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Fosamax vs Reclast after Tymlos??

Posted by sebutler @sebutler, 3 days ago

I have a very specific question, and am not sure if anyone has this detailed info. Anyway, here goes: I need to take a bisphosphonate after finishing with Tymlos, to "hold in the gains." So, Tymlos increases both the build up of bone and the breakdown of bone. You can see this in the P1NP and CTX markers, which both go up significantly. When I started Tymlos, it took a few months for my P1NP (or bone buildup) to increase, so I am guessing that once you stop Tymlos the bone breakdown (CTX) takes time to settle back down -- which is why you have to take a bisphosphonate to "hold in the gains." Moreover, I understand that the bone breakdown is especially evident in the first few months after stopping Tymlos. If that is correct, then I am wondering: Would Reclast be better than Fosamax because Reclast is stronger and will get to work faster to prevent bone breakdown? Not sure whether what I have written is clear, but anyway: If anyone has any info, please share. I tried asking my "specialty pharmacist," but she had no clue.

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njx58 | @njx58 | 2 days ago

My CTX did not go up with Tymlos. Only my P1NP went up, which is what we wanted. Tymlos stimulates osteoblasts which create new bone.

Reclast is stronger; after all, you are getting an annual infusion vs. taking a pill. But... it's an infusion. Some people have had bad reactions; others, no issues. If you have a bad reaction, there is no way to undo an infusion. Some people don't want to risk it.

I think this all depends on where you are when Tymlos is done. If you're well into osteopenia range, then maybe Fosamax is simpler. If you still need to build more bone, then Reclast (or Evenity) might be needed.

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sebutler | @sebutler | 2 days ago
In reply to @njx58 "My CTX did not go up with Tymlos. Only my P1NP went up, which is what..." + (show)
Profile picture for njx58 @njx58

My CTX did not go up with Tymlos. Only my P1NP went up, which is what we wanted. Tymlos stimulates osteoblasts which create new bone.

Reclast is stronger; after all, you are getting an annual infusion vs. taking a pill. But... it's an infusion. Some people have had bad reactions; others, no issues. If you have a bad reaction, there is no way to undo an infusion. Some people don't want to risk it.

I think this all depends on where you are when Tymlos is done. If you're well into osteopenia range, then maybe Fosamax is simpler. If you still need to build more bone, then Reclast (or Evenity) might be needed.

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Thank you for your thoughts, njx58. My CTX did go up (significantly), which my doc said was normal -- ugh!!

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mayblin | @mayblin | 2 days ago

Hi @sebutler, was Tymlos the first osteoporosis medication you’ve taken? Also, do you have your bone marker results - both from baseline before you started Tymlos and your most recent ones that you could share?

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sebutler | @sebutler | 2 days ago

Hi, maybin. Just sent you my bone markers in a private msg to you. I can post them here if it's easier; just let me know. Yes, Tymlos was my first osteoporosis med. My DEXA scan showed severe osteoporosis -- all numbers were well below -3.0.

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