Reclast or Tymlos after 1 yr on Prolia?

annaolivia, the question for the two recommending anabolics-- Tymlos or Evenity would be: After a year on Prolia that was ineffective would I be subject to the devastating rebound that Prolia causes.

While it doesn't make a lot of sense to continue on an antiresorptive when they haven't been effective, the risk of Prolia rebound might be a more significant concern.

You probably know that Prolia effectively represses the release of the cells that resorb bone, but Prolia doesn't prevent their development. They increase in number and size and wait for you to stop taking the medication.
Stopping without using an antiresorptive like Reclast or Fosamax can cause multiple fractures often in the spine, in the first year after stopping.
Evenity slows the production of new osteoclast- the cells that break down bone, but doesn't stop the cells that Prolia has already proliferated.

Is anyone ordering bone markers for you. They would be helpful if you decided to take a less potent than Reclast antiresorptive like Fosamax in the interest of switching to Tymlos or Evenity a little sooner than the two years that Reclast is usually effective.

I would contact each of these doctors recommending Evenity and Tymlos with this important question of rebound either by chart or by phoning and getting an answer through their nurses.

My understanding is that even with only one year of Prolia you risk rebound. But I'm not a medical person.

You might ask for bone markers so you don't lose any more time taking drugs that aren't effective for you.

@gently the crazy thing is MD Anderson wants me to go from Prolia to Evenity directly, my local NP in South Carolina, who works on bone Health said Tymlos will work better without alendronate in my body, but a major osteoporosis clinic is like no, you have to do Reclast or Fosamax at the very least. We need a study on rebound versus anabolic concerns.🙏🏼

annaolivia,

MDA's bone clinic generally treats bone loss and metabolic disorders related to cancer or cancer treatment. They may know something about your bones.
Tymlos does work better, initially, without alendronate. But I think the major osteoporosis clinic has the safest answer. Reclast and Fosamax slow bone turnover to modify rebound. If you have bone markers you'll have a timely idea of how your bones are responding.
You are wise to get three different opinions. If you get clarification from those doctors, I'd be curious about why. We do need that study.
I would take Fosamax for a year leading to Tymlos at the one year mark, if the bone markers looked good and the T-score was above -3.5. I'd be careful for the year of Fosamax --no hang gliding, motorcycles or balance beams. No lifting.
Bless your bones.

I have been on one injection of prolia, because I had two fractures. I had the prolia injection January 2024. I have taken no other medication . I have had poor advice on what to have Drs not checking what you cannot have because of health issues. Now I am looking at having z acid , yearly injection It concerns me because the reaction I have heard people Talk about . Can you have different strengths of this medication ?

cherrypie, you can get lower doses of zoledronate. If you use Reclast the one marketed for osteoporosis, it comes in a 5mg dose, though they know that 4mg is just as effective. You might ask to use Zometa--the same drug marketed as an after cancer drug. I think you can get it in 3mg dosage. One of the contributors here was able to get a 1mg dose. She has cooperative doctors.
You should know that most people don't have the intense long lasting reaction to Reclast. They about 40% have the equivalent of a five day flu. Most have joint and muscle aches.
If you do decide to take it, it is best to have your doctor write for a longer infusion time than the 15minutes. Some are having a 45minute or 60 minute infusion. A longer infusion is easier on the kidneys.
It is seeming as though people with autoimmune disease are having the most difficulty.
Reclast is an antiresorptive drug. It works by cladding to the bone and keeping the cells that resorb bone from attaching to the bone, instead these cells absorb the bisphosphonate with results in their death.
Bone specialists are now advising patients to start with medications that build bone. And after you build up the bone take the drug the prevents resorption.
I haven't taken Reclast.
best luck