Susan
I finished 12 months of Evenity in October and have taken 4 doses of alendronate. Previously I might have had a few bouts of GERD responding to occasional TUMs or Pepsis. Very concerned about taking alendronate but absolutely NEVER taking Prolia. I had textbook improvements with Evenity. So far I had non problem with week 1 and 3 of alendronate but weeks 2 and 4 experienced heartburn 1 1/2-2 days after taking not the day or night of so I am being very mindful and careful to see where this goes.

My endo says at least 2 years on alendronate. I’ve always wondered if evenity become more resorptive in the latter months, could this influence how long you need and anti resorptive before a drug holiday. i’ve not been able to turn up any info specific to this.

Understood. I am skeptical of it all and yet these drugs seem to best that is available at this time. Ah, these frail
human bodies! Good luck to you on your path.

susanfalcon, your endocrinologist makes a good point. ( "After a 2-h intravenous infusion, plasma concentrations of alendronate decline rapidly to approximately 5% of initial values within 6 h. About 50% of a systemic dose is excreted unchanged in the urine in the 72 h following administration." ) about GERD. You can avoid some of the effect of acid reflux by taking great care after ingestion. Gerd is seen with IV and injectibles, so there is the potential GERD effect even with great care.
Alendronate is the bisphosphonate with the least persistence in the bone. It remains unevenly distributed in cortical and trabecular bone for a documented ten years . It doesn't actually leave the bone. You lose the alendronate when the bone leaves the body in the course of remodeling.
Without expertise, only in speculation, I wonder if an anabolic after Evenity might be a better choice, since the final nine months of Evenity are said to be antiresorptive.