Sequence of Osteoporosis Drug Treatment

Maieva, Forteo or Tymlos would be your best next step in my unqualified opinion. Bone acquisition may be delayed because of the prior use of antiresorptives, but at two years you will most likely notice the gain on dexa. Are you using bone markers CTX and P1NP.
I'm avoiding Prolia because it doesn't remodel bone, and because if you have to stop the drug rebound is a major risk. The chart waving in this column doesn't track the fate of those who quit the drug.
You've made a better than good choice.

@gently What about 150mg. of Risedronate once a month?

Do keep us posted. I was told by my endocrinologist that I could not go back to Forteo after Evenity or Reclast.

I can't decide whether to reply, "Oh, my!," or " Why?"

@mmwagner46,
hi. I'd take risedronate rather than the other bisphosphonates because it binds less firmly to the mineral (hydroxyapatite).
Bisphosphonates work by binding to the areas of bone that are weakest. Cells that breakdown bone are attracted to those same areas. When they try to attach to the bisphosphonate they experience cell death. Consequently the body's weakest bone is preserved which is only better than losing the bone without being able to replace it. The cells that breakdown bone summon the cells that build bone. So without these osteoclasts we lose much of the normal process of bone replacement.
Risedronate is less effective or is effective for a shorter period of time than alendronate or zoledronate, thereby allowing more of the natural process of bone replacement to occur.
I'll always be trying to get back to a medication that stimulates both bone loss and bone regeneration.

Hi gently. I was hoping you’d respond. I agree with your assessment. I have never had the suggestion of CTX or PINP testing and my upcoming appointment is with a NP, not my doctor. My endocrinologist just retired so I don’t know who my new doctor is yet as he/she has not been assigned. I will mention this to the person I meet with and see what she says as I’m sure she will need to consult with the new endocrinologist after my appointment, but for sure I am not going on Prolia.

@maieva , I would ask everyone you know if they know a Dr who specializes in OP or Gerontology. My Dr only accepts over people over 65 yrs, but I got in at 62 because my bones were so bad. I have had amazing results from exercise and 11 months so far on Tymlos. You might check with the manufacturer of Tymlos on coupons/discounts. I got their coupon and mine is free because I still have private insurance, but I would probably pay for it if I lost the insurance. I do have minor side effects on Tymlos, but worth it for the gains I've had. I don't know what i will do after the 2 years of Tymlos is up, hoping they come up with newer drugs/research to guide me.

@maieva Is it possible to take a drug holiday? Or do you feel your DEXA scores don't permit that?

@broken13 did your doctor explain why?

@gently I'm confused. If Risedronate is less effective than alendronate or zoledronate(dont know those drugs), why do you recommend it? Thanks