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whd1733 posted:
Hi. I'm a 54 y/o male - was diagnosed w/ osteoporosis in the last year. Had a lot of fractures up until 6 months ago and was walking with a cane. However, then had a shot of cortisone in my hip and have been getting around great since then. I was also diagnosed with osteonecrosis of the right hip so some day will need a hip replacement. I quit smoking 5 months ago :-), have been trying to eat healthier and am excercising regularly.
I was on Boniva for about 6 months - stopped about 5 months ago due to digestive problems with it. I have recently gone to an endocrinologist and she is recommending Recast for me since I have problems w/ the oral bisphosphonates. I have mixed feelings about this from what I've read and am a little nervous about taking it. I have read that when you get the infusion it is very important to be well hydrated and also that it should be administered over a period of 30 minutes vs. 15 minutes. The biggest concern I have is about my kidneys which I know is important with this drug. My last tests show a creatinine level of 1.53 which is high. My regular Dr. and my endo both told me this was high and they would need to watch but did not seem to be concerned about taking Reclast.
Any advice would be appreciated. Thanks!
Michael Lewiecki, MD, FACP, FACE responded:
Reclast (zoledronic acid), administered as an intravenous infusion over no less than 15 minutes, is approved for the treatment of osteoporosis in men. It is often used when there are gastrointestinal side effects, as you have experienced, with oral medication. Reclast should not be given if the serum calcium level is low or if there is severe kidney disease, defined as a creatinine clearance less than 35 ml/min. The creatinine clearance can be measured with a 24-hour urine collection or estimated by calculating a glomerular filtration rate (GFR) based the serum creatinine level. Often the estimated GFR is automatically printed out on the same lab report as the serum creatinine. Your concern about the safety of treatment with Reclast is reasonable and it is appropriate that you discuss this with your physician before starting treatment. Ask about your estimated GFR or creatinine clearance so that you have a good understanding of your kidney function. The best treatment decisions are made collaboratively when you are well informed about the benefit and potential risks of therapy and your physician fully understands your concerns.
whd1733 replied to Michael Lewiecki, MD, FACP, FACE's response:
Thanks for your response. I did check on my lab results and my eGFR was 48, so it seems as if I'm ok with that.

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