What is minimum period of Alendronate to minimise Prolia rebound?

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?

the 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

Reclast 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

Very 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

The 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

Reading 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.

@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.

Yes, 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?