Dental work while taking Tymlos?
Is there risk with the anabolic medications like there is with the biophosphonates (of ONJ or other issues) when getting dental work? I need to start Tymlos, and am being told conflicting answers. Does anyone have personal experience with this? I have actually seen some studies that being on Tymlos during a procedure can actually help the jaw bone (which might make sense bc isn’t it supposed to help grow bone?). Such confusing information out there. Yes, I am asking all my doctors and dentists too;) Thanks!
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@shocknot26
Just asking how you are feeling and how you are moving forward? Get well
@gently
Do you have any info as to how long BMD from Forteo or Tymlos could last if you are given Evista following that? Are we just hoping to buy time? Maybe. Thanks
@gently
It was reported on the site that you can stay on Tymlos or Forteo long term? If you go beyond the original 2 year study doesn’t that mean that you would reach the black box warning for which they did the original study and indicated that a certain amount above the rec dosage caused bone cancer? Please advise
@gently
You are extremely knowledgeable. Now that you are on the 4th year of Forteo, what will you do long term? Does this mean that we will be on this forever? I have a risk of MRONJ and given my medical hx even concerned about Evista. Your thoughts? Good Luck
@ipg it’s kind of you to ask. Each day is a bit better and I find I am able to do more, as long as I continue to take breaks. Heat really helps me. I have a follow up X-ray in July. Fingers crossed for good news then! Hope you are doing well.
Hope you continue to improve. No more heavy lifting. What course of treatment will you choose??
@shocknot26
Hope you continue to improve. No more heavy lifting. What course of treatment will you choose??
ipg, if you stop cells from replicating they don't have the chance misfold to become cancerous. So, theoretically increasing bone building could have increased random cancer risk, to honor your point.
The black box for cancer of the bone with Tymlos and Forteo , though, was based on the rats used in the preclinical. These poor Fisker rats were found to get cancer even without parathyroid supplement. They were given the drug in multiples of the amounts given to humans.
The black box was imposed because of the flaw in their genetics, but was lifted because 20+ years of two years of use didn't cause cancer in humans. It wasn't lifted because of any study on extended use.
As normahorn reminds us, real world trials pretty firmly eliminate those whom the black box would exclude.
Your questioning is good because we don't have anything on extended use.
The science we have on teriparatide doesn't indicate cumulative risk. The hormone doesn't collect in your body but works afresh with each injection depending on washout before the next injection.
I shouldn't advise as I may have a few blind spots, but I can tell you how I'm laying my bets.
My plan is to stay on Forteo. I think it is the best osteoporosis medication out there. And just luckily, it's without sided effects for me. Forteo isn't giving me great BMD, but I'm not looking for heavy bones. I'm watching bone markers. If they eventually indicate greater bone loss, I'll stop the medication for a month and then resume the injections. If that proves ineffective, I'll take risidronate for 1 to 3 months, all while watching bone markers. If I had to run the bases bisphosphonates, Evenity, Prolia, I would. But my intention is to always return to home base on Forteo.
I took Tymlos and was told that, unlike bisphosphonates, it is not commonly associated with osteonecrosis of the jaw (ONJ), and some research suggests it may even support bone healing, but I still coordinated closely with my doctor and dentist before having dental work done.
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1 ReactionI took Tymlos and was told that the risk of osteonecrosis of the jaw (ONJ) is much lower than with bisphosphonates, and my dentist and doctor did not require me to stop treatment before routine dental work, though I still coordinated with both providers to be safe.