I have heard that Tymlos does not work well after Prolia. Not sure about after Fosamax though I have been told there is some effect on the effectiveness of Tymlos after bisphosphonates. Hope the Tymlos helps you!

I am new to this forum and just saw your question. But I wanted to post this response in case anyone can benefit from this information. I know I am glad I found this today because it will change which medication I will begin with.

Fosamax is contraindicated when dental work is to be done that involves dental bone remodeling which occurs with tooth extraction, dental implants or orthodontic treatment. There have been reports of necrosis of the jaw bone when using Fosamax and undergoing these dental treatments. So for some persons this may be a reason they don't use Fosamax first and instead begin with a bone-building medication.

I don't believe this includes dental fillings, crowns or root canals, but please ask/verify with your dentist.

Your question is an important one because when using the these two types of osteoporosis medications (bone building and anti-resorptive medications) one type can affect the benefit/gains of the other.

For reference I will refer to two types of medications below.

The antiresorptive drug is alendronate (brand name Fosamax)
The bone-building drugs are teriparatide (brand name Forteo) and abaloparatide ( brand name Tymlos)

Here is how antiresorptives affect bone-building medications:

Concomitant or prior use of alendronate (Fosamax- anti-resorptive medication), but not raloxifene or estrogen, BLUNTS the effects of teriparatide (Forteo - bone building medication).

The optimal alendronate holiday prior to instituting teriparatide is UNKNOWN, but probably will be at least 6 months.

An antiresorptive should be added AFTER a course of teriparatide is completed to PREVENT loss of bone mineral density (BMD) gains from teriparatide.