My turn ~ Another view on Reclast [Zoledronic acid aka Zometa]

Maybe this doesn't make any difference. But I am 71 years old.

I think you are equating incorrectly acute phase adverse effects with long-term ones. There are protocols for reducing the acute phase ones: however, there are none for those whose lives have been ruined by the long-term effects. The acute phase ones are the more common ones while the long-term ones fortunately are much rarer. I plan on stacking the deck in my favor by insisting I will take only a 1 mg dose of Reclast rather than the standard overdose of 5 mg following Evenity.

@carolynk My reaction, or lack thereof, was similar to yours. I took Fosamax for 5 years and showed moderate gains in bone density. Then, I had radiation therapy in the pelvic area in 2021 (for a recurrence of endometroid adenocarcinoma) and a year later experienced a spontaneous sacral fracture. I saw an endocrinologist who said I had been doing everything possible to avoid more bone loss but the sacral fracture (now healed - see below) meant I needed more help to avoid future fractures.

My mother had osteoporosis, fell and fractured her hip when she was in her mid-60's, had surgery, and never fully recovered function. This was in the 1980's when there were far fewer medications available.

Following athat reduction in bone density I had one year (monthly injections) of Evenity with no short term or long term side effects. I gained significant bone density with Evenity and exercise and so my endocrinologist ordered a Reclast infusion and I had no short term or long term side effects. In December, 2025, I had another bone density DEXA scan and this showed a 10.1% increase in lower back and 4% increase in my hip. During 2025 I had continued with my exercise regime which included weightlifting with particular emphasis on axial compression (deadlights, Romanian deadlifts, etc.), and walking. My endocrinologist was very pleased with these results. He ordered another Reclast infusion in December 2025 and again I had no side effects.

My endocrinologist will monitor my bone density but he said barring any significant bone loss I won't need any other medication for at least 3 years. I will continue my exercise with weightlifting, and nutrition with emphasis on calcium.

I feel like I am the "poster child" for these medications. I was more than willing to go with my endocrinologist's recommendations in addition to what I was already doing because I observed my mother's frailty over the years. She would want me to do everything I could to avoid what she went through. I miss her every day and wish that there had been more options for her.

@naturegirl5 I'm glad to hear that you experienced gains from Evenity after Fosamax. I was on oral alendronate for over five years and even fractured while on it. I am now on Evenity (finishing in April) and took both Tymlos and generic Forteo for six months prior. I am hoping for a good outcome so I am heartened to hear of yours. I have also lifted weights since 2012.

I will also be doing Reclast after I finish so also good to hear of your experience with it.

Preplanning: Maybe I should have said this, too. Because of the [prior] black box warning on Evenity. I got my cardiologist and my neurologist to sign off on my treatment before proceeding.
I read either in Medscape or JAMA, that after the long history with Evenity, that black box has been removed. But it's still a good idea to discuss it with any medical specialist that you may be seeing. Note: The is Evenity not Reclast.

CarolynK, the black box remains on Evenity and was even tightened in 2023. You might be thinking of the Black box on Forteo and Tymlos. It is easy to get turned around in the fun house.

I tried Envenity for 3 months and the headaches were terrible. Dec 5, 2025
I had my first Reclast infusion and was in terrible pain 4 days and some of the side effects have stayed but minimal pain. I am not planning on anymore infusion. I have increased my exercise and take several supplements to hopefully keep my bones from anymore deterioration.

gently I about choked on my coffee laughing about your "fun house" comment! Thanks for a bit of levity as we all deal with this crazy chronic condition and the treatments currently out there!

@gently , You are right, RFK, Jr. has not yet lifted the black box warning. I got out ahead of this. Here is the related information. https://www.medscape.com/viewarticle/does-romosozumab-deserve-its-black-box-warning-2025a1000ish.
When my neurologist was looking at this before I started Evenity, he noted that statistically Evenity was safer than Fosamax. Since I had been taking Fosamax for over 5 years, he felt that Evenity would be safe for ME.
Thus, the importance of our own health history is paramount.

very helpful to have the protocal spelled out .
thanks