Should I consider increasing my prednisolone to cover Zoledronic acid infusion?

[PPop]

Morning all- I need to have an infusion of Zoledronic acid next week as my latest DEXA scan has shown that I am osteoporotic again following a year of prednisolone treatment. I was originally diagnosed with osteoporosis 4 years ago at the age of 52 and was managed initially with HRT and Adcal/Vit D3 which worked. Unfortunately last October I was diagnosed with PMR and commenced on Prednisolone 15mg o.d. My initial reduction was uneventful until I reached 7.5mg in March, when I flared. I have had difficulty reducing ever since- hence the recurrent osteoporosis. I am currently taking 12.5mg o.d and was due to reduce to 11.25mg next week but will probably wait until after my infusion. I have heard that I may feel quite unwell for 24-48hours afterwards and have been advised to take a day’s leave after the infusion. I was just wondering if anyone else had any experience of the infusion whilst taking this level of Prednisolone and whether it was worth increasing the dose on the day, or just wait until I see how things go. I would be grateful for your advice.

[PickyQ]

Hello Ppop, I can't advise you on the amount of Pred you should take- sorry. I have had one infusion of Zoledronic acid and I started to feel unwell exactly 24 hours after the infusion. It lasted for 48 hours which I suspect may be because I am much older than you. I expected to feel unwell but the exactness if the timing surprised me. Good wishes - I remain grateful these treatments exist for us - as previous generations of women were not so fortunate.

[HappyDiamonds]

Hi PPop, I had a Zolendronic Acid infusion last November when I was on 13mg Pred and didn't change my dose or tapering at all. The infusion itself was very uneventful. The next night I had a slight temperature and I suffered with some acid reflux for 24 hours and that was it. Considering how much I was dreading it and had previously resisted it I would advise anyone not to worry. The infusions are now done every 18months not every 12 as it was discovered it worked equally as well. So my next one will be May 2023 and the only thing I would do different is possibly take more Lanzoprazole on the day. Good Luck

[MrsNails]

Hi PPop

I’ve had 6xZolendronic Acid Infusions (while l was on Pred for PMR) it wasn’t for Osteoporosis but as an adjuvant to Chemotherapy to prevent spread to my bones.

It was most unremarkable - so much so l thought they’d forgotten to put it in the infusion!….

Certainly don’t increase your Pred - wether to book the following day off is up to you - if you’re fine you can do other things.

Hopefully you’ll be fine

MrsN

[PMRpro Ambassador in reply to MrsNails]

Snap!!!!!

[MrsNails in reply to PMRpro]

Ha 😂

[PMRpro Ambassador]

I don't see why taking extra pred would make a difference. How you feel after the infusion does seem to vary - I haven't come across anyone before PickyQ who had such a bad reaction

I think MrsNails has had the infusion several times without problems. And I do remember someone saying she'd asked the nurse f they;d forgotten to put the stuff in as she had felt nothing!

[PPop]

Thanks all for taking the time to reply- I ‘ve been advised to take paracetamol for the day of the infusion and after if I get any flu like symptoms, so I’ll just sit tight and hope that it will be uneventful 🤞

[Pollyanna16 in reply to PPop]

I think that’s good advice. I have had 2 infusions with no real after effects. The infusion itself was a breeze. Best wishes

[PPop in reply to Pollyanna16]

👍