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Bone Health
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Pregnancy/heparin Induced Osteoporosis - Forsteo or Zolendronic acid? Advice needed please...

I was recently diagnosed with Pregnancy induced Osteoporosis with the added complication of being on Fragmin/heparin blood thinners for 6 months across the pregnancy and after the birth.

After an unsuccessful kyphoplasty where L2 collapsed following injections of Tri-calcium phosphate into T12, L4 and L5, I’m now lucky to be under the care of the RNOH, Stanmore.

I now have to decide my treatment pathway — either Teraparatide Forsteo/Forteo or Zolendronic acid? Can I ask the community what are the side effects and positives of both drugs.

Huge thanks,

Cristiana

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Hi CLaurence

So sorry to read your posting. You poor love. You are at the best hospital for care now. :)

Big quandry. Teraparatide appears to be the drug giving great results but the downside is that one can only take this for two years maximum and then have to continue with another OP drug to keep up the good work the Teraparatide has done.

There are of course possible side effects from taking either of the two drugs you mention.

Are you in the UK? If so, I would strongly recommend that you give the NOS helplines a call and speak with a nurse. I have not actually used this brilliant facility but have heard from those that have, it was one of the best things they could do.

nos.org.uk/help-and-support...

I am sure others will be along shortly to reply. :)

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That’s so helpful Thankyou! I didn’t realise that with Forsteo/Forteo you have to continue on another drug to keep the bone health strong! A huge Thankyou for letting me know and I’ll definitely contact the NOS. 🤗

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Can't really help with advice in choosing but, if you don't already know, the two drugs work through different mechanisms, which may help you and your doctor decide which one you should use first. The teraparatide works by encouraging formation of more osteoblasts, the bone building cells. Bisphosphonates, including zolendronic acid, work by inhibiting the action of the bone remodelling cells, osteoclasts, the ones that remove old bone. As Kaarina says, both have certain side effects, and nowadays although they are still prescribed for longer even the bisphosphonates are felt not to be good long term treatment. Whatever you decide I hope you are also able to follow a regimen of nutrition, supplements and appropriate exercise which will work towards helping your body establish healthier bones in the long term. Research has shown that micronutrients alone, even without medication, can help to increase bone density. All the best.

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Thankyou so much. I’ll look into micronutrients. Thanks again HeronNS.

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I am on my fourth month of teraparatide injections with no problems at all. If Zolendronic is the same as Alendronic I would say leave it alone. It causes nothing but trouble.

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That’s great to hear, do you also have pregnancy induced osteoporosis?

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Zolendronic is given as an infusion over about an hour. I had it with no ill effecs, unlike Alondronic and risendronic, which both caused bone pain. I had my first Zolendronic last December, but don't need another untl July 2018.

nos.org.uk/about-osteoporos...

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That’s hugely helpful Thankyou. I’ve decided to go with Forsteo because it appears to be safe to use before menopause. Do you have pregnancy induced osteoporosis?

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I am an 83 year old widow , so the answer to your question is no , Claurence. My osteoporosis started at the age of 70+ . 40 Years after my last pregnancy. I am sorry you have it at such a young age.

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I gave myself Forsteo for two years with a great result

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Great news. Did you have a dexa pre and post treatment?

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