Reducing Reclast dosage.

I think they will approve a lower mg recommendation for reclast; many studies seem to point that way and a lot of times medicine amounts end up lowered. I am waiting for the day when there is an osteoporosis specialty in medical school. 54 million of us with osteoporosis and osteopenia and no one doc to see...

Keep in mind that if you’re Reclast and you have teeth problems, you cannot have any pulled. I found this out the hard way.
I’ve been getting the Reclast for 5 years and still managed to break ribs. I am stopping, but unfortunately the damage is done. I too have osteoporosis as osteoarthritis 79 y/o

@dgc

Thank you for sharing this valuable information. I'm presenting some of the Mayo Clinic Connect recommendations to my oncologist who has ordered a Reclast infusion for me. Can you tell me the source for the "additional article re: low dosage reclast" you refer to in your June 9, 2025 post?

I do see your previous reference to this source:
https://pmc.ncbi.nlm.nih.gov/articles/PMC4959627/
Thank you so much!

@prarysky
Hi - this is the link: https://cdn.prod-carehubs.net/n1/748e8fe697af5de8/uploads/2024/09/low-dose-reclast-1.pdf.
I was referencing.

@dgc

Thank you for the citation! I've asked my oncologist who has ordered the Reclast infusion to consider a lower dosage based on recent studies like the one you list. Her response has been "we'll discuss it at my next meeting." So we shall see. I'm delaying that scheduled Reclast infusion so that I can consult with an endocrinologist to see what she recommends.

I'm not sure Reclast is the best drug for me because I've read many here recommending to try an anabolic first. This is just an abstract:
https://www.endocrinepractice.org/article/S1530-891X(20)36020-1/abstract
"Results: Recent pivotal trial data for anabolic agents and randomized trials comparing anabolic and antiresorptive medications suggest that three anabolic agents (teriparatide, abaloparatide, and romosozumab) reduce nonvertebral and vertebral fractures faster and to a greater extent than potent antiresorptive treatments. Furthermore, bone density accrual is maximized when patients are given anabolic agents first, followed by potent antiresorptive therapy. Since total hip bone density during or after osteoporosis treatment has emerged as an excellent surrogate for future fracture risk, attaining a greater hip bone mineral density is a treatment goal for high-risk osteoporosis patients."

I wrote a post entitled "Are we overdosing Reclast???" last year. Here's the link: https://connect.mayoclinic.org/discussion/are-we-overdosing-reclast/

I have only just noticed this discussion and glanced at it so I don't know how much overlap there is with this discussion. The discussion I started is quite long. Has a number of lengthy comments by me and has links to and discussion of several relevant research articles. It generated some good discussion and created some rather odd opposition (at least in my opinion). At any rate it may be of interest to you.

Also, I'm not quite sure if this should be thrown into this discussion but I've thought more and more about how the 3 annual doses of Reclast is the "standard" follow up to Evenity and the other bone builders. Well, that standard protocol is not really based on studies about what's best for an individuals bone health. They got to this "standard" because they realized there were so many problems arising with the previous "standard" of more years of Reclast. So this standard is just a fall back hoping to avoid the mistakes of the previous standard. All of these based on insufficient evidence.
Many people taking Reclast could be taking way less Reclast and or taking Reclast way less often. If you follow bone markers and DXAs you may find that many people only need Reclast every 2 years or more. The every year for 3 years is a one size fits all that is convenient for the medical world but not the best for individuals who want to optimize their care and reduce exposure to powerful meds.

Not trying to argue no one should take Reclast, just trying to bring some clarity into how these so called standards and guidelines come about so that people can at least be clear about what they are being "told" to do.