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Tymlos Titration Scedule?
I’m newly diagnosed with severe osteoporosis. My doctor and insurance have settled on Tymlos as the treatment. I’ve had some past drug sensitivities, even drug allergies, so I’m intrigued by the fact that others have posted here about titrating on Tymlos. My doctor has said there is NO titration for Tymlos and that the pen can only deliver the 80mcg dosage. Can those of you that have titrated share the titration schedule you have used and how the pen is adjusted to deliver smaller dosages?
Thank you.
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Interesting to hear everyone’s experiences! I am 67 with osteoporosis, having tried Evenity followed by Reclast.
Did nothing for past 2 + years except weight training and walking. Held my own, even improved to just over line to osteoporosis now.
Started Tymlos about a week ago at 2 clicks, then 3 and this morning did 4 ( half normal dose)
Doing okay but feeling a little dizzy and tired. Will stay at 40 mcg for a week or so. And continue to exercise.
How are you all doing with your dosage schedules?
@leslie2121 Started 2, 4, 6, then 8. Bad headaches at 8. Went back to 2 for a couple weeks. Then 4 every other day for two weeks. Now 6 each evening. No headaches but noticeably “off” for several hours each day. Also notice mild muscle/joint pain flare ups randomly during the day. Manageable. Will likely be told to go to full dose soon.
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1 ReactionI’m still at 4 clicks and feeling “off” too- tired, a little nauseated- hoping it clears. Will stay at 4 until better.
I think you could stay at 6 or try 7 as your max dose?
I will be reporting in to my endocrinologist next week as to my tolerance at 6 clicks. I won't be surprised if he encourages me to go to 8. I'm a little surprised you are taking your during the day. I was told it is best to take it at night so if there is nausea or dizziness you "sleep it off"!
@jbcat26 I thought I would take it at night too, but it seems to keep me awake if I do.
I started injections in the morning, but moved to night in an attempt to mitigate side effects. After PM move and subsequent decreasing dosage did not resolve issues, I had to return to AM injections, due to sleep disturbances and significant bone pain (plus other issues). Hydrating well and daytime movement seem to help. Below is what my dosage schedule turned out to be, despite my determination (failed) to return to full dose.
First 3 weeks = 80 mcg (full)
Next 10 days = 40 mcg
Next 10 days = 50 mcg
Next 14 days = 60 mcg
Next 2 days = 50 mcg
May 16 to present = 40 mcg
P1NP : (CTX/1000) ratio results will be posted any day now. Very interested to see if I remain > 150, now that I have been at only half-dose for the last 1-1/2 months (and at a reduced dose for the past 3 months). 🙏 DEXA is not until Aug. 28th.
Six months ago, I chose Tymlos (endo recommended any of Tymlos, Forteo, or Evenity) because the Tymlos pen allows you to deliver less than the standard dose (titrate) if the side effects are too hard to bear.
I spent the first month on Tymlos powering through side effects at full dose (8 clicks) then took off a week in despair. I spent the 2nd month working my way back up to a full dose (+1 click every few days) and am carrying on with it (side effects are present but milder and bearable with a bedtime shot). DEXA won't happen for 2 years, but here are my P1NP/CTX values (endo requested and Medicare paid for). Looks like it's working so far (cross fingers)...
Date : CTX/P1NP Ratio
06/05/26 : 1295/198 153 (3 months on Tymlos)
03/01/26 : 1117/211 189 (1 month on Tymlos)
01/01/26 : 985/107 109 (before Tymlos)