Forteo vs. Tymlos: Which did you choose?

Posted by suze317 @suze317, Oct 17, 2018

I have to make a decision on Forteo vs. Tymlos and am not sure what to choose. Forteo has been around a lot longer, but has to be refrigerated. Tymlos only around 1 1/2 years but is shelf stable and seems to have less side effects and less issues with calcium. Can anyone offer their perspective? Thank you!

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@lhankins

I based this on the recommendation of my rheumatologist who believed it would be more effective than Forteo primarily because my osteoporosis is in my spine. It is a more powerful drug than Forteo and as @windyshores noted there are other benefits as well such as, it does not need to be refrigerated the entire time; just upon receipt of the medication. After the first use it can be kept at room temperature. My scan came back with such an abrupt decline from the previous, that I needed the biggest boost I could get.

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Interesting and confusing. Based on other comments I have read in this support group and Dr. McCormick's book, Forteo was considered slightly better for the spine. Here's one comment as an example: "My research has told me Forteo is better to increase density of the spine versus Tymlos . And Tymlos does a little better than Forteo at the hip." (I copy and paste various pieces of info from these boards and put it into my osteoporosis Word doc that I am compiling, organized by subject matter, since I could never remember it all.) I just received my copy of Great Bones, and on the chart on page 556, it says 10 to 12 percent approximate increase in spine BMD during first two years and 1.5-2 percent increase for total hip BMD during first two years. For Tymlos, it says 9-10 percent spine BMD during first two years and for hip 2-3 percent. (Copyright 2023).

In the end, it is a moot point for me because my insurance only covers Forteo (actually the generic teriparatide by Alvogen). My hip is only slightly osteoporotic; my main concern is my spine (-3.9 after nearly 4 years of alendronate, same as it was 4 years ago). So I think I would have been happy with either drug, actually, as I am hopeful either would work better for me than alendronate. I'm prepared for results not as great as I would have liked because of having been on alendronate first, but any increase is welcome. Just hoping I don't have any unmanageable side effects (none at all with alendronate). My first dose is this Thursday.

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@cat1203

Interesting and confusing. Based on other comments I have read in this support group and Dr. McCormick's book, Forteo was considered slightly better for the spine. Here's one comment as an example: "My research has told me Forteo is better to increase density of the spine versus Tymlos . And Tymlos does a little better than Forteo at the hip." (I copy and paste various pieces of info from these boards and put it into my osteoporosis Word doc that I am compiling, organized by subject matter, since I could never remember it all.) I just received my copy of Great Bones, and on the chart on page 556, it says 10 to 12 percent approximate increase in spine BMD during first two years and 1.5-2 percent increase for total hip BMD during first two years. For Tymlos, it says 9-10 percent spine BMD during first two years and for hip 2-3 percent. (Copyright 2023).

In the end, it is a moot point for me because my insurance only covers Forteo (actually the generic teriparatide by Alvogen). My hip is only slightly osteoporotic; my main concern is my spine (-3.9 after nearly 4 years of alendronate, same as it was 4 years ago). So I think I would have been happy with either drug, actually, as I am hopeful either would work better for me than alendronate. I'm prepared for results not as great as I would have liked because of having been on alendronate first, but any increase is welcome. Just hoping I don't have any unmanageable side effects (none at all with alendronate). My first dose is this Thursday.

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You can find charts that favor the opposite conclusion. I think you are wise to just go ahead especially since you have coverage for Forteo!

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@cat1203

Interesting and confusing. Based on other comments I have read in this support group and Dr. McCormick's book, Forteo was considered slightly better for the spine. Here's one comment as an example: "My research has told me Forteo is better to increase density of the spine versus Tymlos . And Tymlos does a little better than Forteo at the hip." (I copy and paste various pieces of info from these boards and put it into my osteoporosis Word doc that I am compiling, organized by subject matter, since I could never remember it all.) I just received my copy of Great Bones, and on the chart on page 556, it says 10 to 12 percent approximate increase in spine BMD during first two years and 1.5-2 percent increase for total hip BMD during first two years. For Tymlos, it says 9-10 percent spine BMD during first two years and for hip 2-3 percent. (Copyright 2023).

In the end, it is a moot point for me because my insurance only covers Forteo (actually the generic teriparatide by Alvogen). My hip is only slightly osteoporotic; my main concern is my spine (-3.9 after nearly 4 years of alendronate, same as it was 4 years ago). So I think I would have been happy with either drug, actually, as I am hopeful either would work better for me than alendronate. I'm prepared for results not as great as I would have liked because of having been on alendronate first, but any increase is welcome. Just hoping I don't have any unmanageable side effects (none at all with alendronate). My first dose is this Thursday.

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I hope the Forteo does the job for you. Honestly, I am very confused at this point. I will go forth with my Rheumatologist plan with the 1 year Tymlos, 1 year Prolia, 1 year Reclast for now. Since I am in my first month with Tymlos I get so much anxiety if I get too far out ahead of myself. Please keep us up to date here with your progress.

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@lhankins

I hope the Forteo does the job for you. Honestly, I am very confused at this point. I will go forth with my Rheumatologist plan with the 1 year Tymlos, 1 year Prolia, 1 year Reclast for now. Since I am in my first month with Tymlos I get so much anxiety if I get too far out ahead of myself. Please keep us up to date here with your progress.

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Thanks. Hope your plan works for you! Let us know how things go. (My tentative plan is teriparatide, Evenity, then Reclast. Then hopefully a drug holiday.)

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To anyone who experienced bloating and belly fat increases from the Tymlos:

Did this side effect go away after treatment? (Were you able to lose the extra belly fat after stopping the Tymlos? )
If so, how did you lose this extra weight? special diet?

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@lhankins

I hope the Forteo does the job for you. Honestly, I am very confused at this point. I will go forth with my Rheumatologist plan with the 1 year Tymlos, 1 year Prolia, 1 year Reclast for now. Since I am in my first month with Tymlos I get so much anxiety if I get too far out ahead of myself. Please keep us up to date here with your progress.

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@lhankins, I'm curious about why you'll use one year of Tymlos instead of two. Will you use bone markers. Tymlos is a great choice.

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@gently My rheumatologist wants me to do one year Tymlos, followed by one year Prolia (terrifies me), followed by one year Reclast (terrifies me more). That’s his protocol. I see him next month and want an alternative plan. As you stated, I would rather stay on Tymlos for two years and then review my options. Even my dentist advised me to stay away from Prolia.

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@lhankins

@gently My rheumatologist wants me to do one year Tymlos, followed by one year Prolia (terrifies me), followed by one year Reclast (terrifies me more). That’s his protocol. I see him next month and want an alternative plan. As you stated, I would rather stay on Tymlos for two years and then review my options. Even my dentist advised me to stay away from Prolia.

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You have to do *something* after Tymlos. You can't just take it and be done with medication, otherwise you will lose the gains you made. The only options are for what to take. It's frustrating, I know.

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