Hi Maryann @mkoch.
My *primary* reason for not wanting to go on Prolia is that I have an autoimmune disorder. Prolia may be more likely than Reclast to negatively impact the immune system. The rebound effect is also of concern as I have had multiple fractures including spinal. I appreciate that with Reclast, the likelihood of rapid bone loss after discontinuation is much lower, so further treatment is more flexible. The potentially higher risk of osteonecrosis of the jaw is concerning - my brother has a history of that (albeit not from medication). When I spoke with the medical team at the infusion center regarding my choice of Reclast, they said that they have seen fewer side effects with that vs Prolia.

All that being said, you never know how an individual will respond to any medication. There are many people who have done very well on Prolia, and many people who aren't happy with Reclast. For reference, so far I've been on Fosamax followed by one year of Evenity, one year of Tymlos and did my first Reclast infusion in May 2025. So far, so good!
Best wishes to you!