Call the manufacturer - ask questions. I did. Called my doctor and bugged the crap out of him. They assigned me a team nurse. There was a lot which was neglected in my case when I started the Reclast and then the Tymlos. Now, 2 years down the road, everything is smoothed out. I had to stop and restart "titrating" up to the full dose. It took 2 weeks on 2, 2 weeks on 4, two weeks on 6, and then to a full 8. They encouraged me to stay on the drug and magically all the side effects would stop after 2 - 3 months. Magically they did!!! I'm glad to be on the medication. My tests are trending positively! work closely with all those you can get your hands on for encouragement!