a hypodermic needle inserted into a vial of medicine

Before agreeing to take any medication, people should be aware of the benefits and risks. There are a number of drugs that are used to combat osteoporosis, which is certainly a benefit. But all of these medications have risks, including the injectable medication Reclast. One reader had a horrifying experience:

“My problem was a reaction to Reclast. Right away I started getting muscle aches and pains. Then I started having problems walking.

“I told my doctor who sent me to an arthritis specialist who gave me a shot which did nothing. I kept going back to my doctor to show him my legs and feet and how swollen they got and how red my feet got. It got to the point I could not walk. I went to his office in a wheel chair and he gave me a handicap sticker but refused to think it was a reaction to this medication.

“I called the manufacturer (Novartis) and they told me to have my doctor call when I went back into the office because it was a sure side effect of the medicine. So I handed him the number and he said he did not have time for this crap. I had to change doctors after spending $9,000 on tests and medications.

“Now the new doctor I have doesn’t believe my symptoms could be caused by the drug either. She said enough time has gone by that I should not be having problems with my feet and knees because of the medicine. She also wants a million tests done that are costly and I just don’t have the money.

“So she shrugs it off by saying you don’t want to pay, so what am I to do. I feel like a person who will never get cured. I am at a loss. And I am only 58 and work full time with limited benefits and hurt all the time.” –Diane

People’s Pharmacy Response:

Reclast is an osteoporosis drug (generic name is zoledronic acid). It belongs to the bisphosphonate class of medications, much like the following:

Alendronate (Fosamax)
Ibandronate (Boniva)
Risedronate (Actonel)

A recent review of randomized controlled trials by British researchers concluded that bisphosphonate drugs do reduce the likelihood of fractures due to weakened bones, but that the benefit-to-risk ratio is defensible only in patients whose likelihood of a fracture is high (Health Technology Assessment, Oct., 2016). That is because of the negative impact on quality of life. For Reclast in particular, flu-like symptoms are considerably more common among people getting the drug than those getting placebo.

Instead of taking an oral drug daily, weekly or monthly, like other osteoporosis drugs, Reclast is a once-a-year injection. That means it has LONG-LASTING effects. That makes it convenient for some, but for those who experience side effects, it may mean long-lasting misery.

Reclast Side Effects:

  • Muscle aches, arthritis, joint pain, bone pain, muscle spasms
  • Pain in arms or legs, back pain, fluid buildup in legs, tingling in extremities
  • Fatigue, flu-like feelings, fever, lethargy
  • Headache, dizziness
  • Digestive distress, stomach pain, nausea, vomiting, loss of appetite, constipation, heartburn, diarrhea
  • Rash, skin irritation, severe allergic reaction
  • Eye irritation, eye damage
  • Jaw bone death (osteonecrosis of the jaw)
  • Unusual fractures of the femur (thigh bone)
  • Kidney damage, kidney failure
  • Low calcium levels in the blood
  • Atrial fibrillation (with other bisphosphonates)

We are saddened that your physicians have ignored the official prescribing information and pretended that your symptoms are unrelated to the medication. This seems irresponsible to us. You can read about ways to protect yourself from this kind of oversight in our book, Top Screwups Doctors Make and How to Avoid Them.

Diane is not the only person to share bad experiences with bisphosphonates. Here are some other case reports:

“I have had 2 infusions of Reclast. I had 2 SEVERE bouts with inner thigh pain. Lasted about 1/2 hour and both time woke me up at night. Pain was debilitating; couldn’t move; VERY DEEP BONE PAIN!! VERY scary…. I did think of the Reclast drug. When I went the second year for my 2nd infusion of Reclast, I asked the lady if she had heard of anyone experiencing severe thigh pain. She told me no.

“Well, after this 2nd infusion I have had 3 bouts with horrible thigh pain. Two of those were of the inner thigh and the last one was on the outer thigh on the left leg! I will never take this drug again. Please be careful, as I think these drugs need MUCH MORE TESTING!

“Best of luck to anyone having these symptoms!!”–Monica

“I have been diagnosed with third stage renal failure and I also have atrial fibrillation. There is a question now about how can we treat the atrial fibrillation (A-fib) since my kidneys are in bad shape.

“I took Forteo injections for 19 months and a couple of years later I had a Reclast infusion. The decline in my kidneys started after I had the Forteo and worsened after the Reclast. I feel sure that I will not be taking another Reclast injection.”–J.C.

