Tymlos blood pressure side effects etc. very nervous! Help…

Posted by osteopatient2026 @osteopatient2026, Nov 11, 2025

I wanted to know if anyone has some info on these specific topics.
We are in a small town one Rheumatologist…has connections with Dartmouth, which isn’t bad.

1. 90/60 blood pressure (10-20% drop with Tymlos)
2. Can you start with smaller dosing first few days to start? He says no others say yes. Tymlos company rep says no, but I see others have said they did that.
3. Can you use Ibuprofen to raise low blood pressure?
4. Phenegran or Zofran for Nausea? What other meds since these can low BP also.
5. Calcium Vitamin supplement schedule?
6. How soon should a Blood test follow up be?

Any other experience with Tymlos would be helpful…supposed to start Thursday

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

Profile picture for njhornung @normahorn

Osteoporosis treatment seems to fall into the "one-size-fits all" category. It is a battle to get lower dose ReClast and patients often have to take matters in hand to adjust the dosage of Tymlos.

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@normahorn I don’t doubt this at all, I’m sad to say.

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Profile picture for gently @gently

@beachesanddreams, I'd bet they'd change the pen if they ever found out patients are titrating.

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@gently Well, let’s not tell them! 😂 to be quite honest, I thought the same. But from the anecdotes I’ve seen here, women are successful moving from a lesser dose to a greater one. It allows us to feel in “control,” and it seems to be working as far as bone density goes.

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Profile picture for osteopatient2026 @osteopatient2026

Still very scary…then to top it off the insurance company said only the first 30 day supply is authorized…now that we already paid for it… The insurance rep said the doctor has to submit another form to fulfill December…then we switch to another insurance because the old one runs out Dec 31. Stressed….

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@osteopatient2026 Try not to stress too much about it. I’m sure your doctor’s office will work with the new insurance. They’re used to having to do that. A word of advice, if I may: contact your doctor the first week of December to make sure they can submit the paperwork to the new insurance before month’s end, OR, to set it up so it goes I suggest this because a lot of docs are closed the last week or two of December, and there’ll be no panicked rushing on your behalf.

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Profile picture for beachesanddreams @beachesanddreams

@osteopatient2026 Try not to stress too much about it. I’m sure your doctor’s office will work with the new insurance. They’re used to having to do that. A word of advice, if I may: contact your doctor the first week of December to make sure they can submit the paperwork to the new insurance before month’s end, OR, to set it up so it goes I suggest this because a lot of docs are closed the last week or two of December, and there’ll be no panicked rushing on your behalf.

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@beachesanddreams
Thank you excellent advice. So far I have just a headache I awoke with this morning I have Hyponutremia (low sodium) …will check BP again in an hour or less.

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Profile picture for gently @gently

darling husband,
she's past the worst but could be unsteady for a bit. If she gets a headache caffeine and something salty should take it away. Bless you both.

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@gently
I’m getting coffee now a little oatmeal with some salt added then ibuprofen…hopefully good after that. 🙂

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Profile picture for mrg1 @mrg1

@osteopatient2026
I am also supposed to start Tymlos soon and have low BP. I will be interested in how you do with it and if you start at the regular dosage. All the potential side effects scare me. My insurance is still trying to work things out with the specialty pharmacy. I have approval, but it just doesn't seem to make it to the pharmacy.

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@mrg1
So far the BP drop I was worried about was minor it dropped about 5mm from 60 to 55 diastolic then came back up in about an hour.

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Profile picture for beachesanddreams @beachesanddreams

@osteopatient2026 Sending you my best today. 🌺 I’ve read here that women do experience success and relief by titrating down if the side effects become too uncomfortable, as well as starting at a low dose and titrating up as side effects are better tolerated.

It just makes perfect sense to me to give those parathyroid glands a gentle nudge by starting low and moving up as your body adjusts.

Why put the meds in a titrating pen if we can’t do that?

Personally, I think there’d be a higher rate of success if we were able to maintain control over the dosage, so long as we commit to getting to the 80 mg dose for optimum results. We all WANT the medicine to work, for heaven’s sake, right?

If no study has been done on titration, I’d honestly wonder why (though we’re smart cookies. We know why.)

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@beachesanddreams I couldn't tolerate the 80mg dose. I cut back to 60mg after the first 6 months, and an now nearing the end of the 2 year limit. I'm February we'll see if it was effective. I pray I haven't silently been losing none mass for 2 years! Of course, the options are limited.

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Profile picture for susyt @susyt

@beachesanddreams I couldn't tolerate the 80mg dose. I cut back to 60mg after the first 6 months, and an now nearing the end of the 2 year limit. I'm February we'll see if it was effective. I pray I haven't silently been losing none mass for 2 years! Of course, the options are limited.

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@susyt
What were your side effects you had a problem with? How long after starting Tymlos did they start? What were your tscores when or before you started?

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I started having increased palpitations (I've had them for 30 years, no big deal) within a couple weeks, but the symptom I needed to address was exhaustion and weakness. I just couldn't keep up with my life, and felt so weak. Cutting back to 60mg did the trick (I still get lots of palpitations, they are harmless PVCs). My lumbar spine T-score was down to -3.6 and the doctor was quite concerned with that. I had just finished 5 years of risedronate, and although my hip score had improved, my spine had deteriorated considerably.
Getting this diagnosis with the warning "don't lift anything more than 20 lbs, don't fall, etc", has changed my life, in that I feel so fragile and am afraid of doing things I loved, like skating, skiing, even bicycling. I'm so afraid of falling, that I have changed my outlook on life activities, and not for the better. It's a bit depressing!

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Profile picture for osteopatient2026 @osteopatient2026

@mrg1
So far the BP drop I was worried about was minor it dropped about 5mm from 60 to 55 diastolic then came back up in about an hour.

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@osteopatient2026
so glad to hear it wasn’t too bad. did you do anything to help with your BP? What time of day did you take it?

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