"Drug Holiday"

I am on a drug holiday. The plan is to check how things are going at about 10 months into this holiday and then decide what to do next. One thing might be to continue the holiday a bit longer. It’s the other possibilities that I am uncertain of at this point. Those who are on drug holidays, what is your plan after the holiday?

My doc put me on a one-year Atelvia holiday. Atlevia is a bisphosphate.

Then she did the Dexa and blood tests and I am starting the Atelvia again.

I assume that is a "good" result -- no need to go on the shots or infusions but I didn't ask.

Hi @researchmaven how long did you take altevia before you take a holiday? Is this your only bone med?

Does altevia upset your stomach? Do you have to take it on an empty stomach and be upright for one hour? I’m asking because most other oral bisphosphonates have strict instruction for patients to protect GI tract. Any info would be very helpful. Thanks a lot!

I think I took it for 4-5 years before the one-year holiday. The brand name Atelvia (35 mg), a weekly pill, does not hurt my stomach for three reasons:

1) It is enteric-coated, 2) I am supposed to take it right after eating a meal (breakfast, I think) and 3) I take it after having "solid but spongy food" like pancakes, rather than something like hot or cold cereal or toast and eggs. I find pancakes provide a great cushion for the pill.

After taking Atelvia, one cannot lay down for 30 minutes afterwards (sitting is fine).

Also (and unfortunately), the generic version I tried once had a different adjuvant than the brand name (adjuvants are used to increase the efficacy or potency of a drug) and I could not tolerate it at all, even on top of pancakes. My doctors had said as much, but I wanted to try the generic as the brand name Atelvia 35 mg is very expensive. That was long ago and whoever is making the generic may have improved it.

Atelvia is the only osteo med I take. I also walk a lot, use 8 lb weights for arm exercises and recently started drinking Lactaid cow's milk. My doctor has said that calcium in food is better absorbed than calcium in pill form.

Thank you so much for your detailed reply! "Solid but spongy food" would be a real life tried-and-true advice, I appreciated it so much! I'd definitely put it into use if I ever use Altevia.

I'm curious, has your doctor ever mentioned what's max number of years for which a person could use a bisphosphonate, in your case, Atelvia? Was a bone builder drug ever in your treatment consideration other than a bisphosphonate (Atelvia)? Or maybe Altevia is enough for treatment in your case?

Thanks a lot!

I am not sure how often I can take Atelvia in a 4-5 years on, 1 year off routine.

I have only been on Atelvia with my doctor. I have a delicate stomach and asked for it at the get-go actually, as enteric-coated.

I think my Dexa bone density numbers are not good, especially my spine. However, I have not had a fracture and I have not lost height. My blood tests are decent and in the right range. I engage in normal life activities except for things that don't make sense with osteo (fall hazard sports or outings).

I assume my doctor thinks I am not in "bad enough shape" yet for all those injections/infusions I see GPs advertising in their offices.

I plan on discussing options though\at my early 2025 annual appointment.

I walk a lot, weather permitting, lift light (8 lb) weights and do core strengthening exercises. I also stretch, which I think is important for balance/fall issues.