Tymlos, then Evenity, then Reclast?

@esb13
Good morning, I have been on Reclast for a few years, decided to stop recently.
I have had 3 broken ribs in July, hospitalized, 1 more rib break on the same side in November, still recovering. I also cannot have a tooth pulled, again, because of Reclast. It definitely did not work for me.

Thanks all--this forum is really helpful. My "endrocrinologist" is an advanced practice nurse who specializes in rheumatology. She seems to really know what she is doing, and is great about laying out options and being flexible about which we pick. She also is familiar with the pitfalls of insurance. She recommended going to Reclast directly after Tymlos, but I was interested in talking about trying Evenity first. She told me that insurance might not agree, worked out a couple of alternatives if they didn't, and then we went ahead with trying Evenity (insurance approved).

I have to say that in general I like working with APNs and PAs more than with physicians--if they have experience, they know what they are doing but seem to be less stuck on their own preferences and are trained to be better listeners.

@janism , I am on the same path as you. Currently on Tymlos (at my 18th month), plan to take it for two years, then fight with insurance for Evenity approval before moving to Reclast to lock in gains.

I'm also working with a PA and totally agree that many RNs and PAs are better listeners and more patient-centered. Any tips for how yours got Evenity approved? I am 56 and want to build more bone before locking in gains, but anticipate insurance resistance because I have moved to "just" having osteopenia now. My osteoporosis is progressive, but the concern is that my T-scores will currently look too good for Evenity approval.

Best of luck to you on your journey, and please keep posting updates. I will share my final DEXA results when I get them, too.

@sesameseedling

Hi, I'm currently on my second month of Tymlos. No major side effects yet although I question my decision to take it everyday (spine score -3.2). Just wondering how you feel about Tymlos after 18 months? I'm also worried about the follow up (Evenity, Reclast, etc) and basically being on meds for the foreseeable future. I'm 64. Still researching and getting more testing (TBS, REMS, bone markers). The PA I'm working with ran all the necessary blood work which was fine. My osteoporosis is likely due to menopause, not taking HRT and (to be honest) not having the best diet in my younger years.

@rileyf Overall, I am pretty pleased with my DEXA results on Tymlos. My lumbar spine went from -2.7 to -1.5, although my hips didn’t move at all and have stayed at -1.5 (my PA said Year 2 is when hips improve so we will see). Bc my osteo will likely keep progressing, I plan to fight for Evenity to build more bone before doing Reclast. Otherwise, when I have to build more up in the future, drugs like Evenity and Forteo will be less effective bc of sub-optimal sequencing. Best of luck to you and everyone else on this journey.