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Reclast vs. Actonel

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Reclast (zoledronic acid) and Risedronate (Actonel) are both bisphosphonates used to treat osteoporosis, but they have some key differences. Reclast is given as an intravenous (IV) infusion once a year or every two years, while Risedronate is taken orally with various dosing options, including daily, weekly, or monthly. Reclast is typically administered in a clinic or provider's office, whereas Risedronate can be taken at home. Reclast is also used for Paget's disease and osteoporosis caused by long-term corticosteroid use, similar to Risedronate. Both medications can cause side effects like muscle pain, joint pain, and headache, but Risedronate may cause esophagus irritation, which is not a side effect expected with Reclast. Both medications can lead to severe jaw problems and low calcium levels, but Reclast has a higher risk of kidney damage. Reclast is available in both brand and generic forms, while Risedronate is available as a lower-cost generic and also comes in a delayed-release form called Atelvia.

Reclast

(zoledronic acid)

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Risedronate

(Actonel)

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Summary for Reclast

Prescription only

Reclast (zoledronic acid) is used to treat osteoporosis. It's only available as an intravenous (IV) infusion that's given at a clinic or your provider's office. The medication is an option for postmenopausal women with osteoporosis who can't take bisphosphonates by mouth or for those at very high fracture risk. Reclast (zoledronic acid) is a long-lasting medication, so the dosing isn't often (either one-time only, once a year, or once every 2 years). It can cause side effects like muscle and joint pain, headache, and fever. This medication is available under the brand name Reclast and as a generic.

Indications for Reclast

Pros and Cons for Reclast

Pros

  • Lowers the risk of fractures in different parts of the body, including the hip and back
  • Infusions are one-time only, once a year, or once every 2 years
  • Can freely choose when to eat, drink, or take other medications
  • Can use if you can't take other bisphosphonates because of trouble swallowing or too much stomach pain
  • Can consider using for postmenopausal women with osteoporosis who have very high fracture risk

Cons

  • Only available as an IV infusion that's given at a clinic or provider's office
  • Risk of many side effects, including joint or muscle pain and severe jaw problems
  • Risk of side effects like fever, pain, and chills after each infusion
  • Might cause breathing problems in people allergic to aspirin

Common Side Effects for Reclast

  • Joint pain (up to 24%)
  • Fever (up to 18%)
  • Higher blood pressure (up to 13%)
  • Headache (up to 12%)
  • Muscle pain (up to 12%)
  • Arm or leg pain (up to 11%)
  • Arthritis (up to 9%)
  • Flu-like symptoms (up to 9%)
  • Nausea (up to 9%)
  • Dizziness (up to 8%)
  • Shoulder pain (up to 7%)
  • Bone pain (up to 6%)
  • Diarrhea (up to 6%)
  • Vomiting (up to 5%)

Warnings for Reclast

  • Breakdown of the jaw (osteonecrosis)
  • Low calcium in the blood
  • Kidney damage
  • Leg bone fractures
  • Severe bone, joint, or muscle pain
  • Harm to unborn baby

Summary for Actonel

Prescription only

Risedronate (Actonel) is a first-choice medication used to treat osteoporosis (bone loss or weakening). It can help improve bone mineral density (BMD) and lower the risk of bone fractures. There are several dosing options and a delayed-release form in case a particular dosing schedule is more convenient for some people.

Indications for Actonel

  • Osteoporosis in women who have gone through menopause (postmenopause)
  • Osteoporosis in men
  • Osteoporosis caused by long-term corticosteroid use
  • Paget's disease

Pros and Cons for Actonel

Pros

  • Can be used for many types of osteoporosis
  • Many available dosing options (daily, weekly, monthly) for postmenopausal women
  • Also comes as a delayed-released form that's taken after breakfast for postmenopausal women
  • Available in a lower-cost generic form

Cons

  • Risk of many side effects, including stomach pain and severe jaw problems
  • Not recommended for people with severe kidney disease

Common Side Effects for Actonel

Note: For once-daily dosing

  • Infection (31%)
  • Back pain (28%)
  • Joint pain (24%)
  • Constipation (13%)
  • Stomach pain (12%)
  • Heartburn (11%)
  • Nausea (11%)
  • Diarrhea (11%)
  • Flu-like symptoms (11%)
  • Urinary tract infection (11%)
  • Arthritis (10%)
  • Headache (10%)
  • Bronchitis (10%)

Warnings for Actonel

  • Stomach and esophagus irritation and ulcers
  • Breakdown of the jawbone (osteonecrosis)
  • Severe bone, joint, or muscle pain
  • Leg bone fractures
  • Low calcium in the blood

Prices with our coupons for Reclast vs. Actonel

Price Card Drug Icon
Zoledronic Acid1 vial / 5ml of 4mg/5ml
$17.68$1,280.89
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Risedronate3 dose packs / 1 tablet of 150mg
$47.14$483.05
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