Julie 59,
a brief rundown
There are basically two classes of osteoporosis medications: antiresorptives and anabolics.
It seems like there are a lot of choices because the bisphosphonates have so many different names. Some based on whether you take them by mouth or by infusion. There are two other medications Prolia and Evenity that are also antiresorptive. The work primarily by interrupting the normal process of bone renewal by stopping the initial stage of breaking the bone down. So they increase bone density by collecting older, fissured bone.
The yearly infusion you are offered is Reclast (brand name) zoledronate (generic). It blocks the cells that break down bone effectively and collects the older bone efficiently. Generally, people are given a second infusion after a year.
Prolia is every six months. Once you start Prolia, it is difficult to quit because it it blocks and collects the cells that breakdown bone and when you stop all those acid producing cells are released on your bone and many have multiple fractures. These patients almost always take Reclast for one or two years after Prolia.
Evenity is an injection every month. It blocks the production of the cells that breakdown bone in the pre-cell stage. And adds some bone over the old. Normally followed by another medication Evenity is given twice, though now some are taking it for two years.
Then there are the anabolics: Tymlos and Forteo. They encourage the normal process of renewal of the bone. Increasing the cells that build bone and the cells that break bone down. Called remodeled bone it is the best most resilient, most integrated bone. Both medications are self given by injection with a tiny needle every day.
With all these drugs there are side effects for some individuals.
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