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@harborside24 I have been searching for this post by @gently and finally found it. Endodoc contributes to this website as well as the Inspire website which has information about osteoporosis. This is from @gently and is for anyone whose doc is hesitant to order more than a 15 minute infusion...
I'm copying a helpful note from the md who led the trials on Reclast in case you haven't seen it.
"My strong recommendation based on my knowledge of bisphosphonates (given that I helped to develop three of them, and treated 13,000 patients in phase 3 trials with them) is to have the infusion center dilute the 5 mg of zoledronic that comes in 100 mL of D5W into 500 mL of NS, and infuse the endodoc recnow 600 mL over 60 minutes. Making the drug more dilute and administering it more slowly significantly improves the renal safety for N-containing bisphosphonates.I also strongly recommend that the infusion nurses give the patient 650 mg of acetaminophen (Tylenol) at the time of the infusion, and that the patient take that same dose 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 of acetaminophen with breakfast the 2nd morning after the infusion. These 8 doses total of Tylenol reduce the chance of a symptomatic APR (Acute Phase Reaction) from 22% to < 1%.Best, Endodoc"
Replies to "@harborside24 I have been searching for this post by @gently and finally found it. Endodoc contributes..."
@harborside24 Wow, this is interesting. Do we know who EndoDoc is?
I think if I had the name of EndoDoc that I might be able to get my doc's attention...
@harborside24
Thank you for posting this. I recall sometime ago that endodoc was quoted in more detail on this topic, but I can’t seem to find the source of it.
Would you happen to have the full text of that earlier post?
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@harborside24
Thank you for finding this particular post which is the closest thing to a peer-reviewed article I've been able to find to present to my doctor. Thank god Endodoc provided this critical protocol, though I wish we could identify the original trial research citation. I made a copy of this protocol and presented it to my oncology PA who ordered my infusion. In my case it was for Zometa rather than Reclast.
It was unclear to me whether the nurse doing the infusion diluted the Zometa as described. I got the feeling she did not but set me up with what was provided. Because I was not sure about whether it was diluted per this protocol, I requested a saline flush both before and after. I must have read that as a suggestion somewhere and asked for it because I don't know if the nurse would have done that just because I requested it.
My infusion was almost an hour. Lots of hydration, tylenol, etc. My nurse did not give me a tylenol during the infusion, if I recall correctly,, but I did take it on my own. I do not recall any major side effects.