@pami my kidney function dropped in 2022 for unknown reasons (I have a lupus diagnosis). My endo ordered a 20% "test dose" of Reclast after Tymlos/Evenity, which is 1 mg. He also ordered IV hydration and a slow one hour infusion. My kidneys did okay.

There is discussion on another thread on the effectiveness of 2mg vs 4 mg of zoledronic acid. I am not sure if I have done enough to "lock in" gains on the other two meds but am going to discuss with my doctor whether I need to do more Reclast. My hope is to do Forteo or more Evenity. I did two years of Tymlos and only 4 months of Evenity. My doc won't prescribe Prolia unless absolutely necessary due to rebound. When I am over 80 I would consider it though any possible effect on immune system concerns me.