Short answer: The Reclast label dose is a 5 mg infusion into a vein over at least 15 minutes, once a year for treating osteoporosis in women and men and for steroid-induced osteoporosis, once every 2 years for preventing postmenopausal osteoporosis, and once for Paget's disease. People drink at least 2 glasses of fluid beforehand. For a missed dose, the Medication Guide says to call to schedule the next one.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Reclast is approved for: Reclast is a bisphosphonate approved to treat and prevent osteoporosis in postmenopausal women, to increase bone mass in men with osteoporosis, to treat and prevent steroid (glucocorticoid)-induced osteoporosis in people taking 7.5 mg or more of prednisone a day for at least 12 months, and to treat Paget's disease of bone (sections 1.1 to 1.5). The label says the best length of use has not been set, and people at low fracture risk may be considered for stopping after 3 to 5 years (section 1.6).
Source
RECLAST (zoledronic acid) injection, for intravenous use, prescribing information and Medication Guide. Sandoz. DailyMed, version published February 13, 2026. DailyMed setid 5a9b3737-9ce6-4a89-b76e-6aab79eba9cf
Reclast is a 5 mg in 100 mL ready-to-infuse solution, given into a vein by a nurse or doctor over no less than 15 minutes at a constant rate, followed by a 10 mL saline flush (sections 2.1, 2.9, 3, 17).
People must be well hydrated first. The Medication Guide says to drink at least 2 glasses of fluid, such as water, within a few hours before the infusion, and eating beforehand is fine (sections 2.1, 17).
Before each dose, serum creatinine is checked and creatinine clearance is calculated. A routine oral exam is done before the first dose (section 2.7).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Use | Dose | How often |
|---|---|---|
| Treatment of osteoporosis in postmenopausal women | 5 mg infusion over no less than 15 minutes | Once a year |
| Prevention of osteoporosis in postmenopausal women | 5 mg infusion over no less than 15 minutes | Once every 2 years |
| Osteoporosis in men | 5 mg infusion over no less than 15 minutes | Once a year |
| Treatment and prevention of glucocorticoid-induced osteoporosis | 5 mg infusion over no less than 15 minutes | Once a year |
| Paget's disease of bone | 5 mg infusion over no less than 15 minutes | Single infusion; re-treatment may be considered after relapse |
Reclast is not given with creatinine clearance under 35 mL/min or signs of acute kidney impairment. At 35 mL/min or more, no dose change is needed.
For Paget's disease, everyone takes 1500 mg elemental calcium a day in divided doses (750 mg twice a day or 500 mg three times a day) and 800 international units of vitamin D, particularly in the 2 weeks after the infusion.
For osteoporosis, calcium and vitamin D supplements are taken if diet is not enough; an average of at least 1200 mg calcium and 800 to 1000 international units vitamin D daily is recommended.
Acetaminophen after the infusion may reduce acute phase reaction symptoms.
The need to continue is reviewed periodically. People at low fracture risk may be considered for stopping after 3 to 5 years, and fracture risk is rechecked periodically after stopping.
Reclast is stopped when pregnancy is recognized.
The Medication Guide says: if you miss a dose of Reclast, call your doctor or healthcare provider to schedule your next dose. The prescribing information gives no separate missed-dose rule.
More on this: missed a dose of Reclast.
People being treated with Zometa, which contains the same active ingredient, are not given Reclast.
In Dose Track you set up Reclast as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.