Choosing between Fosomax and Prolia

Posted by aunt2jack @aunt2jack, Feb 19 12:05pm

Hi everyone! I am a 65-year old female and newly diagnosed with osteoporosis. My L-4/L-5 T-score is -3.1. I am overwhelmed with all of the information out there but have now whittled it down and am deciding between starting out with Fosomax or going straight to Prolia injections? I look forward to your thoughts and thank you!

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Profile picture for sportpop @sportpop

About five years ago, I had a bone density exam! It indicated I had osteoporosis in my back and hips! I am a former marathon runner, so big surprise for me! After, talking to my doctor, I decided to go with Prolia! I get shots every six months with very few side effects! Weak stomach, so Fosomax was not a good option for me!

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@sportpop Thanks for sharing your journey! Good luck!

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Profile picture for jupiterlady @jupiterlady

I am on the brink of deciding whether to go with Prolia with 6 month injections. Since I am a very sensitive, intolerant / Almost allergic person to so many things like gluten, corn, wheat, and sesame seeds, I am very concerned about getting this routine. Also, I don’t need dental work now, but I consulted my dentist / surgeon Who suggested I go on Prolia Since it doesn’t remain in the system that long. I would like to hear from people who have had side effects from these injections. Also, I would like to know what holiday or end / Termination of Prolia Have you planned? I was told that you need to set up a termination before you start with your doctor. Thank you for your helpful comments.

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@jupiterlady I am not sure that there is an exit date, if you have osteoporosis! Also, if you go off of Prolia, then you would have to go on another similar drug. If Prolia has minimum side effects, why would you want to exit! Osteoporosis is not curable, but can be managed with proper medication, diet, and lifestyle!

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Profile picture for oopsiedaisy @oopsiedaisy

@aunt2jack I’m glad you’re seeing an endocrinologist. That makes sense about you not going on Evenity if you have heart disease.

I’ve gained five pounds on Evenity. I’m glad it wasn’t more even though those five pounds are annoying. I hope they’ll come off once I stop.

I am concerned about the rebound effect if you come off Prolia. Prolia doesn’t suppress the formation of osteoclasts like a bisphosphonate does. The osteoclasts continue to develop but are held in an immature stage of development. Once Prolia is stopped, they rapidly mature and go to work destroying bone. So, you end up with a flood of newly mature osteoclasts all at once.

A bisphosphonate taken after Prolia can help slow down this rebound effect but bottom line is that you have a bunch of new osteoclasts going into action all at once.

What happens if you can’t take a bisphosphonate? Say you develop osteonecrosis of the jaw? Or you have a serious side effect?

All of this is just too much risk for me. A lot can happen in a decade or two. Perhaps if I reach my 80s it might be an option I’d try. But at 64, no way.

That said, people do take Prolia without issue for many years.

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@oopsiedaisy Yes, it's the coming off of Prolia that's the problem. You have to transition to something else and quickly or you will lose what you gained.

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Profile picture for jupiterlady @jupiterlady

I am on the brink of deciding whether to go with Prolia with 6 month injections. Since I am a very sensitive, intolerant / Almost allergic person to so many things like gluten, corn, wheat, and sesame seeds, I am very concerned about getting this routine. Also, I don’t need dental work now, but I consulted my dentist / surgeon Who suggested I go on Prolia Since it doesn’t remain in the system that long. I would like to hear from people who have had side effects from these injections. Also, I would like to know what holiday or end / Termination of Prolia Have you planned? I was told that you need to set up a termination before you start with your doctor. Thank you for your helpful comments.

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@jupiterlady I've been on Prolia for 3 years now (age 74 almost) and I don't have an end date. They used to say you could only be on it for 10 years then after that they didn't have any evidence or studies to say if it continued to be effective. Sorry if I haven't got that totally correct but someone else may correct me if I'm wrong. However I believe they're now saying you can stay on it for longer. I have friends who have been on it 10 years plus and haven't had to change to anything else. May depend on any side effects, planned dental work etc but you would most likely want to move to anyother bone drug to stop the rebound effect and they ususally recommend a monthly or weekly tablet. At least that's what I've been told. Any major dental work should be done nearing the end of the 6 monthly injection.

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