Are we overdosing Reclast???

Thank you for the reply. It is good to know you are tolerating it. You have a great endo tailoring individual care with your overall health status in mind. Tolerability to any osteodrug varies so much among different individuals. @awfultruth presented a great topic for discussion here.

What is the issue with your teeth?

Yes please tell us what issues you had with your teeth ?

Presentation by Dr. Susan Ott
Top Ten Important Things About Osteoporosis That Many Doctors Don't Know

@19kcm56 I watched the video and there was a difference in the middle of the graph (in the middle of 10 years) where the 1 mg dose line was much lower than the 5mg line.

I have had two low dose infusions (1 mg each) due to kidneys and afib. I would certainly like to believe that is enough but have strong doubts.

I do believe the 5mg dose was chosen because it covers everyone (like the Evenity dose)- even though it might overdo it for us lightweights.

Reclast can be given at a low dose fairly easily. But that means, at this point, with the protocols in place, that doctors want that low dose given more frequently- 1 mg 4-5 times/year for instance. This would overwhelm the medical system, the cancer infusion centers and the insurance system.

I am not saying there should not be lower doses. But medical appropriateness is clearly not the top priority. Nuance in dosing is expensive and administratively difficult, unfortunately.

Personally I am not sure the lower dose lessens side effects either!

Some of us are rightfully questioning the one size fits all approach. I had cataract surgery without sedation so any would have been more than I needed. Someone else I know was given the standard dose based on her weight (high BWI). That was too much for her. For the second eye, she was given a greatly reduced dosage which was far better for her and for the surgeon. Thankfully, they learned from the first eye and acted accordingly. We deserve to be treated as individuals, to a degree, with osteoporosis meds. If lower doses are reasonably feasible, we should have the option to choose those. We are more important than the system.

@normahorn I wrote "I am not saying there should not be lower doses." No argument here. But I am not as hopeful about that change happening, and not sure how many patients need a lower dose either. It does look like the higher dose works better over 10 years.

I have lower doses of every single medication I have taken in the last 25 years. Usually 20-25%. I have also done that with every osteoporosis medication but partly because of medical necessity. If people cannot handle the full dose, they should work with their doctor or find another doctor. Most people do handle Reclast without problems.

In terms of increased frequency of infusions, I would be concerned about the effect on cancer care . A possible course to advocate for would be a lower dose on the same schedule as the full dose- once or twice a year. I have been told by an endo and by an infusion nurse that 2mg doses are common. Can't people ask for that then?

Basically I am saying, if there is good reason for a lower dose, women (and men) should be empowered to request a lower dose. If a doctor says no, find another doctor. It is easier to effect change that way than to get the company, infusion center or system to change. Change from within.

To say "we are being overdosed" is a passive position leaving anger and fear. There is a more active approach- ask for a lower dose. For most this is not necessary but for some of us, it is.

In fact, we can legally stop an infusion at any point. The doctor might not be pleased, but we can do that at 1mg, 2mg, or 3.

@windyshores When I entitled this discussion "Are we overdosing Reclast???" I certainly did not intend it to be a "passive position leaving anger and fear". Although as I write this it occurs to me that anger and fear are quite reasonable responses to our situation with osteoporosis.

But to get back on topic I did not intend it to be a passive position and I do not see the responders here being passive. Each person is going to respond in their own way to health information. If someone started a grass roots movement that advocated for more careful dosing of medications I would see that as great. If someone talks to their doctor about whether the standard dosage is best for them, then I see that as great too. If another person thinks this is nonsense, well, I'll just have to accept that also, won't I?

For myself I've decided I want to try risedronate or alendronate for a year and then do another round of Evenity. I'm wanting to follow Dr Michael McClung's suggested strategy of using a less powerful bisphosphonate rather than a more powerful and longer lasting one like Reclast to proceed a round two of Evenity. And I'm doing a little dance with my doctor trying to make this happen.

BTW thanks to @19kcm56 for posting the link to Dr Susan Ott who is another doctor having concerns about possible Reclast overdosing. I had seen her work before and forgotten about it.

@awfultruth. I for one want to thank you for the thread and raising the question about potential overdosing. The first step is recognizing that there may be a problem and then looking for solutions if a problem does exist. Making us aware of the issue allows us to discuss with our physicians rather than just blindly following what has been done. Maybe we can get them to also think about the issue.