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 | Aug 13 8:09am

In reply to @weissl "@cathyf31 I already did but it doesn’t help me." + (show)

@weissl So sorry to hear of your experience; I did OK with Reclast but who knows if it has changed bone density after 1 year as I was told it was a powerful drug and my best choice to increase my bone density, apparently no dexa for two years. My directions were to be "well hydrated" whatever that means and to take a Tylenol if I felt like I was getting the flu. Got a packet about the infusion on my way out of the infusion center. Hope your new doc can help you better than the old!

CathyF31 | @cathyf31 | Aug 13 8:20am

In reply to @weissl "@cathyf31 I already did but it doesn’t help me." + (show)

@weissl No, but it will definitely prevent future harm from that doctor, who appears to not be overly familiar with treating osteoporosis or the medications.

hortensia valdes villada | @hortensia0 | Aug 13 8:23am

Scary advice given to patient

friend123 | @friend123 | Aug 30 8:16pm

In reply to @friend123 "Hi Everyone, I had my first in Reclast fusion yesterday. I followed everyone’s terrific advice, hydration..." + (show)

@friend123
Hi! That happened to me and my daughter who is a nurse practitioner told me to drink Gatorade because of the electrolytes, that had definitely helped!!

pollywog | @pollywog | Sep 10 3:59pm

In reply to @gently "friend123, I pass this advice on (frequently), though I've never taken reclast "There are 3 things..." + (show)

@gently

friend123,
I pass this advice on (frequently), though I've never taken reclast
"There are 3 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 safety 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%.The other thing to consider is that in most patients, a 5 mg infusion of zoledronic acid will control the rate of bone turnover for at least 24 months, so most of my patients do not get annual infusions."
Zometa is marketed for cancer. Reclast is marketed for osteoporosis. Same drug zoledronic acid. Zometa is 4mg. Reclast 5mg even though they know that 4 mg is equally effective as 5mg for osteoporosis.
I'm not sure why tylenol would be preferred, as not even being antiflammatory. A kind RN on this site advises that perhaps it prevents the fevers and chills that can follow Reclast injections. I've been advised that without your doctor requesting the slower infusion, the infusion center might refuse the courtesy. If you have a reaction it can start after several days. Some people have little or no reaction. Aching in the joints is common. I hope you have luck. You're giving your bones some protection from fracture for the next ten years with one injection.

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@gently
I have osteoporosis, recovering from surgery on a fractured/crushed T8 vertebrae. Surgeon suggested connecting with endocrinologist for bone build ing and strengthening.
New Dr., first suggestion: daily self injected shot, has to be kept refrigerated. We are retired and travel quite a bit. Did not feel conducive given our lifestyle.
Second suggestion: Reclast. Did a lot of research, seemed to be more cons vs pros. I then found this chat site. Upon reading your suggestions, lots of positive feedback from others and working with my Dr. I have agreed to the Reclast infusion. He also changed the timeframe from 15-30 minutes to 60. I just need to confirm the tylenol in the middle.
My infusion is tomorrow, will try to give a report. In appreciation for your suggestions, advise and to all who have put in your experiences. I feel more positive going into this. Polly

friend123 | @friend123 | Sep 10 5:13pm

Hydration is the key the day before and morning of your infusion. I also took Tylenol before I left for my appointment. Good luck!!

gently | @gently | Sep 10 10:02pm

In reply to @pollywog "@gently I have osteoporosis, recovering from surgery on a fractured/crushed T8 vertebrae. Surgeon suggested connecting with..." + (show)

@polly best luck with your infusion tomorrow. I have this about tylenol from a doctor who ran Reclast clinical trials. He has infusion nurses give the patient 650 mg of acetaminophen (Tylenol) during the infusion. Then.
" I tell the patients to take 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%." So you could easily take two during the infusion. Is that what you meant by "in the middle." In the middle of the infusion.
You should have around six hours before onset, if you have APR. Some patients don't. If you are unlucky and have longer term effects or unbearable effects, steroids are the countermeasure used by most hospitals.
Best luck tomorrow!