What is minimum period of Alendronate to minimise Prolia rebound?
I started on Prolia in July 2022 on advice from my doctor that the treatment would be for only 4-5 years and thereafter I could stop. I have taken 3 Prolia injections, the last one in July 2023.
Before my 4th injection in Jan 2024, I started doing a lot of reading and decided that I do not want to be on any osteoporosis drug at all. So, instead of taking my 4th Prolia injection and to minimise the rebound effect from stopping Prolia, I started on a weekly dose of Alendronate.
However, I am really not comfortable taking Alendronate as well and would like to seek any advice/opinion on whether I am stuck with taking Alendronate for the next 6, 12 or even 24 months.
What is the shortest period I can be on Alendronate? Or should I just risk the rebound effect and stop my Alendronate now (I have taken 3 weekly doses so far)?
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I would not risk rebound! My doc uses Reclast, once a year, for one or two years I believe, though I don't have experience with Prolia. Your doc can do blood tests to monitor and see what is going on. Do you have an endocrinologist?
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1 Reactionthe rebound effect from prolia is compression fractures and more unfortunately you just ca;t stop prolia without taking something read up on prolia and you will see. what else you can take i really do not know but it would be nice if the drs knew. i had a severe reaaction to my 1st shot of prolia and when i asked my dr what do i do he said i don't know made me feel real happy i have posted mu ordeal with prolia which has been horrible after not taking another shot i had 2 compression fractures since and for dome reason developed ra can't tell you why because no one knows but i can say before prolia i was relatively pretty healthy. my ra dr did say it could be possible the prolia caused the ra but he said we will never know i posted under prolia mistake and boy what a mistake it was i now have a little high glucose reading from the medication so i could get diabetes and the list just goes on and on very depressing to say the least i see no light at the end of this tunnel just more heartache and pain
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2 ReactionsReclast is more potent than Alendronate so I am avoiding that as a relay drug. I read that Reclast would be required to minimise the rebound effect once you are on Prolia for around 2 years or more. I have taken 3 Prolia shots so I am opting for Alendronate instead. No, I am not seeing an endocrinologist hence (unfortunately) I did not have my baseline BTMs recorded before starting treatment. I am wondering if doing BTMs now will be helpful in determining when I can stop my Alendronate
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2 ReactionsVery sorry to hear about your experience with Prolia. For my 3 injections, I did not experience any side effects. Nontheless, the thought of being stuck on Prolia for life with no easy way to exit scares me and I decided to stop before my 4th injection
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1 ReactionThe reason some of us try Reclast instead of alendronate is GERD. If you don't have that issue, it sounds like a good choice for follow-up and I hope you can find an endocrinologist who can help you determine when to stop. I also hope your bones are okay and you don't need to think about other treatments! (I have done Tymlos for two years)
I have taken 3 weekly doses of Alendronate so far and other than a mild stomach ache after the 1st dose (which may or may not have been caused by Alendronate), I have not had any side-effects. I should mention that I also didn't have any side-effects for the 3 shots of Prolia that I took and my hip neck TScore actually showed a slight improvement from -2.7 to -2.6. Nontheless, I intend to try non-drug treatment (supplements and exercise) - something which I regretted not doing before agreeing to Prolia. I would prefer to not even be on Alendronate but it looks like I am forced to stay with it just to prevent the rebound effect. I am encouraged by Dr McCormick's statement (on a youtube interview) that for people with TScores -2.8 to -3.0, it may not be necessary to go on any pharmaceutical
If it turns out that I am not able to use BTM readings to time my exit from Alendronate (because I do not have any baseline BTM readings), my tentative plan (subject to what my doctor says) is to stay on Alendronate for 1 year and perhaps another 6 months on half-dose (to ease the withdrawal). I do plan to take another DEXA at the end of 1 yr of Alendronate but I read that it may take 1.5-2yrs for any significant change in bone density to register
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1 ReactionReading your recent post made me feel like it came from my alter-ego. I also need an answer to this question and do not feel I can rely on my primary care doctor.
In May 2023, after only 2 Prolia injections, my DEXA showed astonishing improvement at the hip (had no vertebral OP dx and had been on Fosomax for at least 5 years). My doctor said he would take me off Prolia (and it would no longer be covered by insurance, in any event) and that it was OK to do this cold turkey. I pushed back because of the valuable info I obtained here but he resisted.
I researched the issue and found this summaryhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9081316/. I sent this to my doctor and he agreed to put me on Fosomax for 1 year as a step-down. I do not know whether this is the correct time frame but I do know I do not trust my doctor's judgment and tried to find an endocrinologist, unsuccessfully.
Perhaps it will be of help to you and we can somehow figure this out together.
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2 Reactions@surefire - Sounds like it's going pretty well with Alendronate , but I will share that when I spoke with Dr. McCormick, because I have had in my past some Gerd issues, he said Actonel would probably be a better rebound drug for me, if I was resistant to take Reclast. good luck!!
I'm so sorry to hear about your problems with Pro. You are the second person that I have heard getting RA from it. I am on Tymlos and don't know what I will take after that. My Dr recommends Pro but I'm scared to take it. I have Reflux and other stomach issues. I will ask if I can get a test dose of Reclast.
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1 ReactionYes, I have read that article, thanks. These 2 youtube videos will also be helpful:
From my research, you are likely on the right track as you have only taken 2 shots of Prolia. Dr McCormack in his youtube interview was of the opinion that Reclast would be necessary as a relay drug once you have taken 3 or more shots of Prolia but I have read elsewhere that Alendronate can be used too for up to 2 years of Prolia.
How long have you been on Alendronate and have you had any side-effects?
I know the standard instruction is to keep upright and not eat for 30 mins after Alendronate but I prefer to be cautious and usually do not eat until at least 1.5 to 2 hrs after. Also, I read that during the 30 minutes after taking the tablet, you should drink at least 2 oz of water
On the recommended time-frame for the step-down, I have seen from as low as 6 months to up to 2 years. I think if you can get BTM tests done regularly, they could help give guidance on the best time to stop your Alendronate - this is something I need to explore with my doctor too. Do you have any baseline BTMs to compare with?