“I was taking Fosamax and sustained two femur fractures after its use… Reclast was used two years after the first fracture. When the IM rod was removed after healing…it was causing much hip pain…. the leg spontaneously broke in the mid shaft while I was dressing two days later… we had to place the rod again, so two fractured femurs from medications to prevent fractures.

“I am frightened. Is Reclast part of the Fosamax femur fractures? I have no osteoporosis, but my mother had it severely. The drugs were given for that reason. The fracture is very slow to heal due to these drugs. Another doctor wants to use Forteo…. I am not sure what to do.”–Lee

“I’m a 54 year old healthy, active woman. Two years ago my doctor said I had osteopenia and put me on Actonel, once a week. After one dose, I was in such pain I couldn’t stand for anyone to touch me, and could hardly get out of bed for 2 days.

“I called the doctor who said I had the flu and should try it again in two weeks. I felt so much pain (not flu symptoms) there was no way I was going to try it again. Then he tried Boniva. It worked well for about 6 months, then my heart would start racing when I was relaxing… including about 4 a.m. when I was asleep… which awakened me and prevented me from getting rest. It would take about an hour for me to get over the dizzyness and sick feeling. I wore a heart monitor for 24 hours… and it went from 44 to 147 in an instant in the middle of the night.

“I’ve now just upped calcium, D, and magnesium… because I may break bones, but at least I won’t be a couch potato from the pain.”—Linda

“Have been on Boniva for approximately 8 months and have back, hip, and leg aches which I am now attributing to the drug since I walk regularly at least a mile a day and bike. I am 72 and thought I was falling apart until I read on the web that others are also having this aching problem. If I sit in a chair five minutes or more, my hips, knees and legs are stiff.

“I plan to discontinuing this drug despite osteoporosis in my left hip and will continue with calcium, D and magnesium and weight bearing exercises.”–R.F.

“I could not tolerate Boniva. I had so much joint pain, muscle weakness and fatigue I started taking my husband’s prescription strength ibuprofen. I stopped the Boniva because I was nervous about a stomach ulcer. Then I realized the longer I was off of Boniva, I had no need for the ibuprofen. I am grateful for the early warning and my physician agreed with me in stopping the Boniva.

“I think these drugs do more harm than good. My friend now has atrial fib and has had two spontaneous fractures of her lower legs. She had been on alendronate (Fosamax) for 10 years. I know it is femur fractures they are discussing, but if it can cause a fracture in a strong long bone like a femur, it certainly may cause them in the smaller bones. Her doctor felt alendronate certainly could have contributed to her atrial fib.

“I would strongly recommend patients really read everything they can and be very knowledgeable about the drugs they are prescribed and then make an educated decision with their physician on how to treat osteopenia and osteoporosis.”–S.H.

We would like to learn more about your experience on bisphosphonates such as alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel) and zoledronic acid (Reclast). Have they worked well for you without any side effects. Let us know below. Have you experienced symptoms? If so, please describe what happened.

Although Reclast and other bisphosphonates are probably the most common treatments for osteoporosis, they are not the only ones. To learn more about some alternatives, you may want to check out our Guide to Osteoporosis.

If you’ve had trouble taking Reclast or any other bisphosphonate osteoporosis drug, please share your story in the comment section below.

Revised 11/17/16

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  1. donna

    My husband was given Reclast on the morning of April 19, Immediately started feeling weak with leg pain, doctor told nurse to send him to ER. By the time we reached ER his blood preassure was way down. Cat scan and ultra sound showed an absess in his liver.

    They drained it and by morning his organs started to fail. They thought he wasn’t going to make it that night, but he lived for 7 days. He was on 24 hour dialysis and many antibacterial drugs and breathing tube and induced comma.

    He developed flesh eating bacteria on his left calf and that muscle was removed. I just don’t know what happened. A real mystery!!!

  2. Mia
    highland beach, Florida

    I am 67 years old, in good health and keep up with all my yearly exams. In 2015 I was prescribed Klonopin for restless leg syndrome, never being told it was addictive. After many Doctor visits thinking I had dementia I realized I was addicted to the Klonopin. I went through withdrawal and have been off it since Nov 2017.

    However, I find myself in a similar situation with Alendronate—my fault did not read about it first and realize this was Fosamax I have been taking75 mg weekly for about 5 months . During this time I began having severe neck problems starting at the base of my skull and radiating to my left shoulder. Since I have MRI stating I have arthritis in my neck —-every doctor (again) that I went to said it must be just that –Arthritis.

