This is in response to your question. "How do you stop for a few weeks when Prolia is a twice a year injection?"

I have two questions. Does your dentist know that Prolia is an every 6 month injection? Is the dentist thinking that you postpone the next 6 month dose for two weeks or more?

I do not have an answer to your question, but here is some information that might be helpful:
o Prolia begins to work within 3 days of the injection.
o It has a peak concentration that ranges from 3 to 21 days
o The half-life of Prolia is 25.4 days. (That means that 50% of the medication is still active
25.4 days from the injection date)
o Prolia can stay in you body for up to 6 months from the time of injection

I have added information from an article from the Cleveland Clinic. You can read the full article at https://consultqd.clevelandclinic.org/rapid-bone-loss-and-multiple-vertebral-fractures-after-denosumab-cessation/

Here is a quote from the article:
"In phase 2 trials of denosumab, [Prolia] the gain in bone mass with two years of treatment was completely lost after one year off therapy."
" McClung et al.4 found that bone mineral density in the lumbar spine had increased 16.8% after eight years of denosumab [Prolia] therapy but declined 6.7% in the first year after stopping. Some have described the dramatic decline in bone mass as if bone were a “spring,” (i.e., when pressure is released, the material wants to rebound to the pretreatment state)."

While these studies show that bone mineral density is decreased after one year of being off Prolia, it does not indicate what happens at 1 to 6 months after going off Prolia if you need to stop the medication for dental work. I believe it is safe to assume that there will be some bone loss, how much is not indicated in this article.

Remaining Questions in my mind.
How much bone mineral density is lost if you postpone a Prolia injection for 2-4 weeks or longer but less than a year?
How high is the risk for osteonecrosis of the jaw (ONJ) if you postpone Prolia for 2-4 weeks or longer, but less than a year?
When is it safe to resume Prolia injections after dental surgery on the jaw bone?

Since the bisphosphonates are not an option for you, I hope dental work that involves the bone is not in your future.

Many Blessings