prevention of new clinical fractures after a recent low-trauma hip fracture.
  • Treatment of Paget's disease of bone.
  • Treatment and prevention of glucocorticoid-induced osteoporosis (osteoporosis caused by long-term steroid use).

Dosage and Administration

For Professional Administration Only

Aclasta must be administered by a healthcare professional via intravenous infusion:

  • Dosage for Osteoporosis: A single 5 mg infusion given once a year.
  • Administration: The 100 ml solution is infused slowly into a vein over a period of at least 15 minutes.
  • Pre-treatment Requirements: Patients must be adequately hydrated. Blood tests to check kidney function and calcium levels are mandatory. Any pre-existing hypocalcemia (low blood calcium) must be corrected before starting Aclasta.

Side Effects

The most common side effects are often part of an "acute-phase reaction" that can occur within the first three days after the infusion. These symptoms are usually mild and include fever, headache, and muscle/joint pain. Other potential side effects include:

  • Common: Nausea, vomiting, diarrhea.
  • Serious but Rare:
    • Kidney Problems: Can cause severe renal impairment.
    • Hypocalcemia: A significant drop in blood calcium levels.
    • Osteonecrosis of the Jaw (ONJ): A rare but serious condition involving severe jaw bone problems.
    • Atypical Femur Fractures: Unusual fractures of the thigh bone with long-term use.
    • Eye Problems: Such as uveitis (inflammation of the eye).

Contraindications

Aclasta should not be used in patients with:

  • Hypocalcemia (low blood calcium).
  • Severe renal impairment (creatinine clearance <35 mL/min).
  • Known hypersensitivity to zoledronic acid or other bisphosphonates.

Warnings & Drug Interactions

  • Hydration: Ensure the patient is well-hydrated before and after the infusion to minimize kidney risk.
  • Calcium & Vitamin D: Patients must have an adequate daily intake of calcium and vitamin D.
  • Dental Health: Good oral hygiene is crucial. Inform your dentist you are on Aclasta before any dental procedures.
  • Drug Interactions: Use with caution with other drugs that can affect the kidneys (e.g., NSAIDs, aminoglycosides) or with loop diuretics, which may increase the risk of hypocalcemia.

References

  1. U.S. Food and Drug Administration (FDA): For official prescribing information. FDA - Aclasta Prescribing Information
  2. European Medicines Agency (EMA): For European public assessment reports. EMA - Aclasta
  3. Product Information: Sourced from Sandoz/Novartis.

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