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Reclast prep questions

Posted by friend123 @friend123, Aug 8, 2024

I will be having my first injection next week. I am interested in what would be the best way to prepare. How much water to drink the day before and how much Tylenol to take? Also is Advil ok to take instead of Tylenol?
Thank you!

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jozer | @jozer | Jun 8 8:15am

Good luck to you wildgoose - I did the protocol gently mentioned to the letter - can't remember where I read about endodoc; maybe on inspsire? Had zero side effects. My infusion center had never heard of or done a slower drip, was in and out in less than 40 minutes (including 20 to sit and see if I had a reaction).

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loll | @loll | Jun 8 8:21am
In reply to @gently "wildgoose, call the infusion center as early as possible tomorrow morning and request IV fluids before..." + (show)
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wildgoose, call the infusion center as early as possible tomorrow morning and request IV fluids before the infusion. Explain you situation and ask if you need to call your physician to have that ordered. They might call for you or might just give you the extra fluid and the extra time
The Stanford doctor who ran the clinical trials on Reclast offers this advice.
"A opposed to administering the 5 mg of zoledronic acid in 100 mL of D5W and infusing it over 15 minutes, for the past 29 years I have had the infusion nurse at Stanford dilute it into 500 mL of NS, and to infuse the 600 mL of now diluted BP over 60 minutes. TRUST ME!! By diluting it and administrating it more slowly, it improves the renal (kidney) safety.
The othr thing I do is to instruct the infusion nurses to give the patient 650 mg of acetaminophen (Tylenol) during the infusion. Then I tell the patients to take that same dose (two regular strength tablets) 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. This reduces the patient's risk of experiencing a symptomatic APR from >28% to < 1%."
endodoc
The fluids and the longer infusion are really important giving your kidneys more time to filter out the bisphosphonate.
If it is too late for all of this, I'd reschedule. You should take water with you to sip during the infusion.
Some have a difficult time with side effects. The APR is said to be an achy flu that can last a week or more.
To start out dehydrated puts you a a disadvantage that you don't need.
I hope it goes well. Let us know how you fare.

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@gently helpful to know this, ty, I’m still in the process of getting answers from my primary care doc but my 1st infusion has been prescribed

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gently | @gently | Jun 8 8:56am

loll, sometimes the infusion centers are happy to cater to patient requests. I've heard of people being denied the dilution because the center didn't have the IV fluid available. There was a shortage of IV fluid a couple of years back.
It's nice if the doctor writes the order with the extra fluid have to return. Best luck with the infusion. Reclast can cause hypocalcemia, but your doctor is probably watching your levels. Will you have bone markers,

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loll | @loll | Jun 9 8:12am
In reply to @gently "loll, sometimes the infusion centers are happy to cater to patient requests. I've heard of people..." + (show)
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loll, sometimes the infusion centers are happy to cater to patient requests. I've heard of people being denied the dilution because the center didn't have the IV fluid available. There was a shortage of IV fluid a couple of years back.
It's nice if the doctor writes the order with the extra fluid have to return. Best luck with the infusion. Reclast can cause hypocalcemia, but your doctor is probably watching your levels. Will you have bone markers,

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@gently Thank you, bone markers have not been mentioned, nor hypocalcemia. I’m in the process of trying to get an appointment with my primary care doctor to consult about all of this before going ahead with the infusion.

Here in Minnesota it’s difficult to get appointments. My next question for the Doc's team is who can help me with this if she doesn’t have appointment times available. She sees patients and is the clinic medical director.

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wildgoose14 | @wildgoose14 | Jun 9 9:59am
In reply to @wildgoose14 "I did request the physician to give me some IV fluids first. I haven’t heard back..." + (show)
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I did request the physician to give me some IV fluids first. I haven’t heard back from him yet. He did prescribe the steroids to take the day of and one each day following the infusion. He did request that the infusion Be delivered over 45 minutes to 60 minutes rather than the typical 15. I’m trying to chug the water and appreciate all of your good guidance. Thank you or let you all know how this goes today.

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@wildgoose14
Thanks for the hug. I want everyone to know. I had my first infusion of class yesterday. Everything went perfectly. I feel like the advice I got on here to hydrate the day before and the day of and should take the Tylenol really helped make yesterday painless. They did infuse the rec class at 45 minutes instead of 15. So far I’m feeling great and I feel like I had a positive attitude going into this I had backed out three times before for Prolia and now I’m thinking this was a good decision. Thank you everyone and my name is Pat.

