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@windyshores It has finally become clear to me that the dosages of the drugs available are not chosen based on what's good for the individual. Instead the dosages reflect economic interests and what "they" think will work best for all women with osteoporosis assuming that treatment will not be individualized and nuanced.
For instance, as long ago as 2002 they did a study showing you get almost identical results with Reclast dosages ranging from 0.25 mg to 4 mg with dosing schedules varied depending on the size of the dose. By dosing 0.25 mg at 3 months they accomplished the same bone benefits as 4 mg at one year. So a total of 1 mg in a year got the same result as 4 mg in one year. But what was desired by the various researchers and experts was it seems to improve compliance and convenience and reduce cost and produce the greatest good for all. Assuming of course that there is no health impact of using 4 times more of a drug than necessary to produce the same effect.
"Women received placebo or intravenous zoledronic
acid in doses of 0.25 mg, 0.5 mg, or 1 mg at three month intervals. In addition, one group received a total annual dose of 4 mg as a single dose, and another
received two doses of 2 mg each, six months apart.
Lumbar-spine bone mineral density was the primary end point. There were similar increases in bone mineral density in all the zoledronic acid groups".
See https://www.nejm.org/doi/pdf/10.1056/NEJMoa011807?download=true
There is a paywall for the New England Journal of Medicine (NEJM) but you can create a free account and get 3 free reads a month. That's how I got this paper.
I there are one or two more papers related to this that I have to finish checking out.
Thanks Windy for all your input on this forum.
Replies to "@windyshores It has finally become clear to me that the dosages of the drugs available are..."
Very interesting .... makes total sense to me who weighs in at 112 lbs.
Thank you for this info.
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@awfultruth thank you for posting that link and info! I have been looking for it. As you probably know I have done one 1 mg dose of Reclast (and had 5 days of fever). I was going to do 1.5mg in September, 3 months later, because I remembered reading that 0.25 was as effective as 0.5mg but I am going to talk to my doctor about this study. I would love to do 0. mg every 3 months.
I believe doses are determined by studies (and by manufacturing needs in some cases. For instance, Radius probably doesn't want to spend money to make injection pens of varying full doses. They were smart to make it adjustable!) I did one, not two, shots of Evenity, two out of four times, because a study on that also indicated that dosing varied by weight and the study was based on weight much higher than mine. Some of us are small- another factor!
For every other med that I take, I do 1/4 dose and often react if I do more. I am older, 105 lbs., kidneys aren't great, generally sensitive. I feel fortunate that my doctor recognizes this problem. ps the 4mg zoledronic acid is Zometa, Reclast is 5mg!