Reclast IV half dosage

Thanks @loriesco so glad it helped and so kind of you to share.

I had a bad flare two nights ago and took flurbiprofen the next morning. I use it very sparingly due to kidneys.

I just looked it up and Celebrex is a selective Cox2 and flurbiprofen is non-selective. https://www.medicalnewstoday.com/articles/list-of-nsaids-from-strongest-to-weakest I am going to ask if Celebrex would be better for me (and my kidneys!): I love flurbiprofen and consider it a treat to take. I can't take it often but when I do, I have a better day. Glad Celebrex is going that for you. The quote from the link is below:

"There are two types of cyclooxygenase isoenzymes: COX-1 and COX-2. They each play slightly different roles in the body:

COX-1 helps the body maintain platelet aggregation, gastrointestinal mucosa lining, and kidney function.
COX-2 helps the body with the inflammatory response due to injury or illness.
The majority of NSAIDs are non-selective. This means they target both COX-1 and COX-2 isoenzymes. This may lead to different adverse reactions as they can affect different systems in the body.

Selective, also known as COX-2 selective, only targets COX-2. Currently, in the United States, celecoxib is the only NSAID available in this group.

By selectively targeting only COX-2, celecoxib can help with inflammation without affecting other systems in the body, such as the kidneys."

Yes, Celebrex and its generic are COX 2 inhibitors. They are the ONLY drugs in the class of NSAID that actually INHIBITS production of inflammation-causing enzymes (COX 2) in your body, https://www.goodrx.com/classes/nsaids/is-celebrex-better-than-ibuprofen
It also has less gastric issues. Less hard on kidneys. It also is the ONLY drug you can continue taking before surgery (besides Tylenol) because it doesn't thin or thicken your blood.
It is more than a mask. After doing this all for 35 years I am very very careful (as you seem to be) as to what medications I use. The other NSAIDS will do a lot to relieve pain but they are very hard on your body if injested. I will use aspirin, diclofenac, capsicum, lidocaine, and hydrocortisone as TOPICAL ONLY pain controllers. Vioxx poisoned me and Ibuprofen put me in the hospital. I will take Toradol (Ketorolac) for a crisis of sacral or sciatic pain once in a blue moon. I took it for the flare of the trigeminal neuralgia 2 weeks ago a couple times. But its really bad for you, too. The Celebrex is much better. It is an advanced therapeutic when compared to the older Cox 2/Cox 1 meds. Of course -- insurance always holds back the BEST medicine wanting people to take all the cheap garbage they want to contract for. Lucky I am lactose/gluten intolerant I can get the better ones. However -- celebrex is the ONLY drug I can't find without lactose. So I take a lactaid pill when I take it. I would never take fu

I read last night that L Carnitine is actually a nerve pain reliever. Who know? (It doesn't relieve my pain!) but it's doing a great job of bringing my energy and metabolism back. I forgot to address the low cortisol. I read up and I see why you connect the low cortisol to .... oh geez, I forgot... was it the L Carnitine?) I wasn't using it at the time and I might have cortisol burnout or some prediabetes going on. I'm pretty sure it will snap back when I get tested again. think that midriff bulge and the low cortisol also went together.

I wouldn't take the flurbiprofen because it is in the same class of NSAIDs as the ibuprofen, piroxicam, etc. High blood pressure, edema, anxiety causing, etc. just ibuprofen for a couple days if I pull a muscle in my lower back once a year. I really like the low-dose Percocet 10/325 best after 25 years. No gastric issues and it doesn't conflict with anything and my labs are stable. No addiction since I started it just to stop back pain that doctors can't resolve. That's all it does is handle that pain. If I ever get a "sudden" thing like gout pain or the new TN it will help that too. If the moon and stars align -- and I have no pain -- I don't take it, even after 25 years of daily use.

Here are three studies showing that the 5mg dose of Reclast is not necessary.
There is strong evidence in studies that lower dosages and altered infusion schedules produce very similar results and in one case superior results to the 5 mg dose of Reclast.
It becomes clear from studying the papers that the motivating factors behind the 5mg yearly dose is convenience, patient compliance, money and they say the greater good for the most people. They do not consider intelligent individualized medicine. Nor do any of these papers report anything other than temporary discomfort as a side effect. None of them consider that a lower dose might be safer.

Here are the three papers showing lower doses work just as well:

This one compares 3 different doses and shows that 1mg does well, 2.5mg does best and 5mg does ALMOST as well as 2.5 mg. All three were one dose with result at one year.
https://academic.oup.com/jcem/article/97/1/286/2833555
The next one alters dosing schedules depending on dosage. Combined with the paper above this is great information. They used dosages as small as 0.25mg quarterly with the same result as the large annual dose. It's behind a paywall but you can get a free account and get three free articles a month.
https://www.nejm.org/doi/pdf/10.1056/NEJMoa011807
The third one compares 2mg to 4mg and concludes that 4mg is better. If you dig into the details you see that there is a tiny advantage to 4mg in the spine and a tiny advantage to the femur neck and total hip for the 2mg. Hardly what would make me call the 4mg superior and certainly not a significant difference. The difference in the spine is between 2mg gains 4.86% and 4mg gains 5.35%. So a gain of about 5% either dose. As I said it flips the other way with the hips but they do not consider that even though their study shows it.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8420937/

Thanks so much for this @awfultruth. I am saving it in my Google docs! I believe @mayblin posted it elsewhere...

@loriesco Mind boggeling that clinicians prescribing this potent and potentially dangerous medication can't answer such basic questions. Not very reassuring, IMO.

@windyshores Wow! Thankls so much for this info. I now feel much more equipped to approach my doc!

Add these to those about lower doses of ReClast.