What comes after Evenity?

laurensb,
Thank you for asking this question. I receive my 7th dose of Evenity next week, so I’m starting to think about this. My endocrinologist says fosamax. I’m a little worried about that due to GERD. Reclast is scarier than Evenity - or so I believe.

I'll be getting my fourth injections this month. My endocrinologist wants me to begin prolia after I am done but prolia scares me.

I just had my 9th shots of Evenity and am desperately trying to figure out what should come next to lock in any gains. I was already on Alendronate from 2017 after my first compression fracture until fall of 2021. My second fracture occurred in Jan. of 2023 and started Evenity in March. My PCP strongly suggested Prolia and my Oncologist (breast cancer in 2014 followed by radiation -- which probably did my bones no favors) has recommended Reclast, as a follow-up. Neither option sounds appealing, but I will have to do something.

I took one infusion of rec class and got double vision in my eyes 24 hours after taking it. It lasted 3 months before it subsided to my regular vision. I will never take Reclast again. I have been recommended to take Prolia and I will have to do that for the rest of my life as I am 77 and have severe osteoporosis.
I have severe Gerd, which I believe comes from five years on Fosamax earlier in my Osteoporosis life.

I am doing a 20% test dose of Reclast when I finish Evenity (after Tymlos). McCormick said I could continue with that dose, done more frequently than the full dose. We'll see! I have GERD so can't do Fosamax and my docs don't like to use Prolia, period.

Windyshores,
How are you doing so far on Evenity?

To lakecher46:

I am 76 so very close to you in age and taking Prolia for the rest of my life scares me totally.
Windy shores has mentioned that she is doing a 20% dose of Reclast when she finishes Evenity. My oncologist did mention that one could have a half dose every 6 months instead of a full dose for a full year. I imagine it might become an insusrance issue, if one is going multiple times a year for an infusiion in a hospital setting. Anyone have any insight as to how that would work?

That’s interesting news about taking Reclast every six months instead of once a year so the dose is diminished. I will definitely ask my Endocrinologist when I see him next month for my final injection of Evenity. Thanks for the information.

@windyshores I just send a reply message to you under 'undecided choice of drug for op'.. Sorry I didn't do a thorough reading though different treads. Now I'm seeing you are on evenity after tymlos, and planning on a reduced dose of reclast, right?

The main purpose of this writing is in regards of bisphosphate usage after an anabolic, in your case is after anabolic and evenity. Like you, I have gerd, a mild one and asymptomatic. Upon reading the classic fosamax, I realized that fosamax has a liquid dosage form. It seemed stomach irritations are mainly due to the lining in direct contact of broken down particles, or actice ingredients of fosamax tablets. Some reports indicate that might be why some generic fosamax may cause more irritation because of the differences in disintegrating rate compared to the brand. My thinking is solution 'form' might be the solution! If the transient time in stomach is markedly reduced with the solution form, would that be usable for pts with gerd or stomach issues? I'm yet to do more readings regarding the bioequevalency of the solution since it's available only as a generic. My thinking is that a gentler bisphosphanate might not 'lock in' all the gains of an anabolic, but it might be a better candidate should future repeated anabolic usage is needed. Does this train of thought has any merit? Whats your knowledge about ' lock in' agents after an anabolic? Thank you very much!

@mayblin what an interesting idea! The liquid version of Fosamax...

I have been told that Reclast is much more potent. After the 20% test dose, I am supposed to tell my doc what dose I want after a month of evaluating tolerability, and that second dose would be three months after the first. I have read that a half dose is as effective as full dose (sorry can't cite right now).

Keith McCormick thinks I could do a 20% dose every three months.

I am going to look into this idea of a liquid form of Fosamax. I wonder if, chased with water, it would pass through quickly enough to avoid affecting the esophagus. Or maybe the liquid will coat the lining and be worse than a pill that passes through. At any rate, thanks for the idea!