1. < Osteoporosis & Bone Health

Forteo vs. Tymlos: Which did you choose?

Posted by suze317 @suze317, Oct 17, 2018

I have to make a decision on Forteo vs. Tymlos and am not sure what to choose. Forteo has been around a lot longer, but has to be refrigerated. Tymlos only around 1 1/2 years but is shelf stable and seems to have less side effects and less issues with calcium. Can anyone offer their perspective? Thank you!

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applesforall5370 | @applesforall5370 | Jan 7, 2023

Sorry it was Forteo for two year and after Mayo started me on Reclast I have had 3 doses yearly. Went I go back for a checkup this April. Hopefully I can get it 2years apart. I guess you can only have seven doses. Sorry, I was chasing my grand daughter.......

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windyshores | @windyshores | Jan 7, 2023
In reply to @pami "I had Reclast. It was a once a year infusion." + (show)
@pami

I had Reclast. It was a once a year infusion.

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Reclast and Prolia are infusions. Evenity is injections. But @applesforall5370 said her once a year injection was Forteo, which can't be correct. Sorry I focused on that rather than the correct drug she was probably taking!

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louise2023 | @louise2023 | Jan 8, 2023
In reply to @windyshores "The reason Tymlos might be less effective after Forteo, which is a similar med, is different..." + (show)
@windyshores

The reason Tymlos might be less effective after Forteo, which is a similar med, is different from the reason it might not be as effective after Prolia, which works very differently.

Because Evenity "turbocharges" (saw this term online) bone growth, I have read that it is also more effective to do Tymlos/Forteo then Evenity rather than Evenity then Tymlos/Forteo at least in sequence.

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I am beginning to understand that the order you take the different meds is important. I was on Fosomax for many years. Have been on a drug holiday also for many years. Now my doc wants me to start on Prolia. I wonder if the reasonTymlos/Forteo were not suggested is because either of these drugs would be better taken after Prolia. Also, would Evenity be better taken before or after Prolia? In the dark about these questions.

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2 replies
leeosteo | @leeosteo | Jan 12, 2023
In reply to @leacy "Thank you for reaching out to me. I’ll be happy to check out these links, and..." + (show)
@leacy

Thank you for reaching out to me. I’ll be happy to check out these links, and hear from others.
That is also what I know about TYMLOS, that detail is attractive to me. I have not been treated for osteoporosis before. Every two years, I went to radiology for bone density tests, each test progressively worse, not reaching osteoporosis til this year. Then I was referred to, Center for Osteoporosis, UCONN Musculoskeletal Institute. Come to find out in my spine I have 1or 2 vertebrae @ 3.4. After a urine test I was told I make bone at a normal rate, but lose it faster than I make it. Due to an unrelated chest X-ray, 2 more vertebrae were detected one crumbling, another almost. That’s my history in a nutshell. Now I’m trying to learn as much as I can. Once I hear back from my PCP, I asked for her opinion of TYMLOS, and want her to be aware I’ll be on it. This next week, I’ll know if my insurance will help with prescription costs, then shortly thereafter, I’ll begin treatment.

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Hi. I also live in CT. Can you tell me who you saw at Center for Osteoporosis, UCONN Musculoskeletal Institute? Where you happy with the outcome? Thanks.

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pami | @pami | Jan 13, 2023
In reply to @louise2023 "I am beginning to understand that the order you take the different meds is important. I..." + (show)
@louise2023

I am beginning to understand that the order you take the different meds is important. I was on Fosomax for many years. Have been on a drug holiday also for many years. Now my doc wants me to start on Prolia. I wonder if the reasonTymlos/Forteo were not suggested is because either of these drugs would be better taken after Prolia. Also, would Evenity be better taken before or after Prolia? In the dark about these questions.

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My understanding is that the bone building drugs need to be first.

