I had a horrible first infusion. But I am going back next year. They will do it entirely different. (don't know why they didn't do that from the start!!!) But I read the research and a VERY SMALL amount have reaction (like 1%?) and a one-hundredth of that percent have problems at the second infusion. My take on it is that the medicine causes a reaction in the places in your body that need help. I had the WORST reaction in my cervical spine and it turned out my bones were "mush". So I think the medicine goes where it needs to and that you just don't know that you really needed it there. I'm having positive results, and I'm going to stick with it even with the hardships because I NEED to have stronger bones. I went into menopause early, and it really caused havoc with my bone density. I go to UCSD for infusions and they are caring about making my next infusion better so they will slow it down and give less medicine. They have found that the dose can be lowered without compromising the result. Yes, it was the singularly most awful experience I've had but I'm not giving up.

osteopatient2026, I'm often quoting the gentleman who ran final large clinical trial for Reclast "Things I routinely do when I treat patients with IV zoledronic that not all physicians understand. First, I order the infusion to dilute the 5 mg of zoledronic acid (which comes in 100 mL of D5W) into 500 mL of NS (normal saline), thereby diluting the drug from 5 mg% to 0.8 mg%. Then I order it to be administrated over 60 minutes, instead of 15 minutes. Giving an N-BP more dilute and more slowly makes it even safe{r] for the kidneys. The 3rd thing I always do is order the infusion nurses to administer 650 mg of acetaminophen to the patient during the infusion, and I tell the patient to take at home the same dose of acetaminophen (two regular strength Tylenols) with dinner and at bedtime the day of the infusion, with all 3 meals and at bedtime the day after the infusion, and a final (7th) dose with breakfast the 2nd morning after the infusion. These 8 doses total of acetaminophen reduce the chance of a symptomatic APR from 20-30% to <1%."
At the Stanford infusion clinic 60 minutes with the dilution is standard.

Yes…there is some thinking by some doctors (they all seem to have differing opinions) that it’s a reasonable approach. Again it depends on a patient and what their individual conditions are. TScore, kidneys other organs…previous cancer or existing conditions. Everyone is different…
On the osteonecrosis subject…generally that is caused by existing dental issues, poor hygiene, etc. A general dentist will or should refer a patient to a specialist (oral surgeon or at least someone experienced with osteonecrosis) before beginning a regimen of that class of drugs that do have a known history of Osteonecrosis…Tymlos is one drug used to treat it ironically. There is a special mouth wash used to keep your mouth clean as well.

Chlorhexidine gluconate rinse is commonly recommended for osteonecrosis of the jaw to reduce infection risk. Evidence for their effectiveness is based on expert opinion rather than definitive trials however.

Again if you are in severe osteoporosis your treatment will vary. Fosamax generally won’t help much if you are like me …my spine was -4.8- -5.1 hip was -3.1…the current approach was to try Tymlos or forteo (or Evenity which last year the doctor didn’t have enough experience with) now after a lot more people using it they seem to prescribing it more. There is better compliance with the once a month injection…so many variables…
I’m not a doctor although my husband went to med school and his brother and sister are. They can’t even agree on a lot of things!
I found some good info here… a few members have really scoured the info and found some indispensable info.

hi carole,
most of our doctors aren't using bone markers. You might find the Doug Lucas video interesting https://www.youtube.com/watch I'm not shilling for him so I have to add don't buy anything.

I was using Tymlos while still working but got terrible heart palpations so dr. switched me to Forteo which was great. Too expensive once I retired so switched to Prolia shots which were great. Moved out of state and specialist suggested I could have an infusion just once a year. My bad for not asking for more information. Had I asked the name, I'd have learned it was bisphosphonates which I NEVER wanted in my system. Too late. I had the infusion 3 weeks ago and had horrible flu symptoms for the next 3 or 4 days - thankfully no nausea. However since then I have had awful pounding headaches and neck pain since then. I'm living on Tylenol, sleeping a lot, and limited energy. Going for a contrast MRI next week and really don't expect any answers. Next year I'll go back to Prolia.

I asked for and got a lower dose of Reclast to start. Reclast is 5 mg/Zometa is 4 mg the same drug. I get Zometa. Studies suggest lower doses are just as effective as the 5 mg.
I felt worse and worse with Prolia and came down with shingles after the last shot.
Everyone is different.

I think the only thing the steroid can do is to stop the self sustaining reaction of the cytokines. It can't reverse any damage done to tissue-- organs or vessels. It was disappointing that the steroid didn't help you at all. I wonder though if there are ways separate from cytokine that Reclast causes damage.

@osteopatient2026

For me, seeing my poor dad go through a bout of shingles told me I didn’t ever want to get them - the effects can be pretty devastating. My father made a full recovery, and didn’t have scars to speak of, but I could tell it was painful for him. My skin is very sensitive and probably becoming more so as I age, so I’m doing what I feel is prudent and what I can tolerate…which brings me back around to the Prolia comment.

Hope you’re having a peaceful Sunday. Cheers!

I've considered that it might be enough to warn people with autoimmune disease about Reclast. But from your experience it appears not. Type 2 diabetes isn't autoimmune, and you don't have it anyway.
The endocrinologist who ran the clinical trials for Reclast wouldn't have prescribed it for you.

I did not have chickenpox and I did get shingles but that was before Reclast. I’ve had the shot not had shingles since. Then was told I needed Reclast since I burst a vertebrae and showed osteoporosis in my back. I did the IV and didn’t think I had any major side effects… then about 3-4 month later they discovered I was severely anemic and eventually needed a transfusion. I’m am due for 2nd shot in Sept. but I’m not inclined to take it. They said it wasn’t the Reclast but nothing else changed in my life but that.