What next after Evenity?

This is a good discussion.
https://connect.mayoclinic.org/discussion/need-advise-what-drug-to-follow-up-evenity/
I am in a similar situation since I'll have to follow up my Tymlos treatment at the end of the year. I am leaning toward Fosamax because I don't like the idea of a Reclast infusion. There's no going back if you have a bad reaction. We'll see...

I completed my 12th month of Evenity in April. My endocrinologist and I agreed that Reclast would be the best next step for me. One of the most significant concerns for me is that I have only one parathyroid gland left. Some of the medications are parathyroid-based, so she's concerned that those drugs may interfere with my one functioning parathyroid. She said essentially the same thing - they all potentially have uncomfortable side effects. You just have to choose the one that will serve you best. I had excellent gains on Evenity for my low back (from -3.4 to -2.6), so we want to protect that gain with Reclast. I'm very nervous about the potential side effects (as I was when I started Evenity), but she gave me some good tips. She said to be sure to hydrate well beforehand, drinking at least two full glasses of water immediately before the infusion, and taking Tylenol both before the infusion and after.

If you want a full view of all of the treatments out there, look at Keith McCormick's book, Great Bones.

Here is my experience and I swore I wouldn’t take Reclast again a couple weeks ago after infusion, but I seem to be ok now. I don’t know. I’m in the same boat and probably take another infusion of Reclast if I remain without symptoms. I will update. Here is my original post for your information: "I am 73 and I received my first infusion of Reclast on Mar. 24, 2025. I..."+ (show)
I had a Reclast Infusion 3/24/25 and I have been feeling poorly since and today is 4/13. I got the pain in the left eyeball and thought my head was going to explode the day after infusion. I too saw eye doc and he did not see that I needed steroid drops. The pain finally subsided but it went to back of neck & shoulder . Then it went from there after 3 days into my right jaw where I had teeth removed (I was on Prolia and used oral surgeon one year before). It has subsided after 3 days. I’m better today but still feel crummy. Pain has subsided🤞I am a long term chronic pain patient on pain meds as well. I will tell you I had to use six Tylenol 500 mg each for two days and least two 500 mg since the infusion with normal pain meds. This morning I woke up headache free and yesterday. I’m hoping I can do a little housework starting tomorrow. This will be 12 days in bed mostly for me. I suffered agonizing bone pain with Prolia (4 shots over 2 yrs. Pain started last year so I refused to take. Due to fracture risk they put me on this and I’m reluctant to do it again) Prolia about killed me last year. I couldn’t bend over to pick something off floor and woke up in morning not knowing if I could get up in so much pain. I really thought I was going to die (it was so bad). I couldn’t walk. I missed Christmas and New Years with family. Too much pain. I am hoping to feel better, but I can’t hold my breath. I’ll update in a few days. These drugs are powerful and I wish I had never heard of them. Now I’m stuck because I have spondylitis, severe scoliosis and no space disk in back. Oh and I want to mention my hands hurt so bad I couldn’t cook for several days. It’s been hell for me. Think twice before you do these drugs. It’s a lifetime you have to continue.”