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High anxiety regarding Reclast or Prolia decison for OP meds
Osteoporosis & Bone Health | Last Active: Sep 22 4:39pm | Replies (165)Comment receiving replies
@25anny how long you would take Reclast after Evenity depends on your DEXA and your bone markers. My docs expect me to do it for three years but I doubt I will. The limit is 5 years, not sure if that is for a lifetime or one course. Most people are able to take a drug holiday. Some docs do it every 2 years.
There is no data, according to my doctors, on Evenity after Forteo or Tymlos, let alone on the other way around. I was originally told, I think in a masterclass on osteoporosis, that you could do Tymlos or Forteo first but not Evenity, possibly because Evenity "turbocharges" growth (I remember that word being used) so there is less for the other meds to do. But Evenity came out in 2019, that was early 2021, so I don't know what has come out since. My doctors are very "evidence-based" and are waiting for studies so Reclast is all they discuss right now. I am going to bring up doing more anabolics.
I don't think there are any definite answers right now. It's helpful that we all research (and share it) but in practice the choice right now are limited: seems to be Prolia or Reclast after Evenity and if Prolia is done, many people are doing one year and then doing Reclast. Even that latter strategy is relatively new, at least for me. I am doing lower dose Reclast more often so am in your same position of wondering what to do next.
Replies to "@25anny how long you would take Reclast after Evenity depends on your DEXA and your bone..."
Just want to clarify that the following statement in my response reflects what I have been told by doctors and should be confirmed by your own doctor! "@25anny how long you would take Reclast after Evenity depends on your DEXA and your bone markers. "
Too late to edit!
My doctor is putting me on Alendronate after Evenity. It is similar to reclast, but not so much at once. I take a pill once a week in the morning before eating----you must wait 30 min. and sit or stand during that time before eating. I have no problems with it.
@windyshores I really don't get the strategy of doing Prolia for one year following an anabolic and then doing Reclast. There is some modest advantage in increasing bone density with those 2 Prolia shots over the Reclast shot but to go for a modest bump in density when doing so opens up the possibility of rapid bone loss and multiple fracturing. Seems like a lot of risk and worry (at least if you know what you are doing you would know there is a risk). for again a modest potential gain in density. Both Prolia and Reclast give you an increase in density but with different risk "profiles". Sorry I'm not providing numbers here but I would have to spend too much time searching for that info. I'm in the camp of "No on Prolia" unless I'm convinced I'm in my last years of life and won't have to stop taking it.
Evenity is the newest of the drugs. Read the FDA warnings.
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Thank you, I really appreciate the help. Just when I think I've got a loose grip on understanding these drugs, I get sidetracked by reading something else and lose all direction!
Since my bones scores are so low, -4.7, it seems to me it would take forever for any drug to bring those scores to an acceptable level. But what is an acceptable score for me? It's so complicated.
At some point won't I have to just say ok this is what it is and live my best life?! If I took Reclast for 1 or 2 years, the hopes would be that I can hold on to the pathetic gains I got from this past year of Evenity. But the Prolia would probably give me a bigger boost - but with risk factors I'm not sure I want to live with. I've read many times over that we shouldn't focus on just our T-scores, look at the big picture. Well, my TBS scoring puts me borderline ok. My diet these past few years has no doubt contributed to my bone loss. I have really increased my calcium and protein daily now that I can tolerate more foods. So maybe, fingers crossed, that will help.
I remember my now retired Endo saying the Evenity he was putting me on was "bringing out the big guns"! My initial OP drug was Forteo and I failed to get any gains, so hence the Evenity.
I would not mind going back on Forteo or Tymlos, though I dreaded those dang daily shots. I hated doing that. But would one of those help, who knows. Isn't Tymlos stronger than Forteo?
I know we have all been told don't read all the negative things you see on social media about these drugs. But holy cow, those posts are scary. But I still want to know, good or bad.