Prolea advice...pros cons

[Boywonder56]

MO wants to start prolea injections ...for osteopenia, and repair met damage to spine....insurance has aproved....but i havent yet, the side effect esp jaw problems...is problematic to me as it seems the adt/ erleada has allready wreaked havoc on my smile......thoughts , ty in advance b.w

[TylexGP]

I consulted with my dentist and made sure any really invasive dental work was done before Prolia. I had just finished having 3 crowns done. My dentist emphasized the importance of consistent routine dental care and to let her know of any significant inflammation in gums and if in doubt to call her. One year in and doing good so far.

[Derf4223]

My MO had me get a permission letter from my dentist before starting Prolia. The issue to avoid is risking lower jaw invasive dental treatment -- extractions, surgery, that sort of thing. So my dentist recommended I get 2 back teeth capped because they had lots of old fillings and could break in half vertically if not capped. Most of my other back teeth are already capped. I see the dentist twice a year for cleanings and checkups. With good ongoing dental care, ONJ is not a big worry. The reason my MO wanted me on Prolia is I stood no chance of maintaining BMD due to Lupron+Abiraterone+Prednisone for 2 years. I am already at T= -1.3 per my DXA scan.

[RyderLake2]

Hello,

You are worrying too much about this drug. I have been on Prolia for close to ten years with few, if any, side effects. I get a single 60 mg injection once every six months. Probably a good idea to take 1000 mg of Calcium orally daily and at least 400 IU of Vitamin D for bone health. See your dentist before starting Prolia and, if you require any extractions, have them done now. It is important that you see your dentist regularly and that you practice good mouth care. The possibility of developing osteonecrosis of the jaw is very slim (less than 2%). Good luck!

[Tall_Allen]

It's a valid concern. Maybe a less active bone stimulant like alendronate? Or estrogen patches? Worth a discussion.

[lewicki in reply to Tall_Allen]

Is there any reason an OC would not prescribe this?

[Tall_Allen in reply to lewicki]

Please clarify - What's an OC? Prescribe what?

[lewicki in reply to Tall_Allen]

OC Oncologist and Prolia will work. You think.

[Tall_Allen in reply to lewicki]

I don't understand your question, sorry.

[lewicki in reply to Tall_Allen]

Thank You !

[Seasid in reply to lewicki]

I also would like to understand the question as I am osteoporotic now and thinking hard what to do next. Any input is welcome in this issue. I am also following the bone health forums. István

[Nusch]

Before you start Prolia I would do two things: First get DEXA scan and even more important QCT. DEXA scans can give false results, QCT will provide a clear picture. If bone quality is good, I wouldn’t take Prolia. If none quality is bad and you consider Prolia, i would check bisphosphonates before start. Because once you’ve started with Prolia you mustn’t stop anymore. If you stop, you have to take bisphosphonates for long time of even rest of your life. And if you can’t live with side effects of bisphosphonates you are in real troubles. That’s what I read and therefore I didn’t start Prolia by now. Instead I checked an osteoporosis diet and do a lot of weight lifting and gymnastics.

[Radars in reply to Nusch]

I had a zoledronic acid infusion last Tuesday and on Wednesday night started peeing blood uti infection am on trimethoprim antibiotic for 7 days, what concerns me now is when I finish antibiotic on Wednesday is that the uti infection will come back because zoledronic acid is still in my system.

[Nusch in reply to Radars]

I’m very sorry to hear and hope antibiotics will solve your problem.

[Explorer08]

My wife’s endocrinologist switched her away from Prolia to Tymlos due to emerging lower jaw problems. Also, you may wish to check with a nephrologist before taking calcium supplements. Calcium can be useless in low doses and harmful in higher doses, depending on the individual.

[Magnus1964]

I have been on xgeva (prolea) for 4 years. No side effects. But everyone responds differently to drugs. You can always stop if side effects appear.

Magnus

[NecessarilySo]

It's Prolia...not Prolea. I have a shot every 6 months for a couple of years now. I also take 5000 units Vit D3. I had an old cavity break up last year...otherwise no significant problems. My bone density has increased from osteoporosis to ostopenia.

[Boywonder56 in reply to NecessarilySo]

I stand corrected.....but i wont bendover dr. Lonfinger....

[j-o-h-n in reply to Boywonder56]

Brand new procedure: Doctor bends over.........

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 05/02/2023 9:39 PM DST

[lewicki in reply to j-o-h-n]

LOL I like. How are you doing? I am steady as she goes.

[j-o-h-n]

I before E except after C........ (and Dear Wife, I before U in every thing we do)...

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 05/02/2023 12:21 PM DST

[GMorz]

I am a Dentist in Australia. The risk relates mainly with dental extractions. Have a thorough check with your dentist to ensure no teeth at high that may require extraction in the future and have them dealt with . Then follow regular checkups and risk then is very low.

[NotDFL]

You really need to tell us your T-scores.

Osteopenia can be counteracted with exercise and proper nutrition. The spine issue is more serious IMHO. So I am at a loss whether to recommend Prolia or not.

[Seasid]

What is your T-score?

[Boywonder56]

Ill get back.......i know last dexa said osteopenea left hip... hence the pushing of prolee-a..

[Boywonder56 in reply to Boywonder56]

T score -1.7 left hip, -1.2 lumbar.....osteopena....6 % decrease in b density since last scan

[SimMartin]

it’s a real problem as there is quite a lot of negative reports by people online about most drug treatments for osteoporosis and osteopenia.

I have been advised to try oral biphosphonates first as my lumber spine T scores were -2,8 and my neck of femur -2.4

the problem for being on ADT is that it is another drain on bone loss. I decided to use the FRAX risk of major fracture as an added check using the bone density score as well as the T scores. It came out as a risk for breakage over the norm.

I am having issues with the oral biphosphonates but I am reluctant to go to prolia as whilst effective often once your on it there is no going back as far as I can read, it’s for life.

We’re i not on HT I might not do anything other than diet and try some exercise but that’s isn’t going to do much for me.

Quite a problematic decision …

[Seasid in reply to SimMartin]

Yes, it is a big problem what to do.