Which Osteo Meds Don't Need to Be Followed Up with More Meds

Posted by aspirecreative @aspirecreative, Jun 25, 2025

I see that with some meds, like alendronate, you take a pause after a few years and then see if you need to continue or take another med. With others, like Evenity or Prolia, it seems once you start, you need to be on some kind of osteo med for life. I am puzzled by this, it sounds like if you don't start another med immediately, you are worse off as you start losing bone density right away. Do those drugs change something in your bone chemistry that causes fasterloss when you are off of them? And, which meds can you take for a while and then pause, or even stop medicating?
Thank you.

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Profile picture for oopsiedaisy @oopsiedaisy

I had the same experience with Fosamax. During the first two years I had significant gains in my T-scores but then they started going down again. My current endocrinologist told me this was because the drug stopped working. I found that interesting but neglected to ask her why.

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So, I wonder if Fosomax stopped working, then Reclast would never be prescribed down the road since it is a similar medication?

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It's possible that Tymlos or Forteo could still be used, even if they aren't as effective as if you had used them to begin with.

Honestly, sometimes I feel like I want to spend the money to travel to Baltimore to visit the Johns Hopkins bone center, just to get some straight information!

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Profile picture for aspirecreative @aspirecreative

Thank you both. My doc didn't mention this part of the story when prescribing Evenity.
I was on Fossomax for 4 years, after 2 I showed DEXA gains, and then after 2 more, showed loss even though my labs were good. Now, I wonder if the DEXA was accurate as I have read it isn't always for very small, thin women. I wish I would have asked for a repeat DEXA, even paying out of pocket. But, I will have had 3 doses of Evenity, so at this point, a DEXA might reflect some Evenity gains and it would be hard to sort out.

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Make sure you are getting a DEXA scan with a TBS score. That is the only one that measures apples to apples year after year. I had DEXA scans every year for 25 years and one of the last ones had me out of osteoporosis out of osteopenia and with regular numbers. Then I had cervical spine surgery and my C5 fell apart in the doctors hands. Turns out bones around your body can have different Strengths or weaknesses, and it turns out that the DEXA scans are general and machines are not calibrated for the accuracy which may be required. However, the DEXA scans with TBS score are calibrated so that you can have comparative tests from year to year.

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I am on a five-year program. I had one infusion of Reclast, then the following year I started on daily injections of TYMLOS. I will do that for two years, then return to the RECLAST annually for two more years and then supposedly I am done for life. I had my first marker numbers done after my first two years and my scores are heading in the right direction. I go for my first comparative DEXA with TBS score in August and I pray for good numbers. I’ve had DEX’s for 25 years and did not realize that they are not as targeted as they need to be nor as consistent when you change doctors and machines over the years.

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Hey, all don’t forget with all this talk of medicines and DEXA. That resistance exercise is a critical part of assisting in bone strengthening and maintenance. Of course it needs to be done safely if you have compression fracture issues! Please don’t hesitate to advocate for yourselves and spend some focus time. Researching the medicines and what might work best for your own needs. And if you don’t quite understand, ask your doctor to send you to someone who can help explain. My endocrinologist was very short tempered, but I kept bugging him and finally they appointed a nurse practitioner to support me and explain things on an ongoing basis. Squeaky wheel gets the oil! Don’t forget you can call the drug manufacturers too!

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i am reading all the comments here about this nightmare, have been resisting the meds for ten years now and w last dexa, first where my hips were below 2.5 (now2.9) doctor really pushing the drugs But that whole 'for the rest of your life' thing, o m g I just don't want that. I wonder if the bioidentical HRT idea is better because maybe that does not have the rebound effect, where you lose once you stop Because that bone would be genuine.

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Here is a picture of an upcoming course and it shows link to article.

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Profile picture for loriesco @loriesco

I am on a five-year program. I had one infusion of Reclast, then the following year I started on daily injections of TYMLOS. I will do that for two years, then return to the RECLAST annually for two more years and then supposedly I am done for life. I had my first marker numbers done after my first two years and my scores are heading in the right direction. I go for my first comparative DEXA with TBS score in August and I pray for good numbers. I’ve had DEX’s for 25 years and did not realize that they are not as targeted as they need to be nor as consistent when you change doctors and machines over the years.

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I do annual Reclast injections. Work well. No complaints

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Profile picture for mpc1 @mpc1

Here is a picture of an upcoming course and it shows link to article.

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Did you post the picture with a link? I didn't see it....

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Profile picture for nraeoregon @nraeoregon

Did you post the picture with a link? I didn't see it....

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I thought I did, but guess it did not take. This is an article associated with same topic.
https://www.thelancet.com/pdfs/journals/lanhl/PIIS2666-7568(25)00048-0.pdf

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