ReClast: Warning and Dosage Variation

Posted by njhornung @normahorn, Jan 22 6:11pm

I was trying to find information regarding any options of taking different dosage amounts in place of the one-size-fits-all recommended dosage. I spotted something that I cannot find now. However, I came across this warning:

Conclusion
It is important that the potential patients receive sufficient information about the possibility of side-effects following the administration of intravenous zoledronic acid. To ensure that a zoledronic acid infusion is given as safely as possible, the safety information should include that the patient should not be left without monitoring for a minimum 24 hours after the infusion. Being alone and experiencing serious side-effects may lead to acute cardiac problems.
https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-022-03695-y

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78 year old male with hyperthyroidism. -2.0 osteopenia. Had my first Reclast first week of November 2023. That night I had uncontrollable shaking - tremors without chills for a couple days- but both hands were freezing cold. Next couple days no strength in hands - numb and tingling - couldn’t’t grab and open a doorknob. Joint pain in knees, elbows and feet. Couldn’t walk one foot swollen so bad. Now some 3 1/2 months later still have index finger and thumb still numb and tingly. Last week muscle spasms in back and chest. Urgent care twice because not sure if caused by Reclast. But no other cause surfaced - minimal arthritis, no heart issues. So Reclast seems to be something I am allergic to. Have decided to not have a second infusion.

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I am having a 20% dose (1 mg). One of my docs says they do this a lot. My reduced dose is because of kidney issues, afib, and sensitivity to meds. The advice for all doses is to hydrate well (I requested IV hydration), ask for a slow infusion (up to an hour) and take tylenol before, during and after. Another thing: a 2.5mg half dose may be as effective as the full 5mg: my doc confirmed this as well.

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@jaylee

78 year old male with hyperthyroidism. -2.0 osteopenia. Had my first Reclast first week of November 2023. That night I had uncontrollable shaking - tremors without chills for a couple days- but both hands were freezing cold. Next couple days no strength in hands - numb and tingling - couldn’t’t grab and open a doorknob. Joint pain in knees, elbows and feet. Couldn’t walk one foot swollen so bad. Now some 3 1/2 months later still have index finger and thumb still numb and tingly. Last week muscle spasms in back and chest. Urgent care twice because not sure if caused by Reclast. But no other cause surfaced - minimal arthritis, no heart issues. So Reclast seems to be something I am allergic to. Have decided to not have a second infusion.

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So very sorry to hear this

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@windyshores

I am having a 20% dose (1 mg). One of my docs says they do this a lot. My reduced dose is because of kidney issues, afib, and sensitivity to meds. The advice for all doses is to hydrate well (I requested IV hydration), ask for a slow infusion (up to an hour) and take tylenol before, during and after. Another thing: a 2.5mg half dose may be as effective as the full 5mg: my doc confirmed this as well.

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I this works well for you. How many times will you need to go in to Boston to get the smaller injections?

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@windyshores

I am having a 20% dose (1 mg). One of my docs says they do this a lot. My reduced dose is because of kidney issues, afib, and sensitivity to meds. The advice for all doses is to hydrate well (I requested IV hydration), ask for a slow infusion (up to an hour) and take tylenol before, during and after. Another thing: a 2.5mg half dose may be as effective as the full 5mg: my doc confirmed this as well.

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windyshores, thank you very much. I had 10 years Prolia, then in August 2023 Reclast. I survived but 2 weeks I was in bed with horrible pain. I have many problems with health. Then in November I broke a bone in my hand and there is no another choice, only Reclast. CTX is 678 now, 3 months ago CTX was 454. We live now in Florida, in a small town, when I came to the endocrinologist for the second opinion, she was impressed and asked me to copy all material that I brought to this appointment. I wrote this to explain that in our town I can not find an endocrinologist who has experience with stopping Prolia. You wrote that one of you doc says that they do reduced dose often and I read before in one your comment about this and asked the same dose when I had a second opinion visit and this endocrinologist agreed to do so.
Again thank you so much.
Good health and good luck in everything.

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@jaylee

78 year old male with hyperthyroidism. -2.0 osteopenia. Had my first Reclast first week of November 2023. That night I had uncontrollable shaking - tremors without chills for a couple days- but both hands were freezing cold. Next couple days no strength in hands - numb and tingling - couldn’t’t grab and open a doorknob. Joint pain in knees, elbows and feet. Couldn’t walk one foot swollen so bad. Now some 3 1/2 months later still have index finger and thumb still numb and tingly. Last week muscle spasms in back and chest. Urgent care twice because not sure if caused by Reclast. But no other cause surfaced - minimal arthritis, no heart issues. So Reclast seems to be something I am allergic to. Have decided to not have a second infusion.

Jump to this post

This is curious that people are saying they have taken smaller dosages of Reclast. I questioned the possibility of a lower dose of Reclast. He said there was only one dosage. I'm not sure where to go with this. Any suggestions?

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Interesting reading. Plus I can find a 4 mg/100 mi dose being marketed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959627/
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@sammy26

This is curious that people are saying they have taken smaller dosages of Reclast. I questioned the possibility of a lower dose of Reclast. He said there was only one dosage. I'm not sure where to go with this. Any suggestions?

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@sammy26 my doc will do 1mg (a 20% dose) with IV hydration and slow infusion. After one month, I will tell him how I reacted and tell him what dose I want the second time, which will occur 3 months after the first.

I also asked about the fact that I read that a half dose, 2.5mg, may be as effective as the full 5mg, and the doc agreed.

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