    I am so stupid! I actually again put my faith in the medical community believed them. After going to several Neurologist’s and a Rheumatologist, Thought I needed cervical operation to stop the pain. Can you imagine having an risky operation like that needlessly. That’s right all this pain (which has not been helped by meds)has been caused by the Fosamax Out of pure desperation I began doing research on my condition.

    Do NOT wait like I did—If you are taking shots or Alendronate orally for osteoporosis please read about them and their side effects. Horrible to think I got played again, after having to withdrawal from a benzodiazepine that should never have been prescribed, into taking yet ANOTHER killer drug.

    WHAT IS UP WITH THE MEDICAL COMMUNITY???…..and Insurance companies suggesting this as the best treatment. Can they be this stupid? I have had cervical pain for 5 months and will now stop taking Alendronate. I only hope this with resolve itself once stopped.

    Doctors are really clueless, so be your own advocate when it comes to your health.

  3. Karen
    Madison, WI

    I had this Reclast infusion on Weds. I woke Weds., night with such horrible bone pain EVERYWHERE. I could barley walk. Every bone in my body hurt. I had the chills, headache, so darn tired I could barely stay awake. I slept 19 hours yesterday. I hope this crap ends soon. Not happy with the result. I will not do this infusion again.

  4. Michelle

    I had reclast 5 months ago. I’m stage 4 breast cancer. Between chemo and forced menapause I have developed osteoporosis. I was told reclast has little side effects. I might have flu like symptoms for a couple days. I ended up in the ER. Horrible reaction. 5 months later I’m in severe chronic back pain. Devastated. Can’t work like I used to, can’t do anything physical without severe bone pain.

  5. Regina
    Gilbert, az

    I had a Reclast infusion 3 days ago. The first evening I was sore but not too bad. Woke up at 4:45 a.m. with joint paints including the top of my hands. Cup not hold a cup. Nausea, can’t smell food without getting sick, no energy, lock of concentration, diarrhe, if I had read this blog before I had this infusion I would have never consent to it. My body is killing me and this poison will be in my system 12 minths. I am praying I don’t come down with grave side effects.

  6. Don

    I had a Reclast injection five weeks ago. Still have severe neck and headache pain, mild chills and flu symptoms. How long do these symptoms last? Is there anything that will help get this drug out of the body?

    • Regina

      What do you mean by moderation. There are some typos but you can’t type, my hands hurt. Definitely not going for a second round.

  7. Doris
    South Carolina

    In 2013 i had a reclast infusion three weeks later i had a severe headache which caused a brain hemmorage!! On jan11/2018 I had another reclast infusion in three weeks time, I was so sick i thought it was the flu. So i went to my primary dr who sent me to a hemotoogist because my blood work was so bad! I now have been diagnosed with acute myeleod lukemimia i will never ever take another infusion or anything else for osteoporosis!!!!

  8. Betty
    Plymouth, MA

    I had a Reclast treatment in December & since then have had terrible leg pain at night which wakes me up. Doc says no connection but I find it too much of a coincidence. Have had X-rays, circircilation test & am now going for PT & doing exercises but nothing seems to help. I am 81 years old & very active. Have been diagnosed with osteoporosis but have never experienced anything like this. Just need to know if this will go on indefinitely or is there any relief in sight.

  9. Linda
    West Coast, USA

    I had osteopenia for many years. Had a bone density scan last year which showed fairly advanced osteoporosis. I have been researching these drugs now for close to a year after refusing to take fosamax. My reason is that I have gastric reflux and a hiatal hernia and the potential side effects to the esophagus from the oral osteoporosis meds are horrifying. (By modifying my diet and process of omission, I was able to discontinue the stomach medicine and proton pump inhibitors a decade ago).

    I have had osteoarthritis in my knees since my mid 30’s. One knee was replaced 10 years ago. I refused to take NSAIDS for the pain because of the risk to my stomach. My other knee has been bone on bone for 10 years as well. I could not walk more than a few feet and was in searing pain 24/7. Having no faith in our traditional medical system, and fearful of more surgery due to the unreported fact that over 400,000 people die yearly in USA hospitals due to preventable medical errors, I sold my home to get stem cell and PRP treatments. My pain has been gone since a week after the stem cell treatment and for the first time in 30 years I walk normally and 98% pain free.

    My Blue shield Insurance denied prolia injections ( although I was unsure anyway if I could commit to such a risk). Instead they sent me a letter saying I had to do the reclast for a minimum of 2 years before they would approve prolia; which brought me to this website tonight- as my internist did not warn me at all. These side effects from reclast make the prolia side effects sound like a day in the park.

