Reclast prep questions

I had IV hydration and was told it was equivalent to "two big glasses of water" (16oz?). I had already hydrated all morning. and the previous day. I hydrated well for two days afterward. (I also had a slow infusion.) Kidneys did well (I was given a lower dose too). I had a fever for 5 days, low grade, no big deal.

Advil is contraindicated for me because Reclast is hard on kidneys as are NSAIDS. I have chronic kidney disease. I would ask your doctor about this!

I took 250 mg Tylenol every 4 hrs. starting late afternoon the day before. Stayed hydrated. Day of, I took 500 mg Tylenol every 6 hours all day, before & after infusion. Lots of water before & after. The first infusion, I had mild flu symptoms, achy, headache, slightly raised temp starting about 30 hours after the infusion. It lasted another 30 hrs. Then all was okay. The second infusion I had almost no reaction.

I happened to have a blood draw one week after that second infusion - they were checking kidney function for a CT scan. My score had dropped from my normal 85 to 50. PCP checked kidney function in 5 more weeks and it had recovered to 82. She was not concerned- typical stress on kidneys until Reclast processes through some. I only mention this because you might want to be aware of other procedures you’re doing right after the Reclast. Had I known it would affect my kidneys so much I would not have scheduled a CT scan so soon after.

You are lucky to have found this group as I hadn't when my EX endocrinologist recommended Reclast. I was clueless that there was actually a recommended prep which both the doctor and infusion center failed to mention. Fortunately a friend was having her Reclast infusion several days before me and was under the care of someone who told her to be well hydrated. Actually the package insert mentions that as well. I drank a bit more than the 16 oz of water and popped 1000 mg of acetaminophen as I left the house. I also took a Claritin the night before which was recommended in another group by a doctor who had had a Reclast infusion herself. I continued drinking water upon my return home and suffered no ill effects. And yes, I found a new endocrinologist.

I was just told to drink plenty of water & was told nothing else to do. Ask at the infusion center beforehand if you should take Tylenol or Advil. I would imagine that you could take Tylenol only but please find out before you take anything. Hubby and I just drink plenty of water the day before and afterwards for a few days and we never have any extra pains or feel bad. Hope it goes well for you.

The pharmaceutical compny says to drink liquids before so those of us who are not water drinkers can drink milk, orange juice, or whatever liquid we prefer.

friend123,
I pass this advice on (frequently), though I've never taken reclast
"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.
I'm not sure why tylenol would be preferred, as not even being antiflammatory. A kind RN on this site advises that perhaps it prevents the fevers and chills that can follow Reclast injections. I've been advised that without your doctor requesting the slower infusion, the infusion center might refuse the courtesy. If you have a reaction it can start after several days. Some people have little or no reaction. Aching in the joints is common. I hope you have luck. You're giving your bones some protection from fracture for the next ten years with one injection.

Thank you everyone for all your advice!

I gave the protocol from @gently (provided by an MD expert) to my endo and he replied that their facility might have their own, and I ended up with orders for one hour IV hydration followed by one hour infusion of 1mg Reclast. To protect kidneys, which Rcclast can be very tough on for a few people, I was told.

Tylenol is okay for kidneys. Doing an NSAID like Advil with Reclast would further stress the kidneys.

I switched off of Prolia to Reclast. I had my first infusion about 2 weeks ago. Hydrate and Tylenol is essential. Unfortunately the next day I got so sick. Everything hurt. My eyes, mouth, back, legs, ankles, hands and horrible headaches. Thank goodness it only lasted 24 hours. (I never had side affects of any meds before). Good luck.

2dlc953 I keep reading that the flu-ish illness after the first Reclast is apt not to happen with the second one. I had a fever (99 degrees) for 5 days. Small price in my book. Let us know how your next one goes!