Tymlos or Forteo

My docs want me to do Reclast after Tymlos (and 4 months Evenity) but mention doing more Tymlos or Evenity in the future. I have seen an article on the future possibility of short bursts of Evenity between other meds like bisphosphonates. We need more research! Some is ongoing.

jbfm@jbfm
It may be adviseable to take Forteo for a third year. There aren't studies because the black box has only recently been removed from Forteo.
I have the same reluctance to taking Reclast. It had been written that only 22% of individuals taking Reclast have the severe reaction. Now I'm reading 30%, As Reclast is becoming more commonly prescribed, I suspect that number will rise.
I have an additional reluctance to taking Reclast. It stays in the bones for 10+ years. Effectively blocking normal remodeling. And significantly, blunting the positive effect of the powerful anabolics like Forteo or Tymlos. The only thing Reclast has in its favor (in my opinion) is that it is a far cry above Prolia.
I've just finished my first year of Forteo. My plan is to take another year and if everything looks good I'll take a third.
If I have to take a bisphosphonate, I'll choose risidronate because it doesn't persist in the bone the way Reclast does.

YES. I cannot take Risidronate because it caused my GERD years ago I have no choice except for Reclast. And I may need a tooth extraction in the next few months so my endodontist doesn't want me on it. It's serious stuff causing me a great deal of angst.
Why retake Forteo if I don't want to take Reclast afterwards? OR buy more time in the hopes a new drug will be offered? Thanks

Can you tell us more about yourself and what you are dealing with.

My bone markers appeared to say that Tymlos stopped building bone before 18 months, and my docs all said the same, though they kept me on the full two years for maintenance.

McCormick's book says to avoid risendronate. Are the side effects worse? (I have to find the darn book and check).

I am doing partial dose Reclast and hope that mimics orals since I have GERD and cannot do orals.

Most studies I have seen are about alendronate followed by Forteo, not Reclast. There was reduction in effectiveness by about 1/3 as I remember but again I would have to find the study again. I imagine the reduction would be more with Reclast.

It is stressful and serious. There are other choices besides repeating Forteo which I realize from past posts you could take for at least another two years or three years. But other than bisphosphonates there is only Evenity and Prolia. Both of which will require something after.
If you are back to baseline, Tymlos or Forteo is still the best ( and very good) choice. After Prolia you' have no choice but bisphosphonates. And after Evenity bisphosphonates or Prolia.
There aren't so very many medications, which simplifies things. Both Evenity and Prolia have osteonecrosis of the jaw in their profile.
Are you doing anything with HRT. I've been trying to get Michael to take it as it would make him more reflective and less judgemental, wouldn't help his bones. Which is to say don't take it if you are a male. And I do think you'll be happier with an anabolic.
I advised a neighbbor against Reclast. She decided to take it when her husband said--why would you trust a neighbor over your highly regarded, well-trained physician. Which is an excellent point. But it didn't work out well.

How does a partial dose work? Does that minimize side effects? Can you tell me so i.can tell my dr? Thanks!

I can't take Evenity because of heart issues. And Prolia is for life and has to be administered every 6 months like clockwork according to my Dr. And we travel a lot. I've heard side effects are worse with Prolia, too.

My doctor says I can stay on Tymlos or go off and repeat. I’m looking ahead 20 years, so scary, no great follow up option.

What do you mean when you said Reclast "didn't work out well" for your neighbor?