Tymlos Titration Scedule?

Posted by bharris202 @bharris202, May 22 4:08am

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.

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

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@cbusgma2017

I have been struggling with serious side effects from teriparatide over 8 months and my endocrinologist told me to stop taking it on June 1. I wanted to get a DEXA scan done to see if I had any gain (I did not) and when I went to schedule online, I was surprised to see that the health system said I could have it done once a year if I was on Medicare and I'd been on a medication and wanted to see if it was working. You might want to check this. I'm sure this applies to everyone on Medicare.

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@barb3 If you're on Medicare and are currently taking medication for osteoporosis, you can actually have a DEXA more than once a year. I had them eleven months apart.

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Profile picture for cbusgma2017 @cbusgma2017

This video from Dr. Doug Lucas explains the ratio of bone markers that he believes indicate how your bone building is going.

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@cbusgma2017 Dr Doug Lucas updated his targets. Newer video here:

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My doctor also said there is NO titration on Tymlos, but others had posted that they had titrated.

There is a knob at the end of the pen that you twist to get to the 80mcg (full dosage). As you twist it, it clicks…each click = 10mg. When you reach two arrows, that’s 40mcg (half dose).

I started at 40mcg and figured I would do that for 2 days as long as I didn’t have side effects. No side effects, so day 3 was 50mcg (5 clicks), the next day I could feel “pressure” (no pain) in my spine and both hips. I did 50mcg again and felt the “pressure” again the following day, but less. So I did 50mcg one more time…no side effect the next day, so I moved on to 60mcg…2 days at that dose (no side effects), 70mcg…2 days (no side effects), 80mcg…no side effects. So in 10 days, I was at the full dose.

Now…when I say, “no side effects”, I’m talking about the following day. It is pretty standard that it makes your heart race a bit after the injection. They suggest doing the injection at night in bed. I did experience that…for maybe 10-20 minutes after the injection…for about the first 3 weeks, but that has dissipated.

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Profile picture for njx58 @njx58

@barb3 If you're on Medicare and are currently taking medication for osteoporosis, you can actually have a DEXA more than once a year. I had them eleven months apart.

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@njx58 - I didn't know that. I'll keep that in mind. Thanks for letting me know. Think my doctor is operating on out of date information.

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