High anxiety regarding Reclast or Prolia decison for OP meds

Thank you. Glad you breezed thru it - well pretty much anyway compared to some things I've read.

Thanks for the info. So it's advised to take the Zyrtec after the infusion and next time 5 days before if any reactions popped up? I read somewhere to take the Zyrtec before the infusion to help. I actually was thinking about doing that the day before and maybe for 1 or 2 days after. Along with Tylenol. I don't want to make myself weaker or ill with these OTC meds but I want to do anything I can to avoid horrible reactions.

i also fear prolia and refuse to take it. i took Reclast twice and both times had significant increase in bone density

@gently the Medrol pack starts with six 4mg pills, then 5, then 4 etc. So 24mg, 20, 16, and so on....

I seem to remember another pack that started with 60mg (six 10mg pills). It was 60,60, 40,40, 20, 20, 10, 10 5, 5- for 10 days vs the 6 days above,

Ask your doctor or the infusion center what they recommend. Prior to the infusion I was told to just drink water during a phone call with an infusion nurse, they didn't say to take Tylenol or Zyrtec. When filling out paperwork at the infusion center one of the questions was if I had taken any Zyrtec Claritin etc which I hadn't. Afterwards I thought I should have asked why they ask that, but at that time was more focused on the infusion.
Besides some heartburn which has resolved I had no other side effects and feeling great.

I was on Prolia for 5 years (fractured twice) and relayed onto Fosamax 6 mos ago.
I got a T6 and then a T7 spontaneous vertebrae fracture in the 5th and 6th mos. One Endo wants me to now go onto Evenity for a year and then to Reclast. the other wants me to go straight to Reclast. Both endos are quite renowned in MBD. My CTX is 700.
I can’t decide between those 2 options or to quit altogether because of the brittle bones these drugs have contributed to all of these years.

I’m going through the same decision making process and feel your pain. I wish they would wait until more studies are done before they recommend these drugs to us.

I highly recommend Not going on Prolia. It didn’t prevent me from fracturing —I fell twice in the 5 years I was on it and fractured both times. And when I related off of it to Fosamax I got 2 spontaneous vertebrae fractures, just like they mention in side effects. I’m in my mid 60s.

Welcome, @jpareti1. It's always confusing when you get 2 differing opinions from specialists. I'm tagging several members like @spiderplant @daph @susanfalcon52 @riddick @gravity3 @gently @triciaot @sandrac who have experience with Evenity or Reclast or both.

You might also be interested in these discussions:
Evenity worked for me: Why I chose medication for osteoporosis https://connect.mayoclinic.org/discussion/evenity-worked-for-me/

- Evenity: https://connect.mayoclinic.org/group/osteoporosis/?search=evenity&index=discussions
- Reclast: https://connect.mayoclinic.org/group/osteoporosis/?search=reclast#discussion-listview

Since you've already experienced a fracture, it might be risky to quit altogether. I would talk with each endocrinologist to find out the benefits and risk with each option: Reclast only, Evenity followed by Reclast, risk of no medication.

Are you able to contact your specialists through a patient portal or appointment to help with the decision making?

Thanks. Yes my specialists have given me their opinions. But I like doing my own research. Esp since a specialist put me in this mess in the first place because he didn’t bother to mention that I can’t just quit Prolia, and that I shouldn’t stay on it much more than 2.5 yrs. And he was also a renowned end in MBD at HSS in NYC.
The endo who now wants to put me on Evenity is a researcher who does studies with Amgen , the manufacturer of Prolia and Evenity. I asked her if there are studies of people who have relayed from Prolia to Evenity and she said no, not yet. So I say no thank you!
Thanks for the links. I like to hear from people who have quit Prolia.
I’ll check them out.

jpareti'1,
you may know this already, but you are right about the antiresorptives causing brittle bones. The trouble with Prolia is that it restricts the cells that breakdown bones in their final stage of development. Over the years that you take Prolia they collect waiting until you stop taking Prolia to be suddenly released on your bones. It is the first two years after Prolia that you are most likely to fracture. If you decide to stop at this point, you are likely to continue fracturing.
Between Evenity and Reclast, neither choice is great.
Reclast is the medication that best addresses the flood of osteoclasts. It is stronger than Fosamax and should have been your follow up medication after Prolia. It has other problems.
If you can get a slow infusion at least thirty minutes with greater dilution it is both easier on your kidneys and can help avoid the intense flu-like reaction that many experience. Many ache while on this medication.
Evenity stops the osteoclasts at an earlier stage of development and isn't helpful with the osteoclasts that Prolia made ready for action. It does add bone to your skeleton.
CTX is elevated after a fracture usually for six months, sometimes by as much as 60% as the bone heals. 700 seems reasonable, (though there isn't a number for comparison), and may be why one endocrinologist prefers Evenity.
If you decide on Evenity try to get the two bone markers after a month CTX and P1NP. If the CTX remains elevated and you don't have a compensatory P1NP rise, you might consider a switch to Reclast. Reclast is once a year, so you couldn't switch to Evenity after a month you'd wait for a year.
I'm so sorry you've fractured.