Post Evenity, which is safer, Reclast or Prolia

I took a year of Evenity in 2025 and had no problems with it. I had improvement with my DEXA and did Reclast 3 weeks ago. No problems with the Reclast (so far). I did Reclast because you are able to stop it if needed and I hope to be able to have a drug holiday after 3 yearly IVs. I also liked the once yearly dosage. I did not want to take Prolia because it is harder to stop taking it due to rebound potential. Reclast has also been around for quite some time and has been studied extensively.

My rheumatologist didn't give a choice for this. She recommends Reclast, which is what I'll do.

Depending on your constitution, I recommed tryign the gentlest antiresportive first.. have you BTM checked to see how it is working. If working well, youdo not need to strongest antirepostive.

I took Actonel becsue it stays in the body just 2 motnths and if there is a problem, you can get off it.
In just 6 weeks and it plummeted my BTM to extremely low ( P1NP 18 and CTX 81). I may have needed only 1/2 or 1/3 dose.
Imagine what coudl have happened with reclast - which is long lasting.
We are all different - but I err on side of gentle first - if it works great! If not you can move to stronger medication.
Sending healing light

@dmshope hi, sorry to ask, but what is BTM? I'm pretty new to all of this.

Bones are a very big deal!! If you are elderly and frail with < 10 years life expectancy, Prolia might be your best choice. Get multiple opinions if your doctor seems quick to push Prolia. I am in the middle of “rebound bone loss” and it is a complex issue to manage. Some cannot successfully exit this drug. No data published yet on the greater than 10 year safety profile.

@dmshope
Thanks for this info about Actonel- I think I remember someone commenting on this drug before. I am most of the way through my second year of Tymlos and will have to make a choice what's next this summer. I am only 65 and wish I didn't have to do anything because I dread side effects. But my last Dexa showed my bone density is not good so I know I have to do something. Questions: How long were you on Actonel? Did you have any undesirable side effects ? PS- one of my doctors is pushing prolia for me next. I am getting a second opinion

@2024tymloshelp
We are so very different in constitution ; what one expereinces may never happen to another....
As I mentioned, I was on Actonerl just 6 weeks and it plummeted my BTM to extremely low ( P1NP 18 and CTX 81). I may have needed only 1/2 or 1/3 dose.
I respond qucikly and deeply. I needed somehthing after tymlos and Actonel was chosen becasue it leaves the body quickly but was very strong on full dose. ( for me) That will not be true for most people. I had intense side effects, massive inflammation and acute phase infections and hypersentivity reaction- these are rare on actonel. I did not have any GERD issues but my gut is good. Everything cleared up with 6-8 weeks after treatment. Again, ask for the gentlest medicince - get the BTM checked after 1-3 month and if it isnt working go to stronger med. You can do this and you will find a path forward. I am not a fan of prolia but I know it is a medicine that is helpful for some people.

I consulted an endocrinologist today and he recommended Evenity followed by Prolia because he felt my PCP should have started treatment earlier. Between 2022 and 2026, my spine DXA went from -2.1 to -3.7. The other readings have stayed steady. He also recommended consulting a rheumatologist for another opinion and talking to my dentist.

@followheart87 you might want to do a little research before actually going ahead with your treatment plan; side effects can be a serious issue for some! Just saying!

I’m also trying to decide between prolia or reclast. I have been on tymlos for 10 months and I’m one of the few they call a non responder. My bone markers were tested every 4 months: CTX went from 389 to 485 to 695 and P1NP 42 to 85 to 97. My Dr. consulted with the Tymlos manufacturer’s medical team and another endocrinologist who specializes in bone. They are all saying I need to stop the Tymlos and get a reclast infusion or do prolia for 2 years and follow that with the reclast infusion. Due to being out of the US until
June I have decided to continue Tymlos until I get home and can get another DEXA. Once I see how that compares I will decide on prolia or reclast. My Dr seems to lean more towards the prolia first with a follow up reclast infusion but he wants me to make the final decision. I’m so torn! How does anyone really know if they will or will not suffer from side effects? I’m 67 and try hard to keep up on my on my weight bearing routine but I admit I am not religious on that however I do planks everyday, walk regularly, play some pickle ball, eat healthy and limit alcohol.
Any input on how to decide? I have to do some kind of antiresorptive.