Prescribed Tymlos after Evenity

Posted by hollygs @hollygs, Nov 17, 2024

I completed a one year course of Evenity in September 2023. I switched endocrinologists afterwards, and he prescribed Fosamax after a brief discussion. I contacted the doctor who had prescribed Evenity, and he advised that I come to the office. He prescribed Tymlos, which I have now been on for 8 months. I changed my medical insurance to Medicare, and the doctor who prescribed both Evenity and Tymlos doesn't take it. I went back to the doctor who prescribed Fosamax after Evenity and he freaked out and said Tymlos is NEVER given after Evenity. His colleague in the same office concurred. He then ordered Prolia. I contacted the manufacturers of both Evenity and Tymlos, and they were very considerate and informed me that to their knowledge, there have been no studies about using Tymlos after Evenity. I am currently on a wait list for a new endocrinologist. I have a history of vertebral fractures and I need dental work, and I don't want to be on Prolia. I can finish the remaining months of Tymlos, or switch to Fosamax and wait and see what the new endocrinologist recommends. Needless to say, the situation is not ideal as I'm winging it. That being said, I know that treatment for osteoporosis is complicated and we patients have to be our own advocates and do a lot of research. I'm not opposed to that, but I'm not finding any information for protocols that have a progression of Evenity to Tymlos and then? If anyone has any information to share, I'd really appreciate it.

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grammy9 | @grammy9 | Nov 22 2:19pm

In reply to @hollygs "@grammy9 After Evenity I did one year of Tymlos and then had my first Reclast infusion..." + (show)

@hollygs
I have been told I can't do Tymlos after Evenity. Did it make your numbers go up or stay the same? My endocrinologist wants me to do Prolia or Reclast after Evenity.

hollygs | @hollygs | Nov 22 5:18pm

In reply to @grammy9 "@hollygs I have been told I can't do Tymlos after Evenity. Did it make your numbers..." + (show)

@grammy9 Tymlos after Evenity is an unusual sequence. (You can read more about it if you go back to the beginning of this thread.) My DEXA numbers didn't improve on Tymlos, but that's not uncommon - there have been reports from people who improve in the second year of Tymlos. My TBS did improve slightly.

daisylou | @daisylou | Nov 22 5:47pm

I will be possibly doing the reverse order. I am on Tymlos now . My endocrinologist has discussed following with Evenity or raloxifene. I will need a cardiology consult to make sure Evenity is a good idea for me. I could benefit from the breast cancer risk reduction that comes with raloxifene, although the bone building qualities aren’t as effective.

grammy9 | @grammy9 | Nov 22 5:53pm

In reply to @hollygs "@grammy9 Tymlos after Evenity is an unusual sequence. (You can read more about it if you..." + (show)

@hollygs
Thank you...I was just surprised you got to do it after evenity. Do you know your plans after Tymlos? How often do you get Dexa scans?

hollygs | @hollygs | Nov 22 6:47pm

In reply to @daisylou "I will be possibly doing the reverse order. I am on Tymlos now . My endocrinologist..." + (show)

@daisylou The reverse order is the norm. It will be interesting to learn what your treatment sequence will be! Has your endocrinologist discussed what your options will be after you do Evenity or raloxifene? Have you researched Evenity vs raloxifene after Tymlos on this site? Best wishes to you moving forward!

hollygs | @hollygs | Nov 22 7:01pm

In reply to @grammy9 "@hollygs Thank you...I was just surprised you got to do it after evenity. Do you know..." + (show)

@grammy9 It's highly unusual to do Tymlos after Evenity. After Tymlos, I started on Reclast and had my first infusion in May 2025. I do DEXA and TBS when warranted, and that usually depends on the intervals between medications. It's usually at least once a year.