Prescribed Tymlos after Evenity

Posted by hollygs @hollygs, Nov 17, 2024

I completed a one year course of Evenity in September 2023. I switched endocrinologists afterwards, and he prescribed Fosamax after a brief discussion. I contacted the doctor who had prescribed Evenity, and he advised that I come to the office. He prescribed Tymlos, which I have now been on for 8 months. I changed my medical insurance to Medicare, and the doctor who prescribed both Evenity and Tymlos doesn't take it. I went back to the doctor who prescribed Fosamax after Evenity and he freaked out and said Tymlos is NEVER given after Evenity. His colleague in the same office concurred. He then ordered Prolia. I contacted the manufacturers of both Evenity and Tymlos, and they were very considerate and informed me that to their knowledge, there have been no studies about using Tymlos after Evenity. I am currently on a wait list for a new endocrinologist. I have a history of vertebral fractures and I need dental work, and I don't want to be on Prolia. I can finish the remaining months of Tymlos, or switch to Fosamax and wait and see what the new endocrinologist recommends. Needless to say, the situation is not ideal as I'm winging it. That being said, I know that treatment for osteoporosis is complicated and we patients have to be our own advocates and do a lot of research. I'm not opposed to that, but I'm not finding any information for protocols that have a progression of Evenity to Tymlos and then? If anyone has any information to share, I'd really appreciate it.

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@gently

@hollygs,
Antisclerostin antibodies (Evenity) and abloparatide (Tymlos) can have an additive effect. Evenity blocks sclerostin. Tymlos depletes sclerostin using it to produce the cells that build bone. This unproven caution about is why you might not want to take Tymlos while Evenity is still active in your system. Evenity is thought to be gone from your system within 64 days after your last injection. So:
The unexamined question about Tymlos after Evenity no longer applies in your situation.
In my opinion you could be best served by continuing to take Tymlos for the remaining 4 months. Then I would want a second year of Tymlos.
I don't have experience with either medication.
Prolia and Fosamax can put your dental work at risk for osteonecrosis. Tymlos will protect your jaw bone and speed healing.
Your situation is actually ideal. You are safe now with the Tymlos and you have 4 months to find an endocrinologist who will prescribe a second year. Best wishes

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I am new to this site. I was on Temlos for two years with great results and was told I needed to stop and find a different medication. Before Temlos, I tried Fosamax, which caused stomach problems and a year of Prolia, that because of possibly needing extensive dental work, I should get off of.My doc is unfamiliar with all the osteoporosis meds and another doctor suggested Reclast. I am on my second week of no medication and can’t find anyone to consult with . I have Medicare with an excellent supplement. Is there is a doctor at Mayo that I might set up a video visit? Any help would be very appreciated!

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@mautaylor

I am new to this site. I was on Temlos for two years with great results and was told I needed to stop and find a different medication. Before Temlos, I tried Fosamax, which caused stomach problems and a year of Prolia, that because of possibly needing extensive dental work, I should get off of.My doc is unfamiliar with all the osteoporosis meds and another doctor suggested Reclast. I am on my second week of no medication and can’t find anyone to consult with . I have Medicare with an excellent supplement. Is there is a doctor at Mayo that I might set up a video visit? Any help would be very appreciated!

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Whereabouts are you located? Near a big city? Medical centers often have departments dedicated to endocrinology/osteoporosis. That may be easier than searching for an individual doctor.

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@mautaylor

I am new to this site. I was on Temlos for two years with great results and was told I needed to stop and find a different medication. Before Temlos, I tried Fosamax, which caused stomach problems and a year of Prolia, that because of possibly needing extensive dental work, I should get off of.My doc is unfamiliar with all the osteoporosis meds and another doctor suggested Reclast. I am on my second week of no medication and can’t find anyone to consult with . I have Medicare with an excellent supplement. Is there is a doctor at Mayo that I might set up a video visit? Any help would be very appreciated!

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@mautaylor If your primary goal is to set up an appointment with a doctor at Mayo, then you can go to the "Home" section here and fill out an appointment request form or call the number listed. I don't want to offer you a number of other suggestions as I'm not clear on a few things you mentioned. I hope you get some good news from Mayo Clinic, and if you have any other questions then I hope you'll return here. Best wishes to you!

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Just an FYI... I just finished Evenity after 2 years of Prolia. I went from a -3.8 to a -3.3. Good gain but not as good as others have gotten. I feel like I lost my Prolia gains as Evenity did its work. You might want to lock in Prolia with Reclast before starting Evenity.

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@pami

Just an FYI... I just finished Evenity after 2 years of Prolia. I went from a -3.8 to a -3.3. Good gain but not as good as others have gotten. I feel like I lost my Prolia gains as Evenity did its work. You might want to lock in Prolia with Reclast before starting Evenity.

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I started Tymlos in Nov doing well but had bloodwork done for my yearly and my LDL and cholesterol have significantly increased! Nothing has changed with my diet. The only change is the use of Tymlos, has anyone had this problem

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@arlene1958

I started Tymlos in Nov doing well but had bloodwork done for my yearly and my LDL and cholesterol have significantly increased! Nothing has changed with my diet. The only change is the use of Tymlos, has anyone had this problem

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I had the same problem on Prolia. I was never on a statin until I started Prolia.

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@pami

I had the same problem on Prolia. I was never on a statin until I started Prolia.

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Are you taking the statin? Do you have to look for a specific type when using these injections?

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I am on the statin. I am on Pravastatin, the smallest dose. I cut that pill into fourths and take three fourths. I also take a tablespoon of Extra Virgin Olive oil a day and eat nuts to increase my good cholesterol.

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Sorry took so long to respond! I am taking 5mg rosuvastatin calcium at night. My HDL is very high. My cholesterol and LDLshot up. No changes other than the Tymlos. Not very happy about this but what are you going to do!

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