Risedronate Sodium 150mg

@dbamos1945 , sounds like you had a productive conversation with your doctor. I do agree you should not be alarmed if you had little or no bone growth. But, it depends on your situation. Is stopping bone lose without gains good enough in your situation? Also, some people keep right on losing when taking these meds. So, you're checking not just to see if you gained but also to make sure the drug is working for you and that you are not losing.

And I'll say again it is just plain wrong that it takes years to find out the effects of osteo meds with DXA scans.
Here's just one example and this is not an unusual result for this type of med. From "The efficacy and tolerability of risedronate on bone mineral density and bone turnover markers in osteoporotic Chinese women".
Note that they saw an increase at 3 months and had over 6% gain in a year. It doesn't take years to find out what's happening.
"A significant increase in spine BMD was already evident at month 3 of risedronate treatment (P< 0.001). Risedronate significantly increased BMD and reduced bone turnover markers as compared with placebo. The risedronate group had significant increase in BMD at 12 months at both the spine and hip when compared with the placebo group (L1-4 6.6% vs. 0.4%, P< 0.001; total hip 2.7% vs. 0.3, P< 0.0001; femoral neck 1.8% vs. 1.1%, P< 0.02; trochanter 4% vs. 1.1%, P< 0.0001, respectively).

@dbamos1945 Saying you only need to check the results of taking an osteoporosis medication every 5 years is "just nuts". Traditional Medicare for instance will cover DXAs every year if the doctor bills it properly. The research and studies done in osteoporosis sometimes take DXAs as often as 3 months or 6 months. The great research done by Belinda Beck using heavy resistance exercise for osteoporosis was able to show substantial bone growth at 8 months.
I get DXA scans every year and sometimes more often.

Hi @awfultruth i'm interested in knowing your experience with risedronate as it is an agent in my tool box also, for the future. What's the dosage and frequency that you've used so far? What's your CTX at end of evenity, and the readings after you took risedronate? I read one of the papers regarding risedronate in which CTX of subjects treated with risedronate had decreased from an avg 800 to mid 100s by 4 weeks. Maybe the dose and frequency would make a difference? It will be nice to see how yours compare. Thanks

@mayblin, Good to hear from you. I have not got my use of Risedronate as an interim med in between two rounds of Evenity worked out. Hopefully I am not losing bone but clearly once monthly Risedronate is not holding my CTX down to where I'm guessing it should be.
Here is what's been happening:

Date Osteo Med Testing

09-30-24 Last Evenity shot
10-31-24 264 pg/ml CTX
11-16-24 Risedronate 1
12-13-24 371 pg/ml
12-16-24 Risedronate 2
12-30-24 Risedronate 3
01-14-25 169 pg/ml
01-19-25 Risedronate 4
02-17-25 396 pg/mL
02-21-25 Risedronate 5

My current plan is to just start taking the monthly Risedronate dose every 2 weeks. You can see that I did that with Risedronate dose 3 and it brought my CTX down into a desirable range right away. Otherwise it has not been able to keep the CTX score down.
I've checked the early Risedronate studies and there was no evidence of any side effect issues with increasing the dosage up to 200mg a month. I will be taking 300mg a month in 2 divided doses. There was no attempt to study a higher amount for osteoporosis. A higher amount was taken short term in studies to help Paiget's disease and there were no significant issues with 30mg a day for up to 3 months and for a few patients nearly 6 months. I'm judging from these studies that two 150mg doses is not risky and should get my CTX down to a better level. I'm not having any side effects worth mentioning.

Any thoughts or comments that you might have would be appreciated. Hope you are doing well.

I’ve taken Risenodate Sodium 150mg once a month for over 3 years. No side effects I am aware of. I want bone density test now but primary dr says results are only realistic after 5 yrs. Have you heard this? I am concerned about Osteoporosis levels decreasing while I blindly take monthly med! Is there evidence taking Risenodate for more than 2 yrs causing decrease in bone density? Please share your info with me. Thanks.

