Prescribed Tymlos after Evenity

Posted by hollygs @hollygs, Nov 17 4:59pm

I completed a one year course of Evenity in September 2023. I switched endocrinologists afterwards, and he prescribed Fosamax after a brief discussion. I contacted the doctor who had prescribed Evenity, and he advised that I come to the office. He prescribed Tymlos, which I have now been on for 8 months. I changed my medical insurance to Medicare, and the doctor who prescribed both Evenity and Tymlos doesn't take it. I went back to the doctor who prescribed Fosamax after Evenity and he freaked out and said Tymlos is NEVER given after Evenity. His colleague in the same office concurred. He then ordered Prolia. I contacted the manufacturers of both Evenity and Tymlos, and they were very considerate and informed me that to their knowledge, there have been no studies about using Tymlos after Evenity. I am currently on a wait list for a new endocrinologist. I have a history of vertebral fractures and I need dental work, and I don't want to be on Prolia. I can finish the remaining months of Tymlos, or switch to Fosamax and wait and see what the new endocrinologist recommends. Needless to say, the situation is not ideal as I'm winging it. That being said, I know that treatment for osteoporosis is complicated and we patients have to be our own advocates and do a lot of research. I'm not opposed to that, but I'm not finding any information for protocols that have a progression of Evenity to Tymlos and then? If anyone has any information to share, I'd really appreciate it.

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@awfultruth

@normahorn Wow! Early on I saw the problem about multiple fractures with Prolia and that seemed like such an overwhelming "NO!!!!" that I didn't look closely about other issues with it. People considering it really need to do through checking.

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I spotted some papers that seemed to refute this but I trust drugs.com to not publish something without basis. And Amgen would be on their case if the info were incorrect.

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@awfultruth

@hollygs Hi, I've never heard of producing abnormal bone. Could you direct me to the source of that information? And, I'd love to hear your results after a year on Tymlos.

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This information is anecdotal, gleaned from doctors I've spoken with. That concern is probably influenced by the occurrence of osteosarcoma in female rats. Nonetheless, many doctors prefer to cycle off of anabolics in part to avoid this issue. Very simply put, the theory is that it's best to build bone, then focus on maintenance/antiresorptives , evaluate DXA and TBS and then consider re-introducing an anabolic. Since Evenity is so new, the protocols are not yet firmly established.

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