Reclast infusion protocol question

"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 other 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
It might be difficult to get any of this without your doctor ordering it this way. You might brave it concentrate on taking your own tylenol and hydrating on your own. This Stanford doctor clearly has control of the infusion clinic. But I think without orders the clinic wouldn't be able to dilute the infusion. You might delay the infusion until your doctor can write the order. (I mean to say that I would) On the other hand you may have no trouble with the infusion.
Best wishes

@gently thanks you so much for your time and sharing your protocol advice. The Infusion center has agreed to do the infusion over 45 minutes. Does this mean that they will be diluting so that it will go for 45 minutes or do I need to I ask them to dilute it.? Thank you.

Exactly the protocol I followed...I kept it going an extra day after the infusion. And I actually measured and counted out 64 oz of water each day. Also, the drug literature says to have 16 oz water within 2 hours of the infusion. My infusion center never heard of a slower drip or extra saline; I was done and on my way home in 40 minutes (allowing 20 to hang around to see if an allergic reaction would occur). That said zero side effects (maybe a little tired?) except a bad headache on day 5 but I am prone to migraines so not a big surprise there.

I asked for a one hour infusion followed by a 30 minute saline rinse. The infusion center was willing to do that. It was worth my time being there because with all the literature I collected from this site, I felt it was the best way to go! I had no side effects after the infusion. I also hydrated, took Tylenol and Claritin 2 days before and 2 days after.

@kaa1, it has to be diluted to run longer. But you might call the center and ask for the dilution the Stanford doctor recommends. I've heard here on connect of a patient who was denied the longer process because there was not IV fluid on hand. I'm happy to hear the center's response to your request.
Endodoc says he has never seen a long term negative reaction to Reclast, maybe because he is so careful with his patients.
I hope this is a good experience.

@lee1447
Thank you for sharing your experience.

@gently
Thank you for this information🙏🏻

@lee1447
Good info, thank you.

@kaa1
Good luck. Let us know how it goes!

Thanks everyone for your kind words and support. I had the infusion yesterday. I had to jump through some hoops to get the Infusion spread out over 60 minutes with a 30 minute saline rinse. They did not dilute the Infusion however (it’s premixed), they just slowed down the drip. I don’t know if that helped my situation or not. Tylenol and tons of water and was feeling good until about midnight, severe flu symptoms, high fever (102.6 at one point),tons of bodyaches and throwing up. I couldn’t eat or take the Tylenol at that point because I was throwing up but later on I was able to keep it down and fever is now 100.9. We’ll, I’m up now having some coffee and thankfully I don’t have to work today. I know some people have no side effects at all with this. I guess I’m not one of those lucky ones but I’m hoping it passes in a day or two. Be well everybody.