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343 Highgate, Roslyn, Dunedin 9010
Phone 034640041 Fax 034640628
Aclasta infusions
Aclasta infusions are available at Amity Health Centre for patients with low bone density. This service is available to Amity patients, and also to patients who may be referred from another medical centre.

Please discuss your suitability for this treatment with your own doctor.

There is a
fee for this service.

Below:
Patient Information Sheet - Zoledronate (Aclasta)
My doctor has suggested I have an Aclasta infusion: What do I need to do?

PATIENT INFORMATION SHEET - ZOLEDRONATE (ACLASTA) 

Zoledronate (also known as zoledronic acid or Aclasta) is the most potent medicine in the bisphosphonate class currently available.  Bisphosphonates work by preventing resorption of bone by inhibiting the function of bone-dissolving cells called osteoclasts.  Bisphosphonates are commonly used in the treatment of osteoporosis and Paget’s disease, and are also used for preventing some forms of cancer from spreading in bone. 

Zoledronate is given by an intravenous infusion (into a vein in the arm via a “drip”) over about 15-30 minutes and can be given each 12-24 months as needed for treatment of osteoporosis.   Treatment of Paget’s disease involves even less frequent infusions.  Zoledronate increases the bone density in patients with osteoporosis, to about the same extent as other medicines such as alendronate (Fosamax), and is effective at reducing fracture rates, by 35-70%.  It also reduces bone pain in Paget’s disease. It is licensed in New Zealand for treatment of osteoporosis and Paget’s disease. 

Other than flu-like symptoms after the first infusion, side effects from zoledronate treatment are uncommon, and are in general no different from placebo-treated patients in randomised trials.  It should be remembered that major fractures can be very dangerous, so this should be balanced against the small risk of ill effects from treatments.  Treatment is usually accompanied by some calcium tablets and /or vitamin D tablets given at the time of the infusion, to keep blood calcium levels normal.


Possible side effects with zoledronate include:

1.   About 30% of individuals may experience a flu-like feeling after their first treatment, which usually last 24-72 hours, but which can occasionally go on for longer, sometimes with associated muscle or joint aching.  This usually responds well to regular paracetamol or an anti-inflammatory such as Nurofen or diclofenac.  The chance of this side-effect occurring after second or third zoledronate infusions is much lower (about 3-4%).

2.  Individuals with severe pre-existing kidney damage can sometimes experience deterioration in their kidney function after the administration of zoledronate.  It is normal practice not to use zoledronate in people whose kidneys are not functioning well.

3.  Very rarely, drugs in the bisphosphonate class can cause eye inflammation. 
 

Unproven side effects with zoledronate include:

1.  Osteonecrosis of the jaw (ulceration in tooth sockets or the gums, observed in a small number of cancer patients receiving high-dose treatment but not increased in those treated for osteoporosis or Paget’s disease).

2.   Atrial fibrillation (an abnormal heart rhythm noted by one group of overseas investigations but not seen in any other clinical trails).

3.   Upper leg fractures (Reported in isolated cases by doctors in Singapore and the USA, but not clearly related to bisphosphonate therapy).

 
If you have any other questions about this medicine, or your bone condition, you should feel free to ask your doctor or one of the practice nurses in person or by phone on           03 4640041.

Adapted from Auckland Bone Density www.bonedensity.co.nz  Sep 2011

My doctor has suggested I have an Aclasta infusion: What I do I need to do?
1.
 Please read the above information about zolendronate infusion.
2. Obtain  a blood test with the form you will be given, to check your kidney function and calcium levels.

Once your doctor has confirmed that your blood tests are satisfactory for you to have the treatment, and you wish to proceed:
1. Stop risendronate,  fosamax, or etidrate, if you are already on this.
2. Make an appointment for the infusion, allowing up to an hour.
3. Take your prescription for zolendronate  to the chemist, as well as  your prescription for Vitamin D (cholecalciferol) and take 2 tablets of Vitamin D ( all at once) during the week before your infusion. (Ignore this if you are already taking monthly vitamin D)
4.  Collect the zolendronate from the chemist on  the day of your infusion.

On the morning of your visit:
1. Take your normal medication. 
2. Do not take anti-inflammatories- eg diclofenac, ibuprofen
3. Ensure you have at least 2 glasses of water or other fluids.
4. Bring the consent form with you to the appointment.
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343 Highgate, Roslyn, Dunedin 9010
Phone 03 464 0041 Fax 03 464 0628
reception@amityhc.co.nz
 



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