I do a lower dose due to kidney disease and afib @sue417. My doctor said that doses of 2mg are not uncommon. I think if we all did low dose, the cancer infusion centers might be overwhelmed. Patient convenience and compliance are also reasons for the 5mg once a year dose.

You end up with the same long term effects I believe, if lower dose is given more frequently and equals the annual one time dose in a year.

I am curious why you did Reclast instead of a bone builder like Forteo, Tymlos or Evenity if you already have a fracture. Insurance covers us once we fracture. Do you see an endocrinologist? Reclast will temper the effectiveness of bone builders but lots of people do benefit from bone builders after Reclast.

The problem you might run into is that Reclast is limited to 3-5 years. All those other drugs need to be "locked in" by Reclast so you might want to talk to your doctor about switching before you do more years of Reclast. I am a lay person who does not know your situation so am only writing what I would do.