Pros /Cons of Prolia versus Tymlos for osteoporosis

Prolia is an anti-resorptive (affects bone turnover). There is a rebound when stopped, with a drop in bone density and increase in fracture risk, sometimes managed with Reclast. Prolia can later interfere with the effectiveness of some of the bone building drugs (like Tymlos). It is often prescribed by primary care doctors and more often, I believe, for less severe osteoporosis.

Tymlos is an anabolic (builds new bone) and is given for 18-24 months then followed with a bisphosphonate or, more recently, Evenity. It is especially good for the spine. Tymlos is given at home via injection and has a pen with adjustable dosing. It leaves the body in a few hours.

This info is all from my doctor or "Great Bones' by McCormick and either your doctor or that book or some other resource (videos) can provide more information. I am giving you my lay person's explanation as a fellow patient.

ps I had excellent gains on Tymlos, personally!

@2024tymloshelp
You've been prescribed the drug that builds the best bone. Tymlos remodels--repairs bone and then adds new bone Prolia models-- and collects the older bone preventing it from repair.
There could be a reason hidden in the difference in your health histories. Your friend could have hyperparathyroidism, hypercaclemia or allergies to the excipients of Tymlos. Patients with a history of cancer with bone mets or the likelihood of metastasis to the bone are sometimes prescribed Prolia.
Some patients can't bear the thought of injecting themselves or really don't want the daily trouble when they could a bi yearly injecting.
Your neighbor's insurance coverage of Tymlos may leave a large copay.
Would you have agreed to Prolia if it had been prescribed?

Thanks for the info !
I think my friend might have a different health history - you’re right .
She did say she’s had zero side effects from prolia and has already seen improvement in bone density in testing .
But for some reason the same Dr prescribed me Tymlos. Other than weight gain I’m doing okay on it .
To answer your question I didn’t like what I read about prolia so no I probably wouldn’t have chosen it

2024tymloshelp,
Her bone density will probably look better than yours especially in the hips at two years. Your bone will have structural integrity. I'm glad you are doing okay on Tymlos. I'm on Forteo and will have a third year of it. I'd switch to Tymlos for the next year, but the providing doctor won't agree, at least not yet.

I did 24 months of Forteo 8 years ago and followed up with one shot of Prolia, which did not go well, so then went on Evista for 5 years. Now due to long wait to get approved for Evenity, I have restarted Forteo, generic brand. Just started second month. How are you doing with yours? Any weight gain or upset stomach/headache. Brain fog?

What do you mean that the one shot of Prolia 'did not go well'. Did you have bad side effects?

Hi @windyshores ,
I’ve gone full circle since our last conversation. My pain is still severe and pain doctors telling that they can’t help me anymore. Thinking about functional medicine. I am still on Evenity because doctor pushes me to finish. My bone density is behind bad and he is telling me that I probably not be approved for another bone builder. He thinks I should go on Prolia next. I can’t think straight because my pain clouds my mind. I probably need to insist to switch me to Tymlos. I am very skinny - my belly doesn’t have no fat- just skin. Question: I remember you were writing me that you are tiny too. Is it easy to inject just under the skin? I am trying to gain some weight without any success. I dropped 20 lbs this year. Doctors can’t explain why. Maybe some other ladies who are 100-110 lbs can share experience too. I have to be prepared in case he decides to prescribe Tymlos after Evenity or I talk him in to switching me on Tymlos after 7th shot. Appreciate any opinion or advice.

@broken 13 The endocrinologist I see says that all the Forteo headaches are caused by vasodilation Nausea might be caused by increased serum calcium, or a loss of sense of balance from blood pressure drop.
You might try a having something a little salty before injecting and a glass of water. The salt causes a balancing vasoconstriction and the extra fluid reduces the blood pressure drop.
My blood pressure does drop almost immediately with the injection, but I haven't had any side effect with Forteo. I haven't gained any belly fat. I inject in my right thigh; it still looks exactly like my left thigh. I so like this drug. The dxa after a year wasn't impressive for bmw
and certainly didn't put me in clear, but I may not be taking enough calcium.
Did you have headaches eight years ago.

@sunny65 I am 105 and shorter by the minute 🙂 Injecting Tymlos was no problem at all. You pinch the skin, stick the small needle in, and let go as you inject.

The discussion of belly fat puzzles me. My belly got puffy but I didn't think of it as more fat. It went back down after I stopped. Fractures make my belly stick out more than Tymlos!

So so sorry you are in pain. Does anything help?