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Reclast vs. Prolia

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

Key takeaways

Reclast (zoledronic acid) and Prolia (denosumab) are both used to treat osteoporosis, but they have some key differences. Reclast is a bisphosphonate given as an intravenous (IV) infusion once a year or every two years, while Prolia is a monoclonal antibody given as an injection under the skin every six months. Reclast is available in both brand and generic forms, whereas Prolia is only available as a brand. Reclast works by slowing down bone breakdown, while Prolia blocks a protein that signals bone breakdown. Prolia can also help with bone loss due to certain cancers, which Reclast does not. Both medications can cause side effects like muscle and joint pain, but Prolia has additional risks like dangerously low calcium levels and serious infections. You need to take calcium and vitamin D supplements with both medications to help keep your bones strong.

Reclast

(zoledronic acid)

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Prolia

(denosumab)

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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 Prolia

Prescription only

Prolia (denosumab) is an injection that's used to treat osteoporosis in adults at high risk of fracture. It's also for those at high risk of fractures from certain cancer medications. It works as a monoclonal antibody called a RANKL inhibitor to strengthen your bones. Prolia (denosumab) is a convenient option because you only need an injection every 6 months. It's injected under the skin by a healthcare professional at a medical office. Side effects include back and muscle pain. It also has a risk of causing dangerously low calcium levels.

Indications for Prolia

Pros and Cons for Prolia

Pros

Cons

  • Must go to the medical office to get the injection
  • Must take with calcium and vitamin D supplements
  • Can cause bone and muscle pain
  • Not safe during pregnancy

Common Side Effects for Prolia

Warnings for Prolia

  • Dangerously low calcium levels
  • Risk of fractures in the thigh bone
  • Risk of spine fractures after stopping Prolia (denosumab)
  • Risk of serious infections
  • Risk of problems in the jawbone
  • Serious allergic reactions and skin reactions
  • Severe bone, muscle, or joint pain
  • Don't take with Xgeva (denosumab)

Prices with our coupons for Reclast vs. Prolia

Price Card Drug Icon
Zoledronic Acid1 vial / 5ml of 4mg/5ml
$17.68$1,280.89
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Price Card Drug Icon
Prolia1 syringe / 1ml of 60mg/ml
$1,870.20$2,497.09
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