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wildgoose14 | @wildgoose14 | Jun 9 10:26am
In reply to @jozer "Good luck to you wildgoose - I did the protocol gently mentioned to the letter -..." + (show)
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Good luck to you wildgoose - I did the protocol gently mentioned to the letter - can't remember where I read about endodoc; maybe on inspsire? Had zero side effects. My infusion center had never heard of or done a slower drip, was in and out in less than 40 minutes (including 20 to sit and see if I had a reaction).

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@jozer
My doctor recommended the slower infusion. And on day two I haven’t had a single side effect. I’m still taking Tylenol and drinking the water. I hope you continue to do well.

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jozer | @jozer | Jun 9 2:18pm

Wonderful for you...may you also continue to do well...I did just fine (bad headache on day 5 but I am prone to migraines)!

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gently | @gently | Jun 9 2:52pm
In reply to @wildgoose14 "@wildgoose14 Thanks for the hug. I want everyone to know. I had my first infusion of..." + (show)
Profile picture for wildgoose14 @wildgoose14

@wildgoose14
Thanks for the hug. I want everyone to know. I had my first infusion of class yesterday. Everything went perfectly. I feel like the advice I got on here to hydrate the day before and the day of and should take the Tylenol really helped make yesterday painless. They did infuse the rec class at 45 minutes instead of 15. So far I’m feeling great and I feel like I had a positive attitude going into this I had backed out three times before for Prolia and now I’m thinking this was a good decision. Thank you everyone and my name is Pat.

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@wildgoose14, I'm so happy about this result.

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bytheriver | @bytheriver | Jun 9 6:19pm

Well. Let me tell you the latest on Rrclast. Yes, I’m the the one that keeps posting on all the trouble I have had (bytheriver). The latest thing…..I had a minor surgery in May (fatty eyelids). Should have been simple…well on the table I aspirated and had to have my stomach pumped. Now I hadn’t had anything to eat or drink in 16 hours so I should have had an empty stomach…..not so if you have have Reclast. Remember all the muscle pain I have had for 6 months (pain worse than the back surgery) well as the Reclast has caused all the muscle pain it seems it has affected the stomach muscles as well preventing the stomach to empty as it should…. Imagine that! It’s been 6 months and I can’t wait to get this stuff out of my system!!

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kortdanie | @kortdanie | Jul 5 10:14pm
In reply to @dlc1953 "I switched off of Prolia to Reclast. I had my first infusion about 2 weeks ago...." + (show)
Profile picture for dlc1953 @dlc1953

I switched off of Prolia to Reclast. I had my first infusion about 2 weeks ago. Hydrate and Tylenol is essential. Unfortunately the next day I got so sick. Everything hurt. My eyes, mouth, back, legs, ankles, hands and horrible headaches. Thank goodness it only lasted 24 hours. (I never had side affects of any meds before). Good luck.

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@dlc1953

I did the same, switch from Prolia to Reclast. I was informed to take ibuprofen by my Dr, which I learned is not recommended. I also had server symptoms that started the night of the infusion. My whole body was in extreme pain to the point I could barely walk to the bathroom. That lasted two days, after that there was still pain but I coild at least find the courage to attempt walking, I did it but it was not easy. The second day the pain eased a bit more and then I was vomiting everywhere. I could not eat and nausea medication did not help at all. I could not sleep due to the pain and vomiting, I got body chills and then sweats with a fever. I attempted to contact my dr. however they were not reachable. I called the pharmacist and they recommended Tylenol and zofran, i was already taking zofran and I switched from ibuprofen to Tylenol and it did nothing, I was still ibmn bad shape, I called the pharmacist again because dr was still out of reach, the pharmacist said I just had to wait it out.
I informed my doctor of all of this once I had my follow up and she said that was abnormal bit they wanted me to continue the infusion and it shouldn't be too bad the second time around. My second one is this coming friday, and I am terrified. I have asked the dr for any meds that could help but they stated over the counter drugs should suffice. I have my grandmother coming to watch over me during this process. Wish me luck.

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