Prolia doseage

Posted by lucychristine46 @lucychristine46, Oct 1 11:00am

I am currently taking fosmax for the last year .
My spinal osteoporosis is 3.4 . I am scheduled for a Dexa scan in October 2024 . I am hoping that the fosmax has helped my osteoporosis as I have fear of taking a60-70 mg prolia injection .

Is it possible that I could get the prolia injection in a smaller dose age or an oral tablet ?

Thank you for sharing your knowledge

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

Hello @lucychristine46. While we wait for a few others to join in, are you comfortable sharing if you have had this discussion with your provider? Dosages and how we all respond to medications can be vastly different which makes it difficult to predict how we handle medications. When you have your next DEXA, are you hoping to discuss your concerns with the higher dose of Prolia? What in particular has your concerned about the 60-70 mg dosage?

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Yes, last year I discussed my fear of taking prolia and so along with my PCP ‘s recommendation I stated taking foamax I had a DEXA scan today and so the results will determine how I will proceed . My discomfort with injections came about when my PCP gave me an “ extra large dose flu shot .when I turned 65 . I was not given a chance to refuse it . I rarely had flu before that or a vaccination. 4 days later , when I woke I could not lift the blankets off my body . Painful muscle pain came about after that and so after 2 weeks went to my PCP and was quickly diagnosed with. PMR ! I started on a 10mg of prednisone and it took 9 months to wean off it and be free of the muscle pain . PMR recurred 2 years later with the same prednisone prescription for the same time . OF course , it did not take me long to determine that the flu shot caused this PMR .BUT no doctor would agree with my assessment. I have had indoor and outdoor allergies all
My life and understand how the immunity system can overreact . I never took a Covid vaccination or had Covid , I ,along with others believe that 1 dose of vaccinations is not good for all . I for many years have been physically active with a moderate diet with no cholesterol or diabetes medications

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Hi @lucychristine46

I have a few data points for you that might help.

1. If you were taking Prolia to help treat bone metastases from solid tumors, the dosage would be 120mg every four weeks, which is much greater than the osteoporosis dosage of 60mg every 6 months.

2. The phase 2 trial or Prolia tested 6, 14, or 30 mg doses every 3 mo as well as 14, 60, 100, or 210 mg every 6 mo. I don’t have the details on why they selected 60mg/6mo, but you could buy the trail white paper if you like or do some searching to find out. This will get you close https://doi.org/10.1359/jbmr.070809 . You could also type this into ChatGPT and get a little more info “Why did Amgen choose 60mg of denosumab for the treatment of osteoporosis?”.

As for taking a smaller dose, it’s only sold as 60mg but it is possible to just use part of the syringe, though not sure if you could tell how much you were using while injecting. It has a funky syringe and I can’t remember seeing the levels on the side.

There is not currently a tablet solution for denosumab (Prolia), but I think there is one in the works. I actually think it’s safer to have the subcutaneous injections.

I’m on Prolia now and have not had any adverse reactions. It seems to be working as well. It is a humanized monoclonal antibody that gives me a bit more confidence as well.

At a T-score of -3.4, you probably should have started with an osteoanabolic drug like Evenity, Tymlos or Forteo. Fosamax is a good drug, but it might not be able to get you out of the osteoporosis range. Hopefully your hip is better as it’s tougher to build bone there. If your results do not come back that positive, you might consider transitioning to Evenity for 12 months. Tymlos and Forteo don’t work that well following a bisphosphonate like Fosamax. Otherwise, Prolia might be your best choice.

Taking these drugs do come with risks, but they have to be weighed against the risk reduction of breaking a spine or hip. It has to be your educated decision.

Good luck!!!

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Michael,
Thank you in volumes !
A lot for me to process but you have covered so much .

I still am concerned about my body ( immunity system ) overacting to any high dose injection or oral use of osteo medication
Of course this is based on my “ getting “ PMR after a high dose flu shot 13 years ago . I have not had in vaccinations since then .

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I wish I skipped the Covid vaccine myself. It seems too coincidental that both myself and my wife started having PVC heart events about 6 months after our shots. So much for informed consent. 🙁

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@michaellavacot

I wish I skipped the Covid vaccine myself. It seems too coincidental that both myself and my wife started having PVC heart events about 6 months after our shots. So much for informed consent. 🙁

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Michael , thank you for sharing your opinion about the Covid vaccine . ,and the patient rights …

My recent Dexa scan showed my lumbar going from -3.4 to -3.1 . But my right neck reading went from .04 to - 1..6 .
I still am not very knowledgeable about reading the chart with my TBS .

But , with the communication on this “ Mayo group “ is giving me knowledge on how to ask questions at my PA orthopedic person next week , One concern that I will ask her and my PCP. is malabsorption. For a long time I have had allergies to food items and bloating , skin rashes , etc .
I am wondering how this affects digestion in my small intestine or how these osteo drugs affect the small intestine . Hopefully I will have an informed, helpful discussion in this appointment.

Thank you for sharing this recent information!

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