Reclast Infusions: Side-effects & Recovery time

hi @mayblin. I did two years of Tymlos and had a DEXA after 18 months. I am considering self-pay for a DEXA..next covered one is April 2025. My doctor doesn't do bone marker testing. As a result I have seen another doctor who does, and after several visits with McCormick (I have seen him for years) I had my PCP order them. But they have not been very useful and for now I have no need.

PINP was disappointing at 18 months with Tymlos (but I had no valid baseline since intended baseline was not fasting) and disappointing with Evenity (possibly I missed the peak but I doubt it).

It is a feeling of flying a plane in the dark with no instrument panel at times. I just watched a couple of videos- Paul Miller and a doctor with the IDF- and they say "we don't know" a lot. The whole field is full of "we don't know yets."

Noone has much to say about what to do after Reclast, besides a possible drug holiday followed by what?

My main concern now is being able to do an anabolic again after Reclast. I am going to ask about risendronate though my esophagus might not like it. I don't really trust my DEXA's after Tymlos. The gains were too large! And my femur neck was still -3.6. I might buy hip pads.

It may be possible to do another short burst (for me, others might do longer) Evenity after Reclast. Guess what? They don't know yet!

Hope you had a nice vacation. You were missed here!

I ended up in the ER within 8 hours with severe spine pain. It lasted about 5 days. It was horrible pain so I chose not to take another infusion. My doctors recommended a different rote and have on my medical records allergic to reclast.

@krainger what did you do instead? Had you been on another drug before Reclast that needed to be "locked in"? Were you able to do an oral bisphosphonate or are you avoiding all of them?

I am interpreting pain right now as some sort of positive effect, but I don't have bad pain. I am kind of med Polyanna at this point! We'll see what happens...it hasn't been a week yet.

So sorry you went through that. I hope they gave you some pain relief. The Reclast stays in your body so you are probably still on it!

I have had 2 prolia injections since the reclast infusion and only had minimal side effects. The spinal pain I experienced from the reclast was in my T spine area and it still comes and goes.

Evenity is 'anti-resorptive?' I thought its claim to fame is that it is a bone-builder. If anti-resorptive, how does it differ from Prolia?

What does it mean that Reclast is better at 'coating the bones?'

Thanx windy.

@rjd the first half of Evenity is bone building and the second half, roughly, is anti-resorptive. It works very differently from other medications. It inhibits sclerostin. People born with low sclerostin may have very positive DEXA's and very dense bones (too dense). So researchers got the idea it might help osteoporosis and studies were done.

All the anti-resorptives work via different mechanisms. That's why Prolia has a rebound problem while bisphosphonates are used to deal with rebound.

The language about "coating bones" is from Keith MCormick's book "Great Bones," where he basically says Fosamax and other orals give spottier coverage, so to speak, in terms of protecting against rebound. But orals are fine if Prolia is taken for a year or a year and a half, he wrote.

@kgrainer but you will need Reclast or an oral bisphophonate if you go off Prolia. We are all between a rock and a hard place! Maybe you can stay on Prolia long term-? Apparently Evenity is a possibility after Prolia but that requires a bisphosphonate too.

I guess I need to speak to my doctor since I am not educated on this at all. I need to know how long in can take prolia. I have only had 2 injections

What did the ER do to help with your spine pain? So sorry you went through that.

They ran all kinds of test Like MRI and blood work. They sent me home after nothing showed up and ruled it as a reaction to reclast. They gave me some muscle relaxers while there and I had to do heat and ice with Tylenol at home.