Side effects from Zoledronic Acid?

My friend is on Reclast with no side effects. I have my first infusion of Reclast in June. Will tell all.

Hi
I too looked at the list of side effects and then spoke with my pharmacist who reassured me things would be fine and this July will be my third injection and I have been fine the only advice he gave me was to hydrate the day before and the morning of take two Tylenol and hydrate so I take an electrolyte drink called Roar. And every year my bone density is better. It's a lot simpler than having to take a drug every day doing it once a year.

Your reply is greatly appreciated.

Hi @jo2184 - My guess is that moving from alendronate after 3.5 years to Reclast is not going to help your hip gain much if any BMD. They are both bisphosphonates with basically the same action. Both drugs stop gaining BMD in the hip after about 3 to 4 years. Attached are two graphs from the main trials showing BMD gains.

Depending on what your T-scores are now and where you want them to be, you might consider an osteoanabolic like Evenity or potentially Prolia.

I appreciate your extremely helpful response.

@jo184 my docs don't use Prolia. It is risky getting off it. My doc jokes that he might prescribe it when he is retiring, so he doesn't have to deal with transitioning patients off Prolia, usually to Reclast.

Reclast has a greater affinity for bone than alendronate enhanced even further because of bioavailability because it is given IV.
You probably would have increased BMD with a single year of Reclast. One injection would put you at 4.5 years.
Prolia is not an anabolic.
Evenity is anabolic for only the first three months of use.
You may have increased bone density with any of the three. They all pose risks that should be considered carefully.
If you get bone markers you'll have a better idea of what medication would advantage you.
Forteo and Tymlos are most worthy of consideration.

I've taken Prolia for 4 years and will transition off it in December. My oncologist is recommending Zometa which is also zoledronic acid and I also am concerned after reading so much about the side effects.. I asked at my prolia infusion today about side effects expected. The nurse consulted with their triage team and reported back that side effects varied depending on what the drug was being used for. As I am being treated for bone loss, I was told I should be okay with a little tylenol.

dimdinia,
30 to 40 % of zoledronic acid patients experience an accute phase response. Medical literature describes it an intense flu lasting for 3 to 4 days. Patient reporting indicates that it can last much longer.
The md who ran the clinical trials offers this advice.
"I am an osteoporosis expert, and have treated many patients with IV zoledronic acid. I have also played a key role in the development of Fosamax, oral and IV Boniva, so I know a lot more about bisphosphonates than most physicians. There are 3 things I routinely do when I treat patients with IV zoledronic that not all physicians understand. First, I order the infusion to dilute the 5 mg of zoledronic acid (which comes in 100 mL of D5W) into 500 mL of NS (normal saline), thereby diluting the drug from 5 mg% to 0.8 mg%. Then I order it to be administrated over 60 minutes, instead of 15 minutes. Giving an N-BP more dilute and more slowly makes it even safety for the kidneys. The 3rd thing I always do is order the infusion nurses to administer 650 mg of acetaminophen to the patient during the infusion, and I tell the patient to take at home the same dose of acetaminophen (two regular strength Tylenols) 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. These 8 doses total of acetaminophen reduce the chance of a symptomatic APR from 20-30% to < 1%.The other thing to consider is that in most patients, a 5 mg infusion of zoledronic acid will control the rate of bone turnover for at least 24 months, so most of my patients do not get annual infusions."
Zometa is marketed for cancer. Reclast is marketed for osteoporosis. Same drug zoledronic acid. Zometa is 4mg. Reclast 5mg even though they know that 4 mg is equally effective as 5mg for osteoporosis.
If you can get Zometa it would be better than Reclast because of less unnecessary exposure. You might print the above advice and give it to your prescribing physician so that they can direct the infusion center.
Some people don't have adverse effect.
Best wishes

Very interesting information, gently. And new.
Can you please share the name of the doctor who ran the zoledronic acid clinic trials?
I am due Reclast in 5 months (after 12 months Evenity), and my endo is not that well informed, or chooses not to share such info.

Thank you.