Can you restart bisphosphonates after a drug holiday from them

Generally, yes unless you have contraindications that you didn’t have before. While on a drug vacation, the bisphosphonate efficacy gradually wanes (they have a long half-life). It’s advisable to have bone turnover marker tests (ideally CTx and P1NP) to determine when is the best time to get further treatment.

@seriuos in your question ‘after a drug holiday, does the clock reset for you?’, are you asking whether or not your body return to the state where you were never treated by bisphosphonate before?

I have heard that you can be on these bisphosphonates for five years. What I would like clarified is this for your life time or if you stop for one or two or more years can you start taking them again?

@serious. My primary care doctor told me that I could take Fosamax for 5 years and then I was done. I could not take it again.

My endocrinologist told me this actually not true. A person can take Fosamax for up to about 5 years and then can take that med again - or a different one from the same classification - a year or two later. I was told this by an orthopedic surgeon and my endocrinologist, both at Mayo Clinic.

I had a bone density scan and blood tests prior to starting on Evenity last Fall, 2023, as I needed medication to "build" bone. Despite the gains I made on Fosamax I lost bone mass because I had a radiation therapy (a known side effect of radiation therapy to the pelvic area in particular where I had it for endometrial cancer).

I spoke with an Orthopedic dr about Prolia. He said studies have shown very few complications if taken for five years, take a year break from it and then could go back on it.
I have been a patient at Mayo Jacksonville for lung issues and wanted to make an appointment with a dr for osteoporosis. I was told not available for that. I wish I had asked if osteoporosis care is primarily for cancer patients.

@jessicamc I was referred after a CT scan showed my sacrum had fractured. This was an unexpected finding as the CT was done for cancer surveillance. However, I had to meet first with an orthopedic surgeon who then referred me to endocrinology. I learned that endocrinology is very busy and it took me several months to get an appointment. Have you had any fractures? I hope not. Can you get a referral at Mayo-Jacksonville through your physician there?

I haven’t asked for a referral. I have insurance that do not require referrals. I made my first trip there in 2012 by making my own appointment. I will ask if a referral would help me see someone about osteoporosis.
I am 77, had 3 compression fractures in L1, L2, L3. Had osteopenia for years, after compression fractures in 2023 took first shot of Prolia. Oral meds aren’t suitable for me due to a hiatal hernia. My stomach is not very forgiving.

@jessicamc I don't need a referral either for Medicare. Often it's smoother and faster to get an appointment when you have a referral and some practices require a referral. I would think with your compression fractures that you may be able to get in with endocrinology at Mayo. It's worth asking anyway.

Does Mayo in Jacksonville have specialists in osteoporosis or do you have to go to Rochester?

I live in FL and Mayo is 1 1/2 hrs from my home. Have never been to Rochester. The dr who advised me about Prolia is in my hometown, Deland. He has an osteoporosis clinic, rehab on site.