If you stop Prolia, there is a quick drop in bone density and high risk of fracture, so you have to go on something else. This could be Reclast or another biphosphonate.

Among my docs' patients, those who have severe osteoporosis and a fracture go on a bone-building drug first (Forteo, Tymlos or Evenity) first. As I posted previously studies are showing that the sequence of drugs matter and it might be better to do an anabolic before an anti-resorptive. In other words, if you go on Prolia first, then the other drugs may not work as well.

I am curious about those who say they will stay on Prolia forever. My friend's doc took her off Prolia after several years due to risk of atypical fracture from many years of suppressing bone turnover, as well as dental issues. Are some people hearing from docs that it is okay to stay on past 5-10 years?

@cmt I would ask for Tymlos or Evenity. Insurance should cover it but these can still be expensive. Together with Tymlos would help get free Tymlos if you meet income guidelines. Tymlos comes in a pen with 8 clicks and you can start with two or four clicks and move up, to minimize side effects.