@susanfalcon52 Susan 1 year is the standard. All the docs seem uninformed that there are studies showing that Reclast is effective much longer than that. Knowledgeable bone people like Lani Simpson suggest using ctx to guide when you need your next Reclast shot. If ctx stays low you then Reclast is still working and you don't need another shot. That could be a year possibly but my memory is that it would more likely be 18 months or two years or more. I'm not certain my memory is correct on the details of that.