Osteoporosis Drug of Choice for Elderly after Evenity

I think you can offset and prevent many of the side effects of Reclast by protocols such as:: Drinking lots of water before and after, taking Tylenol the day of and 2 days after, taking an antihistamine the day of, a slow infusion with normal saline (45 minutes to an. hour). This is what I did for my first one and I had no side effects. I know everyone is different but some others have posted on this forum. I am 72 but I don't really consider myself elderly (maybe I am but don't feel that way). I chose Reclast because I know a couple of people who took it without issues and also the ease of treatment (only once per year). Having said that you may feel more comfortable with Fosamax and there is nothing whatsoever wrong with that..that is something your provider can guide you with depending on the results of your Dexa screens.

@deborahla choice of how to deal with OP meds is a serious one…true if many infusion meds that prep and ore-meds help…be sure your kidney numbers indicate that your body can handle these meds !

I am on alendronate once a week for 4 months and experiencing more than normal fatigue, back pain, stomach issues. Dr. reduced dose from 70mg to the 35 mg once a week. Nobody talks about how long, when, or if I can expect to see good results. Is this drug worth taking?
Grace

@gracierose You and your doctor need to make the decision on whether the drug is worth taking for you. Personally, I declined Fosamax after reading articles that said bisphosphonates offered minimal benefits as far as fracture prevention. It slows down the loss of bone but also slows down the formation of new bone. Your DEXA may appear better, but you could have older, more brittle bones. My doctor does not agree with this, but respect my decision to refuse the medication.

Here are some articles that may be of interest.

https://www.amjmed.com/article/S0002-9343(24)00101-3/pdf
https://www.consumerreports.org/cro/2012/04/popular-osteoporosis-drugs-come-with-mounting-concerns/index.htm

Thank you Daisy 17!!! I plowed thru the articles and it’s really interesting to see what was learned from the studies! I’ve had osteopenia for years, with no fractures and since dairy is off limits for me, I use the alternative milks and a calcium tablet fairly regularly. Was surprised after scan, was just told to take the 75mg once a week. During first 3 months, the trouble/pain started and Dr. reduced to 35mg. Seems like I need a clearer understanding of why and what gains can I make with this med. Seems like the “cure” is worse than the disease…Thank you for the information…jury is still out as to whether I will take that next pill on Sunday!!! Or NOT!

@nycmusic corrections. True of many infusion meds…eliminate auto correct..’’that prep….help’’. be sure , etc. my apologies !

@daisy17 unfortunately, after taking bone repair drugs like Evenity, or Forteo and finishing up the prescribed doses, the next phase is biophosphates. So the dilemma is, which one is the best for you to take. It is not taking Fosamax to repair bone, it is taking biophosphates to follow up after the first phase has been completed. If I could have continued taking Evenity, I would have.

@gracierose I am wondering the same thing. What is its value considering potential side effects!

susanew your logic is sound. Unfortunately there is no great solution available at present. I agree that Fosamax seems a safer alternative than Reclast and Prolia but all of them have significant risks. I followed Evenity with Risedronate with the intention of more rounds of Evenity after a year or so on Risedronate. The logic for this is that Risedronate is the weakest and least long lasting of the bisphosphonates and will therefore (hopefully) reduce the effectiveness of Evenity the least.
I had great success with Evenity and no side effects worth even mentioning so I like the idea of repeating Evenity but perhaps with short rounds alternating with Risedronate or perhaps Fosamax and time off without anything. This alternating between Evenity, Risedronate/alendronate and no meds is just an idea at this point with no studies to back it up. I was getting ready to do another round of Evenity but I hit a detour due to perhaps needing invasive dental work. I'm off all osteo meds until I get that handled. Hopefully I will get back on track.
Best of luck to you with your choices
I, like all of you wish there were better long term solutions.

@susanew I am now 74 years old. After a fracture (sacrum) a few years ago I followed my endocrinologist’s advice. He said I was already doing everything possible to maintain my bone density but the fracture “changed” that equation. After a DEXA scan showed bone loss density due to pelvic radiation therapy (thus the sacral fracture) I followed my endocrinologist’s advice. I did one year of Evenity injections. I then did a Reclast infusion. I did not have any side effects with Evenity or Reclast.

I feel healthy. I lift weights twice a week, walk, work outside in my yard and garden and can do most anything physical I want to do. This includes getting up from the floor (I’m on the floor sometimes doing chores or with my cats) as I have strong thighs and legs.

This is a decision best made with your doctor who will help you consider the benefits and risks associated with these medications.