Short answer: Zoledronic acid has a half-life of about 146 hours (terminal). People vary, so treat these as estimates.
Zoledronic acid is a bisphosphonate, a drug that binds to bone and slows the cells that break bone down. Reclast (Sandoz) is a 5 mg infusion into a vein given once a year or once every 2 years for osteoporosis, or once for Paget's disease of bone. The same drug is sold as Zometa for cancer-related uses.
Also known as: Reclast, zoledronate.
Reclast is a ready-to-infuse 5 mg in 100 mL solution, given into a vein by a nurse or doctor over at least 15 minutes, followed by a saline flush.
The Reclast label approves zoledronic acid to treat and prevent osteoporosis in women after menopause, to build bone in men with osteoporosis, to treat and prevent steroid-caused osteoporosis, and to treat Paget's disease of bone. Label dosing is 5 mg once a year to treat osteoporosis (women and men) and steroid-caused osteoporosis, 5 mg once every 2 years to prevent osteoporosis after menopause, and a single 5 mg dose for Paget's disease. People drink at least 2 glasses of fluid within a few hours before, and kidney function is checked before each dose. The best length of use is not known, and people at low fracture risk may be considered for stopping after 3 to 5 years.
The label has no boxed warning. It is not used with low calcium, creatinine clearance below 35 mL/min or acute kidney injury. Warnings cover kidney failure (a dose is never more than 5 mg and never faster than 15 minutes), low calcium, jaw bone death, unusual thigh fractures and severe bone, joint or muscle pain. People on Zometa are not given Reclast. In the 3-year trial of 7,736 women, fever (17.9% vs 4.6%), muscle pain (11.7% vs 3.7%) and flu-like illness (8.8% vs 2.7%) ran above placebo, mostly within 3 days of the infusion. Full numbers are on the Reclast side effects, Reclast dosing schedule, missed Reclast dose and Reclast storage pages. Comparisons: Reclast vs Fosamax and Reclast vs Prolia.
The Reclast label says blood levels fall quickly after the infusion ends, to under 1% of the peak by 24 hours, with early-phase half-lives of 0.24 and 1.87 hours, then a long low tail with a terminal half-life of 146 hours. Because it is given into a vein, the peak is at the end of the infusion, so we list no time to peak.
Numbers shown are taken from the source above. Half-life varies from person to person.
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