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Reclast followed by HRT, is a drug holiday required?

Posted by tillymack @tillymack, Nov 6 2:47pm

I've received 4 Reclast infustions following 20 years of Evista. I'd like to switch to HRT. Does anyone know if a drug holiday is necessary to separate the Reclast and HRT?

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mayblin | @mayblin | Nov 7 10:06am

tillymack, many people who’ve been on Reclast for around 3 years will take a “drug holiday” if their DEXA results are stable. Some also monitor CTX. I think it’s a good time to discuss with your doctor to see whether this might be an appropriate point to take a break.

If you’re planning to start HRT for both bone benefits and menopausal symptoms, that changes the picture a bit. HRT and Reclast overlap in how they work. Reclast stays in the bone for quite a while and can keep bone turnover low for 12–24 months after the last dose. HRT, on the other hand, takes a few months to reach its full effect on bone. Because of the dynamic changes, your doctor can help time the transition so you continue to have bone protection without over-suppressing turnover.

Just wondering if an anabolic agent ever came up in discussion with your doctor?

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tillymack | @tillymack | Nov 7 5:28pm
In reply to @mayblin "tillymack, many people who’ve been on Reclast for around 3 years will take a “drug holiday”..." + (show)
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tillymack, many people who’ve been on Reclast for around 3 years will take a “drug holiday” if their DEXA results are stable. Some also monitor CTX. I think it’s a good time to discuss with your doctor to see whether this might be an appropriate point to take a break.

If you’re planning to start HRT for both bone benefits and menopausal symptoms, that changes the picture a bit. HRT and Reclast overlap in how they work. Reclast stays in the bone for quite a while and can keep bone turnover low for 12–24 months after the last dose. HRT, on the other hand, takes a few months to reach its full effect on bone. Because of the dynamic changes, your doctor can help time the transition so you continue to have bone protection without over-suppressing turnover.

Just wondering if an anabolic agent ever came up in discussion with your doctor?

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@mayblin
Thank you mayblin! My endocrinologist did give me literature on the various anabolic agents as well as other choices for osteoporosis (I also have scoliosis). I'm currently coming to terms with a long term feeling of imbalance which may have been caused by Reclast. With that in mind, I'm not interested in contining with Reclast nor taking a chance with anabolic agents which may present more risk for heart attacks and stroke and other unknown side effects than HRT.

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