Choosing between Fosomax and Prolia

About five years ago, I had a bone density exam! It indicated I had osteoporosis in my back and hips! I am a former marathon runner, so big surprise for me! After, talking to my doctor, I decided to go with Prolia! I get shots every six months with very few side effects! Weak stomach, so Fosomax was not a good option for me!

I am on the brink of deciding whether to go with Prolia with 6 month injections. Since I am a very sensitive, intolerant / Almost allergic person to so many things like gluten, corn, wheat, and sesame seeds, I am very concerned about getting this routine. Also, I don’t need dental work now, but I consulted my dentist / surgeon Who suggested I go on Prolia Since it doesn’t remain in the system that long. I would like to hear from people who have had side effects from these injections. Also, I would like to know what holiday or end / Termination of Prolia Have you planned? I was told that you need to set up a termination before you start with your doctor. Thank you for your helpful comments.

Hard decision but not sure Fosamax gets great results…they didn’t suggest Tymelos or Forteo? I ultimately went with Prolia this time! So far no problems!!!

@bswpb Doctor did mention Tymlos and Forteo but I don't want to do the self-injections. Doctor just warmed about the importance of transitioning to another drug immediately if Prolia is stopped. You mention "this time." Have you tried other options?

@jupiterlady The doctor did not advise that I needed to set a termination date. He just warned of the importance of immediately starting another drug if going off the Prolia.

Fosamax won't help you grow new bone. It will only slow down the progression of bone loss.

Did the doctor mention Evenity? Speaking only for myself, that's what I'd do first instead of Prolia.

I've tried Fosamax, Tymlos, Forteo, and now Evenity. Prolia would be my very last resort. I'm not going to take a drug that potentially could do more harm than good.

Fosamax didn't do much for me. I fractured after being on it for five years. Obviously that was the wrong choice for me.

Are you seeing an endocrinologist who has screened you for underlying issues? I didn't see an endocrinologist for the first 7 years of treatment and nobody bothered to screen me for anything other than the basics. My endocrinologist recently identified that I have idiopathic hypercalciuria which has likely contributed to my osteoporosis. I wish I'd known how important seeing someone who knows what they're doing was years ago.

@oopsiedaisy Thanks for your thoughtful comments. The doctor did mention Evenity but I have some coronary artery disease and Evenity has a warning about that so I'm a little reluctant. I have also read about people gaining 10-20 pounds while on it. I am seeing an endorcrinologist and have had all the needed blood work and x-rays to screen for underlying issues. Why do you say that Prolia could do more harm than good? Thanks!

@aunt2jack I’m glad you’re seeing an endocrinologist. That makes sense about you not going on Evenity if you have heart disease.

I’ve gained five pounds on Evenity. I’m glad it wasn’t more even though those five pounds are annoying. I hope they’ll come off once I stop.

I am concerned about the rebound effect if you come off Prolia. Prolia doesn’t suppress the formation of osteoclasts like a bisphosphonate does. The osteoclasts continue to develop but are held in an immature stage of development. Once Prolia is stopped, they rapidly mature and go to work destroying bone. So, you end up with a flood of newly mature osteoclasts all at once.

A bisphosphonate taken after Prolia can help slow down this rebound effect but bottom line is that you have a bunch of new osteoclasts going into action all at once.

What happens if you can’t take a bisphosphonate? Say you develop osteonecrosis of the jaw? Or you have a serious side effect?

All of this is just too much risk for me. A lot can happen in a decade or two. Perhaps if I reach my 80s it might be an option I’d try. But at 64, no way.

That said, people do take Prolia without issue for many years.

Any discussion with your doctor of starting with an anabolic?

@oopsiedaisy

I, too, have hypercalciuria only just discovered in a 24-hour “pee in the hat” test. It seems as though this is something the medical world has known about for some time, but has only recently begun taking seriously? I’ve been treated for OP for over 15 years without benefit of any real bloodwork; just standard vitamin D and calcium (didn’t know CTX or P1NP existed before my friends here mentioned them).

My new doc ordered labs to perhaps find out if there might be a reason for my bone loss. If his theory is correct, things should get better for me.

I wish you the best!