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Have others had this severe a reclast reaction?
Hi,
I had my first Reclast infusion on Saturday, with a slow infusion time, tylenol ahead of time.
Sunday I woke up feeling fluish. By 3:30PM I had a fever of 104F, rigors (sort of severe full body shivering), and brain fog (a bit delirious, I guess). I was directed by Mayo Phoenix Nurse Triage to immediately go to the ER.
I did and was diagnosed with SIRS (the fever and my heart rate of 116 were enough for that). The started their SIRS protocol - which is to empirically administer antibiotics while testing everything you can imagine and a lot more, including chest X-ray. They also gave my more Tylenol for the fever.
I got better - rigors went away, fever down some. They admitted me to Mayo Hospital and there gave me another antibiotic drip (which I had a reaction to also).
The next day I was fine except very tired. The tests gave no clue to the cause, leading to the strong suspicion it was the Reclast.
I should add, I have a history of rapidly developing SIRS, although the two previous time it was significant infections.
BTW, age 78, male.
On the bright side, the reaction seems gone, rather than lasting for days (at a lower level, obviously) than advertised.
SIRS - Systemic Inflammatory Reaction Syndrome.
Anyone else?
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rotate, hi. About 30% of Reclast patients experience the acute phase reaction you describe. You were sort of lucky though, some have a several week extension and the very few are hospitalized to have IV steroid infusions.
Here is an interesting description from correspondence with a bone expert.
"When amino-bisphosphonates (N-BPs) are administered IV, resulting in a high systemic exposure (unlike when taken orally, where the very low oral bioavailability results in a quite low systemic exposure), phagocytic cells other than just osteoclasts can encounter the N-BP, Up to 30% of patients can experience an APR (acute phase reaction) after their initial infusion of zoledronic acid. This APR, which starts usually about 6 hours post-infusion, and can last several days, consists of a mild fever associated with muscle and joint pains, similar to the symptoms with a bad viral infection such as the flu. And it turns out that the cause is very similar, as well. When a special category of phagocytic T-cells, called gamma-delta T-cells, encounter the zoledronic acid, they engulf it, just like an osteoclast will engulf alendronate or zoledronic bound to the bone surface. And just like an osteoclast that engulfs a N_BP undergoes apoptosis (programmed cell death), the gamma-delta T-cells that engulfs a N-BP also undergoes apoptosis. The difference is, when a gamma-delta T-cell undergoes apoptosis, it releases inflammatory cytokines, such as IL-1, IL-6, and TNF-alpha, just like when it encounters a flu virus. And these inflammatory cytokines mediate the temperature rise and myalgias, just as with a flu infection."
Don't be surprised if your joints begin to ache. At least your bones will be getting stronger.
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5 ReactionsTks.
What's different from that in my case is how sick I got - temp 104F, rigors to where it was hard to breathe -necessitating hospital admission. They didn't give steroids, just Tylenol, which didn't seem to matter. But it ran its course in 12 hours or so.
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1 ReactionI moved through the flu-like symptoms okay, then was slammed with severe, stabbing hip pain which has now lasted for eight months. Are there solutions? How long will this pain last?
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