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1 reply
windyshores | @windyshores | Jan 13, 2023
In reply to @louise2023 "I am beginning to understand that the order you take the different meds is important. I..." + (show)
@louise2023

I am beginning to understand that the order you take the different meds is important. I was on Fosomax for many years. Have been on a drug holiday also for many years. Now my doc wants me to start on Prolia. I wonder if the reasonTymlos/Forteo were not suggested is because either of these drugs would be better taken after Prolia. Also, would Evenity be better taken before or after Prolia? In the dark about these questions.

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@louise2023 the bone builders like Tymlos, Forteo or Evenity, are most effective if taken first, before bisphosphonates or Prolia. If you can take a bone builder, don't take Prolia first.

To pick that apart further, I was told that I might take Tymlos before Evenity but that I would not be able to take Evenity after Tymlos.

Some of this is also an insurance problem. Insurers like you to have "failed" a bisphosphonate or Prolia first, or mine does. Severity of DEXA scores or presence of fractures allows coverage of bone builders for many of us, but a MD might be able to advocate too.

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1 reply
louise2023 | @louise2023 | Jan 13, 2023
In reply to @pami "My understanding is that the bone building drugs need to be first." + (show)
@pami

My understanding is that the bone building drugs need to be first.

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Thank you for your reply. Based on my readings, it is also my understanding. My doctor, however, firmly believes that Prolia is the next best treatment for me. When I asked about Forteo, she said she would only recommend it in extremely rare circumstances.

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1 reply
windyshores | @windyshores | Jan 13, 2023
In reply to @louise2023 "Thank you for your reply. Based on my readings, it is also my understanding. My doctor,..." + (show)
@louise2023

Thank you for your reply. Based on my readings, it is also my understanding. My doctor, however, firmly believes that Prolia is the next best treatment for me. When I asked about Forteo, she said she would only recommend it in extremely rare circumstances.

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@louise2023 what are your DEXA scores and do you have any fractures?

Your problem may be insurance coverage, and the policy is misguided in that the bone builders are covered for those who have fractured, have severe scores and/or cannot tolerate first line drugs.

If your scores are bad, you might want a second opinion. My doc won't prescribe Prolia because bone density drops off abruptly if you stop and you have to follow with another med.

I think the other issue is that you have been on Fosamax "for many years." Bone quality issues, dental issues and atypical femur fracture risks go up, I believe, after many years on anti-resorptives, and Prolia is also an anti-resorptive. I would ask your doc about this. It may be that your doc could get insurance to cover Tymlos or Forteo on the basis of your previous Fosamax use.

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1 reply
louise2023 | @louise2023 | Jan 13, 2023
In reply to @windyshores "@louise2023 what are your DEXA scores and do you have any fractures? Your problem may be..." + (show)
@windyshores

@louise2023 what are your DEXA scores and do you have any fractures?

Your problem may be insurance coverage, and the policy is misguided in that the bone builders are covered for those who have fractured, have severe scores and/or cannot tolerate first line drugs.

If your scores are bad, you might want a second opinion. My doc won't prescribe Prolia because bone density drops off abruptly if you stop and you have to follow with another med.

I think the other issue is that you have been on Fosamax "for many years." Bone quality issues, dental issues and atypical femur fracture risks go up, I believe, after many years on anti-resorptives, and Prolia is also an anti-resorptive. I would ask your doc about this. It may be that your doc could get insurance to cover Tymlos or Forteo on the basis of your previous Fosamax use.

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Thank you again for following up. I do not have any fractures but, my t scores in my spine are not good-3.7. I should say that I do respect my doctor’s opinion. He certainly is more knowledge than I am re: treatments but, I have to say that he is not someone very open to discussion. I have no idea if insurance has anything to do with his choice but, he does know my concerns about increased risk of AFF and ONJ

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1 reply
leeosteo | @leeosteo | Jan 13, 2023
In reply to @pami "I had Reclast. It was a once a year infusion." + (show)
@pami

I had Reclast. It was a once a year infusion.

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Did you have a reaction to Reclast?

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