Side effects from Zoledronic Acid?

dimdinia,
30 to 40 % of zoledronic acid patients experience an accute phase response. Medical literature describes it an intense flu lasting for 3 to 4 days. Patient reporting indicates that it can last much longer.
The md who ran the clinical trials offers this advice.
"I am an osteoporosis expert, and have treated many patients with IV zoledronic acid. I have also played a key role in the development of Fosamax, oral and IV Boniva, so I know a lot more about bisphosphonates than most physicians. There are 3 things I routinely do when I treat patients with IV zoledronic that not all physicians understand. First, I order the infusion to dilute the 5 mg of zoledronic acid (which comes in 100 mL of D5W) into 500 mL of NS (normal saline), thereby diluting the drug from 5 mg% to 0.8 mg%. Then I order it to be administrated over 60 minutes, instead of 15 minutes. Giving an N-BP more dilute and more slowly makes it even safety for the kidneys. The 3rd thing I always do is order the infusion nurses to administer 650 mg of acetaminophen to the patient during the infusion, and I tell the patient to take at home the same dose of acetaminophen (two regular strength Tylenols) with dinner and at bedtime the day of the infusion, with all 3 meals and at bedtime the day after the infusion, and a final (7th) dose with breakfast the 2nd morning after the infusion. These 8 doses total of acetaminophen reduce the chance of a symptomatic APR from 20-30% to < 1%.The other thing to consider is that in most patients, a 5 mg infusion of zoledronic acid will control the rate of bone turnover for at least 24 months, so most of my patients do not get annual infusions."
Zometa is marketed for cancer. Reclast is marketed for osteoporosis. Same drug zoledronic acid. Zometa is 4mg. Reclast 5mg even though they know that 4 mg is equally effective as 5mg for osteoporosis.
If you can get Zometa it would be better than Reclast because of less unnecessary exposure. You might print the above advice and give it to your prescribing physician so that they can direct the infusion center.
Some people don't have adverse effect.
Best wishes

As I pointed out in my post, zoledronic acid is used for many different medical conditions. I would assume this means different dosages at different intervals interacting with other medications and other pre-existing conditions. This advice is for those using it strictly for osteoporosis (in my case osteopenia) and only because I'm on an aromatase inhibitor which can cause bone loss. My hospital is an NCI Designated Cancer Center of which there are only 72 in 36 states. In this group it is a Comprehensive Cancer Center of which there are only 57. I don't think I need to share anything with them. But thanks for your interest.

As I pointed out in my post, zoledronic acid is used for many different medical conditions. I would assume this means different dosages at different intervals interacting with other medications and other pre-existing conditions. This advice is for those using it strictly for osteoporosis (in my case osteopenia) and only because I'm on an aromatase inhibitor which can cause bone loss. My hospital is an NCI Designated Cancer Center of which there are only 72 in 36 states. In this group it is a Comprehensive Cancer Center of which there are only 57. I don't think I need to share anything with them. But thanks for your interest.

I know you don't mean to be offensive but I'm not dimdinia. It's DLMDINIA as in DLMD IN IA. It's my oncologist recommending this, not an endocrinologist. I will be discussing it with my dentist next week. If she doesn't sign off on Zometa, the point will be moot. As I will need to contact my oncologist afterwards to set up an appointment I can certainly throw it out there at that time. It won't be happening until December. I did notice that you have not provided a link to substantiate this idea, and the typos are troubling. And how are you so sure what my comprehensive cancer center does or does not know? Until then, be sure I'll take your advice under consideration.

dimdinia,
30 to 40 % of zoledronic acid patients experience an accute phase response. Medical literature describes it an intense flu lasting for 3 to 4 days. Patient reporting indicates that it can last much longer.
The md who ran the clinical trials offers this advice.
"I am an osteoporosis expert, and have treated many patients with IV zoledronic acid. I have also played a key role in the development of Fosamax, oral and IV Boniva, so I know a lot more about bisphosphonates than most physicians. There are 3 things I routinely do when I treat patients with IV zoledronic that not all physicians understand. First, I order the infusion to dilute the 5 mg of zoledronic acid (which comes in 100 mL of D5W) into 500 mL of NS (normal saline), thereby diluting the drug from 5 mg% to 0.8 mg%. Then I order it to be administrated over 60 minutes, instead of 15 minutes. Giving an N-BP more dilute and more slowly makes it even safety for the kidneys. The 3rd thing I always do is order the infusion nurses to administer 650 mg of acetaminophen to the patient during the infusion, and I tell the patient to take at home the same dose of acetaminophen (two regular strength Tylenols) with dinner and at bedtime the day of the infusion, with all 3 meals and at bedtime the day after the infusion, and a final (7th) dose with breakfast the 2nd morning after the infusion. These 8 doses total of acetaminophen reduce the chance of a symptomatic APR from 20-30% to < 1%.The other thing to consider is that in most patients, a 5 mg infusion of zoledronic acid will control the rate of bone turnover for at least 24 months, so most of my patients do not get annual infusions."
Zometa is marketed for cancer. Reclast is marketed for osteoporosis. Same drug zoledronic acid. Zometa is 4mg. Reclast 5mg even though they know that 4 mg is equally effective as 5mg for osteoporosis.
If you can get Zometa it would be better than Reclast because of less unnecessary exposure. You might print the above advice and give it to your prescribing physician so that they can direct the infusion center.
Some people don't have adverse effect.
Best wishes

dimdinia,
30 to 40 % of zoledronic acid patients experience an accute phase response. Medical literature describes it an intense flu lasting for 3 to 4 days. Patient reporting indicates that it can last much longer.
The md who ran the clinical trials offers this advice.
"I am an osteoporosis expert, and have treated many patients with IV zoledronic acid. I have also played a key role in the development of Fosamax, oral and IV Boniva, so I know a lot more about bisphosphonates than most physicians. There are 3 things I routinely do when I treat patients with IV zoledronic that not all physicians understand. First, I order the infusion to dilute the 5 mg of zoledronic acid (which comes in 100 mL of D5W) into 500 mL of NS (normal saline), thereby diluting the drug from 5 mg% to 0.8 mg%. Then I order it to be administrated over 60 minutes, instead of 15 minutes. Giving an N-BP more dilute and more slowly makes it even safety for the kidneys. The 3rd thing I always do is order the infusion nurses to administer 650 mg of acetaminophen to the patient during the infusion, and I tell the patient to take at home the same dose of acetaminophen (two regular strength Tylenols) with dinner and at bedtime the day of the infusion, with all 3 meals and at bedtime the day after the infusion, and a final (7th) dose with breakfast the 2nd morning after the infusion. These 8 doses total of acetaminophen reduce the chance of a symptomatic APR from 20-30% to < 1%.The other thing to consider is that in most patients, a 5 mg infusion of zoledronic acid will control the rate of bone turnover for at least 24 months, so most of my patients do not get annual infusions."
Zometa is marketed for cancer. Reclast is marketed for osteoporosis. Same drug zoledronic acid. Zometa is 4mg. Reclast 5mg even though they know that 4 mg is equally effective as 5mg for osteoporosis.
If you can get Zometa it would be better than Reclast because of less unnecessary exposure. You might print the above advice and give it to your prescribing physician so that they can direct the infusion center.
Some people don't have adverse effect.
Best wishes

Super helpful! THANK YOU!!!!
Do you know the name of the MD who ran the trials? If I have Reclast or Zometa as a follow-up to Evenity, I want to share this with my specialist, and have them follow the instructions. I bet I'll be asked who the doctor is.