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@kell4042 and @gently I have never seen this timeline before, as posted by @gently
" Some 30% have a miserable flu-like response that lasts for weeks, before resolving gradually. "
Three weeks is out of the usual timeline that I have read about for that acute phase reaction (APR). It is possible. But Reclast can have longer term side effects that are not part of that acute phase reaction, which I personally distinguish from the APR. I didn't mind 5 days of fever and myalgia (even on 20% dose that happened) - it's transient and less likely to happen again- but of more concern are effects over the next weeks and months for some few of us. Many do fine. (I am having GI effects, and increased tinnitus.) If you are having a longer acute phase reaction, that would be better because the symptoms do tend to disappear. Let us know!
Of more concern is why you @kell4042 were put on this in the first place. It seems your DEXA is low enough to qualify for an anabolic like Tymlos, Forteo or Evenity. Is there an insurance problem? The thing is, Reclast renders these anabolics less effective and many of us do Relcast after the others to "lock in gains."
A few things that came up on google:
https://www.ccjm.org/content/ccjom/85/9/675.full.pdf This one says APR dissipates in one week.
"Bisphosphonates, especially intravenous zoledronic acid, often cause influenza-like symptoms such as severe musculoskeletal pain, fever, headache, malaise, and fatigue, sometimes accompanied by nausea, vomiting, and diarrhea. As many as 30% of patients experience these symptoms, which are usually transient, last up to 1 week, and, in most patients, only rarely recur with subsequent infusions. "
Some statistics from that same article concerning Reclast only (see the full article):
"42.4% of the zoledronic acid group experienced symptoms that could be attributed to an acute-phase reaction after the first infusion.....most resolved within 1 week."
https://www.aafp.org/pubs/afp/issues/2008/0815/p508.html This one does say up to two weeks, which is longer than what I usually see.
Replies to "@kell4042 and @gently I have never seen this timeline before, as posted by @gently " Some..."
@windyshores That is an excellent comment. It is really important that we make a distinction between those very common flu-like acute phase reaction (APR)s which go away generally in 3-5 days and possible long term side effects which are potentially life changing.
It is acknowledged that the flu like reaction happens in 30-40% of patients. What is not readily acknowledged is the possible long term effects that are seemingly not related to the flu like reactions that occur within a few days of the infusion. These worrisome long term problems can seemingly occur any time after the infusion, not just in the first few days. That makes them harder to study, harder to show up in the drug trials, and difficult to attribute to a definite cause. I caution against just assuming it's Reclast because you had an infusion 2 weeks ago. It may be but you don't want to overlook other possible causes and perhaps miss something else happening to you that needs addressing.
I have never taken Reclast, I'm just looking at studies and bone med talks and user groups. From that I have no idea how frequently these long term side effects may be happening. I wish we knew!
And just to help us all appreciate how complex life can be, there is a study that indicates that those who have the flu like reaction to Reclast are less likely to fracture than those who do not have that reaction. And that leads to speculation that maybe folks shouldn't take all that Tylenol and Claritin, etc to prevent those flu like reactions. Please note I'm not making any recommendations here on this particular tangent. It does look like properly done research done by respected researchers but they do not claim it is conclusive.
https://onlinelibrary.wiley.com/doi/full/10.1111/joim.13354
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Thank you.
Kelly A. McCollum