← Return to High anxiety regarding Reclast or Prolia decison for OP meds
DiscussionHigh anxiety regarding Reclast or Prolia decison for OP meds
Osteoporosis & Bone Health | Last Active: 11 hours ago | Replies (191)Comment receiving replies
Replies to "I was on Prolia for 5 years (fractured twice) and relayed onto Fosamax 6 mos ago...."
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.
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?