    My heart goes out to each and every woman on here whose life has been horribly impacted by these hideous side effects. I have read almost every blog and site like this; and literally thousands of woman around the country have had these life altering side effects.

    The low numbers and percentages the pharmaceutical companies indicate for these horrific side effects do not match up at all given my extensive research and readings on the thousands of woman suffering and losing their lives at young ages. I am equally horrified the Insurance companies try to force people into these treatments.

    I know I am taking a calculated risk, (I am otherwise in excellent health) but I cannot consent to this type of treatment knowing the odds of not having a side effect or risking heart and kidney disease are low. I am having trouble seeing how any benefit from these drugs is worth the extreme risk.

    Thank you to all who have shared, I hope you all get some relief from these nightmare effects. I have begun calcium, vit D, and light weight bearing exercise several times a week. Hopefully they will come up with better treatments for Osteoporosis. This has made me completely disgusted with drug companies, Insurance companies, and many physicians. Good luck to all of you.

  10. Shannon
    Virginia Beach, VA

    I had a recla infusion three weeks ago. Twelve hours after the infusion, I woke up to astounding bone, muscle and joint pain. My lower back, where my osteoporosis is the worst is debilitating at best. I cannot use my hands and have had a migraine ongoing since the medication. The drs office(RA) that gave me the infusion says it cannot be the medication. I know it is. It is no coincidence that every listed symptom both rare and common began to affect me from the 12 hour mark until now, three weeks later with no end in sight. The ER told me I was crazy and actually hurt me worse. Mine own dr has no experience with patients having long term pain. Pain management put me on Demerol every 6 hours at 100 mg per dose. I’m allergic to nsaids and acetaminophen. The demerol does not touch the pain. My heart also races out of the blue and I cannot control my bowels or bladder. I’ve actually woken up in the middle of the night in my own bile. This is crazy. I cannot leave my bedroom. No one will help me. They just keep sending me in circles to ther drs. I have scoured the internet and found dozens upon dozens of patient testimony about the horrible side effects. What can someone like me do? HELP!

  11. Hilde
    Ohio (Lorain County)

    I had a Reclast infusion December 7. Became very sick during the first night and went through all the side effects mentioned. It took about three weeks to feel better and two weeks more to get some energy back. A week after that, my skin started to show red dots, was very dry and started to itch. Even with humidifier and lotion the skin rash became a full blown allergic reaction. I am now treated for that. My question is, because of my severe first reaction and the long lasting working of Reclast does that mean that I can expect more side effects for months to come?

    • Terry Graedon

      Hilde, it is possible. We just don’t have good data on this. There is probably quite a bit of individual variation in how long the side effects last.

  12. Wendy
    Fred, md

    I had my first reclast infusion 2 weeks ago today. Was informed i will have flu like system for 3 to 5 days . The joint and bone pain has been so severe, it hurts to touch, i can not lift 2 pounds without severe pain, i have a hard rime doing stairs the list goes on. I went from being extremely active to almist bed ridden. I went to the doctor today. She said i have all the signs of fibermalga. I reassured her, I have never experienced this type of pain until after the infusion. Now she has me in a anti-inflammatory. Symptom should dissipate in a month. Not a HAPPY individual. Will not be having another reclast infusuin. God i pray for relief.

  13. Melyn Richman

    I had severe hip and joint problems 2 years ago and was told I needed to have both my hips and knees replaced in series. I wouldn’t go for that, so I started taking every known supplement and vitamin which is supposed to be good for osteoporosis and joints, and I GOT AN INVERSION TABLE AND CONTINUE TO USE IT REGULARLY.

    After two weeks on this program all my joint pain went away, and my hips worked again. I gave up my cane and could live life again. I went back to riding my horses and actually doing everything I love! Now I’m 72 and Doctors are concerned about my osteoporosis which they see is getting slightly worse as time goes by, although I had no pain or mobility issues at all. Dr. sent me for Reclast infusion and 24 hrs later I was SICK!!!! Flu like stuff and extreme pain in all the joints and bones I had ever hurt!! Knees, ankles, wrists!!, jaw joints, skull and other stuff. That was a month ago, and I still have pain, especially in wrists, ankles, and my back. My bunions, which were at least dormant for around 15 years, are now painful and red again. But surprisingly, I think, my old problematic hip joints are NOT bothering me! How long is this supposed to last, and what can I do to stop these side effects? I am SOOOOOOO fatigued!!!!

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