Has anyone had new on of osteoarthritis or flare up with Reclast?

Posted by linda1194 @linda1194, Jul 4 10:53am

In January 2025, I had intravenous zolendronic acid (Reclast) for osteoporosis the first time. The following week (January 21) I began to experience right knee pain. It became sharp. I was concerned that I might have had a blood clot and went to the ED on January 28. They found it was a Baker’s cyst. Then, later in February, my left leg knee started to hurt and swell and went to a sports medicine doctor who said my left leg also had a Baker’s cyst and that it was due to osteoarthritis. But I have not up until this point ever had knee joint pain and never before been diagnosed with osteoarthritis. Neither or my parents or grandmother had arthritis to my knowledge. The knee pain came on so suddenly and just around a week or so since I had the infusion. I recently checked some medical sources and it appears this might be related to the zolendronic acid. I am concerned because I cannot do my regular activities such as walking very far and working out—this has really messed up my life. (I was on Prolia for a number of years and never had pain). I reported this to my prescribing doctor and she was sympathetic. My question—has anyone had a new case or flare-up of osteoarthritis—and if so, how long did it last? Thank you.

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In January of 2024 I received my one and only reclast infusion. I had the extreme reaction some others have had about 10 hours after-the rib, back pain, "hit by a truck" feeling which lasted about a day then slowly abated. However, about 2 months later I began with musculoskeletal pain which only affected my right leg-hip to ankle. It began a cycle of flareups that would last a month or more then go away almost completely only to return a couple of months later. The pain eventually settled in my right knee which has had some extreme flareups. Xray showed osteoarthritis, bone on bone laterally. I received a steroid injection and PT which helped but it still flares up depending on my activity, especially at night. Like you, I was very active before and this has had a huge impact on my life. I will note that I had a similar reaction as far as pain goes when I took Fosamax years ago and I stopped that weekly pill after 4 months with no recurrence until the Reclast. I took a chance, knowing this, and regret that decision. For now, I do the exercises PT assigned to strengthen my muscles that support the knee with hopes of avoiding a knee replacement. I am holding off on another steroid injection as you can only have so many and concern how it may affect my osteoporosis. I wish you the best and some answers so hope to hear how you do.

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I am so sorry that you both are having this happen to you. So far my left arm is my only problem with pain and limited movement but every morning when I get up I wonder if some other part of my body is going to be affected by this infusion. I wish I had more faith in it. Still not sure if I will have the next one already scheduled for December 2025.

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@fabpainter

In January of 2024 I received my one and only reclast infusion. I had the extreme reaction some others have had about 10 hours after-the rib, back pain, "hit by a truck" feeling which lasted about a day then slowly abated. However, about 2 months later I began with musculoskeletal pain which only affected my right leg-hip to ankle. It began a cycle of flareups that would last a month or more then go away almost completely only to return a couple of months later. The pain eventually settled in my right knee which has had some extreme flareups. Xray showed osteoarthritis, bone on bone laterally. I received a steroid injection and PT which helped but it still flares up depending on my activity, especially at night. Like you, I was very active before and this has had a huge impact on my life. I will note that I had a similar reaction as far as pain goes when I took Fosamax years ago and I stopped that weekly pill after 4 months with no recurrence until the Reclast. I took a chance, knowing this, and regret that decision. For now, I do the exercises PT assigned to strengthen my muscles that support the knee with hopes of avoiding a knee replacement. I am holding off on another steroid injection as you can only have so many and concern how it may affect my osteoporosis. I wish you the best and some answers so hope to hear how you do.

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Thank you so much for sharing your experience. I'm sorry you have had to go through all this. Your response is very helpful for me. It gives me a sense of what is happening and how to deal with it. I had Prolia injections for 5-6 years and never had a problem. Do you have a sense of whether your reaction to Reclast will become less severe over time as the drug presumably loses its effects over time? And is there some site to report the effects we have?

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@ladybugnc

I am so sorry that you both are having this happen to you. So far my left arm is my only problem with pain and limited movement but every morning when I get up I wonder if some other part of my body is going to be affected by this infusion. I wish I had more faith in it. Still not sure if I will have the next one already scheduled for December 2025.

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Thank you for weighing in. Have you tried Prolia? As I noted below, I didn't have a bad reaction to that.

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As time goes on, I do feel it will improve from the overall right leg bone pain flareups I was having but now the knee has to be managed as it is osteoarthritis. I feel one thing can lead to another and so try to be very consistent with my PT exercises to support the knee with stronger muscles. I will have a DEXA in the fall and hope that despite all of this it will show generalized improvement as my spine numbers were -3.8 in 2023. I would be very reluctant to take Reclast again, though, as I feel I am not a candidate for it or any bisphosonates. I'm also working on taking in more anti-inflammatory foods-ginger, turmeric and avoiding salt and other triggers some have mentioned. Some have posted an FDA website to report and I have not done that but my Dr is aware. She said 30% of more patients have musculoskeletal side effects. Hope you soon feel better as time passes.

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Thank you again for your thoughtful, helpful comments. You have given me some hope. I wish the best for you also!

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I was on Reclast 4 yrs with no prblems and no improvement. After a fx AND A parathyroid issue my Dr recommended Evenity . Evenity has cause severe increase in arthritis to the point I can barely walk. I have been off it since since February but no real improvement. I am wondering if I ever will. I also had aleft femur injury possible fx and severe groin pain has just now begun. Both S/E of Evenity. I did get one follow up Reclast infusion after Evenity in March but not sure I will continue as I just get worse. My arthritis is worse in hands and feet but hip is worse. I never had hip pain before Evenity. Hopefully my knees will hold me. My back fx 2 yrs ago did great with no pain after surgery and bone replacement at L2-4. Good luck. I would like to hear from any one on how long it takes to get rid of s/e after last dose

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Thank you for sharing this. Helpful to learn about Evenity. I hope you fare better as well over time.

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I had Reclast in Nov. 2024- my osteoarthritis has gotten worse since that time, along with what the MD thinks may be an inflammatory response that looks like rheumatoid arthritis (or actual RA- no one seems to know). I am on methotrexate for now. Will never do Reclast again.
I am sorry you are going through this. Was there a reason they switched you from Prolia? The only reason I had Reclast was because my insurance required me to try (and fail) with something else first.

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@jcthomas

I had Reclast in Nov. 2024- my osteoarthritis has gotten worse since that time, along with what the MD thinks may be an inflammatory response that looks like rheumatoid arthritis (or actual RA- no one seems to know). I am on methotrexate for now. Will never do Reclast again.
I am sorry you are going through this. Was there a reason they switched you from Prolia? The only reason I had Reclast was because my insurance required me to try (and fail) with something else first.

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Thank you for sharing your experience. I'm sorry you are going through something similar as well. My doctor indicated that one should not be on Prolia for many years and that the idea was to move me to Reclast for a couple of years and then take a holiday from osteoporosis meds for a few years.

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