Does anyone have a solution to help manage Reclast side effects?

@cccs from what I was told, about 18 months. Well, I am on my 18th month and I can say, on a good day, my pain has gone from a 10 to a 3 on average; some days lower and others a bit higher. I just feel it is slowly getting better and the last thing I want is a full reoccurrence and I fear another infusion of any medication can and more than likely will cause additional or continuous pain all over again.

@dannyandebbie

Did you have a full dose of reclast?

cccs, sorry about you knee. There are studies that suggest that the bisphosphonates have protective effect against degradation in the knee, but others suggesting that bisphosphonates have deleterious effect.
There isn't enough research to warn us or encourage us.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11505443/
The mechanism of action is thought to be that aminobisphosphonates transiently stimulate the production of proinflammatory cytokines such as interleukin-1, interleukin-6, and tumor necrosis factor-alpha.
https://pubmed.ncbi.nlm.nih.gov/16755241/.
https://www.sciencedirect.com/science/article/pii/S1063458420310864
from communication with an endocrinologis who oversaw the Reclast trials.
"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."
I think that this https://pmc.ncbi.nlm.nih.gov/articles/PMC8373857/.
article might explain the longer term consequences for some on this and other medications.

@dannyandebbie

Did you have a full dose of reclast?

@gravity3 I have been told that receiving the dose over a longer period, an hour in my case, lessens the side effects.

cccs, I would expect that it will. Here is a case report regarding a different bisphosphonate alendronate. https://academic.oup.com/rheumatology/article-abstract/44/1/131/2899192

cccs, sorry about you knee. There are studies that suggest that the bisphosphonates have protective effect against degradation in the knee, but others suggesting that bisphosphonates have deleterious effect.
There isn't enough research to warn us or encourage us.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11505443/
The mechanism of action is thought to be that aminobisphosphonates transiently stimulate the production of proinflammatory cytokines such as interleukin-1, interleukin-6, and tumor necrosis factor-alpha.
https://pubmed.ncbi.nlm.nih.gov/16755241/.
https://www.sciencedirect.com/science/article/pii/S1063458420310864
from communication with an endocrinologis who oversaw the Reclast trials.
"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."
I think that this https://pmc.ncbi.nlm.nih.gov/articles/PMC8373857/.
article might explain the longer term consequences for some on this and other medications.

@gently
I love all of the links to research. But could you summarize your post for us non-medical people? Do I understand you to say that treating the long-term effects of Reclast would be similar to or exactly like treating inflammation from any chronic disease, such as lupus?

Yes, I am reading the articles linked and I have a general understanding of what each is saying. But I wondered about your overall conclusion. I understand that if you are not a medical provider you might not want to give a conclusion. But you can give your opinion.