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DiscussionTymlos side effects I've encountered
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Replies to "I had been on Prolia for two and a half years with small but steady gains..."
I had heard from a doc last week and also read in McCormick's "Great Bones" book (pg. 569) that Tymlos doesn't work well after Prolia and that you need to do Reclast or alendronate. I'll try to find it. It seems Evenity might be better but I don't know if there is data, and it might still be problematic. Ask an endocrinologist who is an osteoporosis expert.
The concern about losing bone density after stopping Prolia is a big one. You are so wise to be proactive.
ps here is the paragraph in McCormick's book but check with your doc:
"If you've been treated with demosumab, sequencing to teriparatide or abaloparatide (or even romosozumab) will increase bone porosity, accelerate bone loss, and heighten risk of fracture! If your doctor suggests this type of sequential therapy, please get a second opinion."
It is unclear what McCormick thinks about Evenity after Prolia but other sections of the book are more positive about that than Tymlos. But people mainly lock things in with Reclast. The timing of that is important. Maybe you could buy this book...or get it from the library. And talk with another osteoporosis doc.
According to McCormick and my doc, Reclast is usually given 6 months after Prolia is stopped, though it is much better to do CTX blood tests to determing the best timing.