@mayblin, Good to hear from you. I have not got my use of Risedronate as an interim med in between two rounds of Evenity worked out. Hopefully I am not losing bone but clearly once monthly Risedronate is not holding my CTX down to where I'm guessing it should be.
Here is what's been happening:

Date Osteo Med Testing

09-30-24 Last Evenity shot
10-31-24 264 pg/ml CTX
11-16-24 Risedronate 1
12-13-24 371 pg/ml
12-16-24 Risedronate 2
12-30-24 Risedronate 3
01-14-25 169 pg/ml
01-19-25 Risedronate 4
02-17-25 396 pg/mL
02-21-25 Risedronate 5

My current plan is to just start taking the monthly Risedronate dose every 2 weeks. You can see that I did that with Risedronate dose 3 and it brought my CTX down into a desirable range right away. Otherwise it has not been able to keep the CTX score down.
I've checked the early Risedronate studies and there was no evidence of any side effect issues with increasing the dosage up to 200mg a month. I will be taking 300mg a month in 2 divided doses. There was no attempt to study a higher amount for osteoporosis. A higher amount was taken short term in studies to help Paiget's disease and there were no significant issues with 30mg a day for up to 3 months and for a few patients nearly 6 months. I'm judging from these studies that two 150mg doses is not risky and should get my CTX down to a better level. I'm not having any side effects worth mentioning.

Any thoughts or comments that you might have would be appreciated. Hope you are doing well.

@awfultruth , I appreciate it very much for your first hand information! It's interesting how your CTX presented and responded to dosing variation. Guess there are a few challenges: there might be a latency period for the full effectiveness of oral tablets to achieve your desired CTX. Also, terminal half life for once monthly dosing of risedronate (~23days) may affect your CTX readings, or at least at the beginning. As I recall, your baseline CTx prior to evenity was kinda high - if it returns to that level, you may need extra effort to suppress it.

The drug information which the manufacturer provided indicates that for men treated with 35mg actonel/wk, CTX has a mean decrease of 45% compared to placebo; for postmenopausal women with osteoporosis treated with actonel 150mg/month, urine NTx was decreased by 49%. And bone turnover markers reached a nadir below baseline within about 6 months of treatment.

The larger decrease in CTX I was talking about in my last post was from this paper:
https://pubmed.ncbi.nlm.nih.gov/17500121/
The pdf version can be downloaded via another site. In this study, they used 10mg/day risedronate x1yr and achieved suppression of CTX from 800 to -~mid 100s at end of one month and remained low thereafter. Total monthly dose is the same as that in your 2x monthly dosing, but with a different dosage and dosing regimen.

Based on above information, dosage, dosing regimen and baseline CTX level may make a difference in achieving desired CTX.

It will be a trial and error for anyone who tries to use a sensible "relay" drug without a lot of established protocol. My use of a low dose HRT after Forteo turned out to be a surprise too - CTX reached a low of 163 at 6mo. Now I have to watch it closely too to avoid the oversupprssion of bone remodeling.

Hope your CTX stabalizes soon, and, please keep us posted!

@dbamos1945
Five years seems excessive. So many changes can happen in that period of time. I agree with @sbcher. Check with your insurance; I thought two years was the benchmark. You may also look into paying for the scan yourself. I am getting a REMS scan in two weeks that my insurance, nor my rheumatologist will even acknowledge as a tool for diagnostics. It is costing me $275 which is higher than in most states but worth it for me to know.

@mayblin Thanks for all that info. I had not seen that paper you gave the link to. And it led me to another paper I had also not seen. It's useful to see how you approach this kind of situation. I feel fairly confident with my current plan to go to twice monthly with "monthly" Risedronate. But I will keep up the monthly CTX testing to be sure it does work. Not clear yet how I'll get the prescriptions I'll need.
And finally your strong reduction in CTX with HRT is surprising to me and I guess very useful for you?
Wishing you the best in dealing with this bone business.

Thank you so much for this information! I too was on Evenity, 10 months and then my dexa read stage FRANK. Was very upset because out of pocket I paid a lot of money per injection. Understand not all drugs work the same for everyone.

Glad you're doing better with Risedronate!