Gbrodnan 1945,

Yes. One of the bone experts who conducted the clinical trials and had a private practice at Stanford has developed a procedure for delivery that you should print and take to your physician so that he can prescribe the delivery and to the practitioner who will apply the injection.

"As I have substantial experience with bisphosphonates, having led the clinical development of three of them, I recommend the following improvements/modifications to the zoledronic [Reclast} acid label.

First, I always have the infusion nursed dilute the 5mg in 100ml DSW into 500mL of NS, so that the now 600mL infuses over 60 minutes Making the N-BP less concentrated and infusing it more slowly substantially improves renal safety, based on data.
Second, I always in struct the infusion nurses to administer 650mg of acetaminophen at the time of the infusion, and instruct thepatient to take that same dose of acetamino;hen with dinner and at bedtime the day of the infusion, with all three 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 risk of a symptomatic acute phase reaction (APR) from 22% to < 1%
The 3rd thing I do is to repeat the BTMs (U, NTX, and serum BSAP 4-6 weeks after the infusion of zoledronic acid, to assess the maximal effect (nadir in the rate of bone turnover. This serves as a comparison when I repeat the BTMs 12 months after the infusion. In my extensive 32 years of experience with IV bisphosphonates, the average woman (not taking aromatase inhiitors) will show a weel-controlled rate of bone turnover (much lower than baseline, and not meaningfully higher then 4-6 week psot-infusion), and only needs a 2nd infusion after an average of 24 months. This is similar to the Phase 2 study conducted by Novartis, where the demonstrated in Pm{ treated with 4mg of zoledronic acid that all of them maintained a normal rateof turnover through at least the final visit at 18 months."
These instructions will likely be something your care providers have not heard. It will be a little extra effort to make on your behalf. You'll want to be sure that your prescription provider gets the information to whomever will be giving the IV so they can prepare to have you for the hour instead of the fifteen minutes.
Some individuals report reflux symptoms with the IV bisphosphonates. So take the extra care after eating not to exercise or bend over or lie down or wear constricting belts or pants.
I'm curious about how at 66, 12 years ago you decided to have a dxa.
Some people really do have intensely negative experience following the infusion, lasting for weeks. So don't let any jaded medical provider wave off these precautions as unnecessary.
Best wishes.