Tymlos blood pressure side effects etc. very nervous! Help…

osteopatient 2026
I have the same blood pressure drop with Forteo. These two medications increase serum calcium and expand the blood vessels immediately upon taking the shot. You can counteract the expansion by taking something salty or caffiene before injecting. I use both tea and an olive or blue corn chip. That tightens the blood vessels. Increasing the volume of fluid by taking a glass of water will make it easier for your heart to circulate the blood.
You can lower the dose by listening for the clicks when you turn the dial. Each click is 10mcg of PTH 1-34. You can start a low as you like. The doctors and the drug reps don't approve, but they don't understand what it is lie to have this reaction to the shot. Your goal might be to reach 80 mcgs or you might stop at 40mcg. Some of us think that the dosage is too high for our lighter weight anyway.
Some have reported effective bone acquisition even with never reaching 80mcg. If you do this you might keep the pen in the refrigerator, so that you can use the pen for more than 28 or 30 days.
Let us know how this works for you.
Sorry you are having nausea. The lower dose might eliminate that. I think that it is the calcium causing it. You might schedule the calcium away from the injection by 4 four hours, after unless you take the injection at night.
I'd want bone markers at one month at least P1NP. Metabolic panel is good at three months, though some doctors won't. Calcium anyway though the draw should be done at least 4 hours after the injection. I like magnesium, too. But none of these doctors do what I say. The endocrinologist ran a three month parathyroid. Following with CMP every year and so parathyroid the first year at 9months.
How long have you been on Tymlos. These side effects lessen with time for some. And, will lessen with the lower dose. So some report gradually increasing the dose until they get to the dose that causes misery, then they back down on the clicks and try at a later date.
You have been prescribed the best, most amazing medication by this small town Rheumatologist.

@gently Really helpful info here with regard to lessening some of the immediate side effects. I’ll remember the tea and salty snack combo as you inject (if I take Tymlos, that is; not sure yet). Thank you!

Thank you to you both. I am suppose to start for the first time Thursday night (11-13-tomorrow)
When I asked Tymlos and my doctor they both said not to
“lower the dose by listening for the clicks when you turn the dial. Each click is 10mcg of PTH 1-34.”
I am not sure why. Many other drugs allow to start slow and acclimate except antibiotics some pain meds etc.
There does not seem to be any published safety guidance on this approach…it sure seems like it would be easier. Hoping to hear from the “Tymlos Nurse” today and or speak with the specialty pharmacy before I start.
Thank you for taking the time to respond.

osteopatient2026, neither the doctors or the nurses or the drug reps will advise you to start with less than the full dose. You will likely be fine on full dose. You may not have any side effects at all. If you do have side effects the way this drug works and the reason you have to inject every day is because its effect is dependent on the fact that it leaves your body very quickly, usually within four hours of the injection. You may have the usual blood pressure drop, maybe a headache and/or light nausea. Those side effects go away after 4 to 6 hours. And in most people they diminish with continued use.
You won't find any published guidance because Tymlos has never been tested with this method. And the most effective dose is going to be 80mg.
The reduced dose method comes from patients. The first time I heard about it was here. The patient told her doctor who now uses graduated dosing with some patients.
Be careful today after the injection in case you get dizzy. And then post your experience. Your bones are going to love this.

Really appreciate your kind response. Anxiety is high…the doctor said if I don’t like daily injections I could go to Prolia…that’s worrying because it isn’t a anabolic…he is a Rheumatologist…Hope he knows what he is doing…my T score is -4.8 spine and -3.3 hip.

Pharmaceutical companies do not just magically decide on a dosage level. In the early stage of development, dosage level had to be varied in order to decide on the "optimum" dosage for the average person. There is a movement in the cancer field to rethink this. (I cannot think of the name for this program now.) That quality of life is also important and should be balanced with effectiveness. I have mentioned this Shkreli Award winner before.

"3. Amgen. Amgen’s cancer drug Lumakras, approved in 2021 at a 960 mg daily dose, showed in trials that a lower 240 mg dose offers similar efficacy with fewer side effects. Despite this, Amgen continues to market the higher dose and seeks final FDA approval at that level, potentially protecting $180,000 in annual revenue per patient. Pharmacologist Donald Harvey, PharmD, interviewed by KFF Health News, called Lumakras “a poster child for incredibly bad development.” Amgen defends the 960 mg dose, citing FDA acceptance of it as the recommended level. "