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Taking Tymlos but Forteo recommended
Osteoporosis & Bone Health | Last Active: Oct 23 9:11am | Replies (27)Comment receiving replies
I tried one dose of tymlos at full dose and had the worst migraine in my entire life. I'm very small, history of migraine, and have lower blood pressure to begin with also. I am not sure which of these drugs would be safe for me to try again as it seems I'm very sensitive to changes in factors that influence blood vessel dilation. So is the dose of Forteo equivalent to Tymlos? Dose of what? Is it basically the same drug? Or different enough the doses don't match? I get confused about what to ask for. Evenity was a failure too...I had such bad insomnia i was in tears for weeks.
Replies to "I tried one dose of tymlos at full dose and had the worst migraine in my..."
@tkdesign yes try 20mcg (two clicks of the pen). You can stay on that for a week or two and move up to 40, then keep going as tolerated. My doctor was okay with 60mcg, and very happy with 70. I never got to 80mcg (full dose) but had dramatic gains.
Oh- I did do full dose once, at the beginning and ended up in the ER. Yet I was able to do two years at an adequate dose (eventually 70mcg) with 20% gain in spine. Good luck!
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There was a discussion a few months ago on this forum regarding the comparison in dosing between Tymlos and Forteo. Since these two drugs are similar in molecular weight (thanks to @normahorn ), an equivalent of 4x in weight of teriparatide (Forteo 20mcg) is needed for abaloparatide (Tymlos 80mcg) to achieve similar efficacy. Of course these two drugs are not exactly the same although they are closely related chemically and mechanism wise. Abaloparatide/Tymlos binds to PTH receptor differently than teriparatide/Forteo does, this may result in its slightly better clinical outcome - fracture risk reduction as well as bmd increase.
In ACTIVE (a phase III study) trial, a head to head comparisons between abaloparatide/Tymlos 80mcg vs teriparatide/Forteo 20mcg were studied. 80mcg abaloparatide/Tymlos were slightly better in fracture reduction as well as bmd increase when compared to 20mcg teriparatide/Forteo. The dropout rate due to adverse event though, is higher among abaloparatide/tymlos group (9.9%) vs teriparatide/forteo group (6.8%).
It's an advantage that Tymlos pen is adjustable. You could try @windyshores "ramping up" method -start with a low dose, ramp up once stabalized until you get to maximum (tolerable) dose. Hope your body could adapt to a full dose gradually with minimum migraine occurance. Best of luck in your journey!