Osteoporosis treatment

[smtamt]

Is Biphosphonates (taken more than 3 years) trigger fracture of the thigh bone (femur) and osteonecrosis (bone death) of the jaw? Can my mother Sobha Ghoshal (aged 78 years) take biphosphonates like Aclasta /Stoplos One (zolendronic acid) for more than 5 years after completing Bonmax Pth (teriparatide) injection for 2 years (spanning from October 2015 to September 2017) for Osteoporosis? Which is the better option for biphosphonates treatment 1) Alendronae (Fosammax) or Zolendronic Acid (Aclasta)? Is the effects of Prolia (denosumab) leave the body quickly and generally disappear after one stops taking them? I was told that alendronate, Zolendronic acid stay in the bones after you stop taking them and will continue to work and offer protection even afer one stops taking them. Is it true?

smtkrgsl (son)

[Kaarina]

You should delete your email address for your own security. Hopefully an admin will do this, if you do not.

[smtamt in reply to Kaarina]

what security concerns are their if I show my emails to others? if there is any security issues , then delete my email.

[Kaarina in reply to smtamt]

This is a copy of the forum rules: healthunlocked.com/american...

*Members should not post personal contact information on the site, though they may choose to do so in the Messages module.

[Mark_ABH in reply to smtamt]

Hi smtamt, I went ahead and deleted your email.

[smtamt in reply to Mark_ABH]

Thank you very much. I did not go through the forum rules before. That is my mistake.

[Met00]

There are possible side effects to all osteoporosis medications, some mild, others quite nasty, so it's impossible to advise what would be best for an individual. Most people don't get the nasty side effects, but nobody can predict who will and who won't. Yes, bisphosphonates do stay in the body after you stop taking them - they alter the bones, so that old bone is retained, thereby increasing bone density for most people (though this isn't guaranteed). When you stop taking them, over time the old bone will start to break down again. But old bone is more fragile than new bone and the medication interferes with the natural process of old bone being replaced by new, which is why it's now recommended that most people take bisphosphonates for no longer than 5 years, followed by a "holiday" of 1-3 years. Your mother also needs to be aware that if she takes Prolia, she either needs to stay on it permanently, or swap to another medication if she stops (usually a bisphosphonate) to avoid an extremely high risk of rebound fractures.

[KidneyCoach in reply to Met00]

No Prolia should not be taken any longer than 2 years per their own guidelines. I quit after one injection.

[Met00 in reply to KidneyCoach]

A rheumatologist here (UK) said it's for life!

[KidneyCoach in reply to Met00]

Oh okay I'm just going by the manufacturer's printed literature included with the medication. Thanks

[Met00 in reply to KidneyCoach]

I think it's because of the risk of rebound fractures if you stop.

[KidneyCoach in reply to Met00]

Perhaps. I only know I acquired ALL my fractures while taking medications for osteoporosis. I've had 4 bad falls since stopping all those meds as well as an abscessed molar with NO fractures 2 years post. To me that says a lot. That's just me. Maybe they tell you not to stop as a way of forcing us to continue as consumers forever?? Sound feasible. Lol Blessings

[HeronNS in reply to Met00]

The reason (for taking Prolia for the rest of your life) is because you run the risk of rebound osteoporosis (a condition unrelated to the original reson for your osteoporosis) once Prolia is discontinued. This effect can occur almost as soon as a dose is missed. As you have to take another med anyway once it's stopped for whatever reason (can have very serious side effects including damage to immune system) you might as well skip the Prolia altogether and avoid its dangers.

[smtamt in reply to KidneyCoach]

If you quit Prolia then you have to go for biphosphonates treatment. Which is the better option for biphosphonates treatment 1) Alendronae (Fosammax) or Zolendronic Acid (Aclasta)?

[KidneyCoach in reply to smtamt]

No, you don't have to. I stopped Fosamax per my nephrologist in 2010 and took nothing until 2017. I took one injection of Prolia and suffered 3 fractures in the first few weeks. When I stopped Prolia the doctor told me I must take another drug which was basically a parathyroid hormone. For me as a renal failure patient it could have been devastating to my bones and potentially deadly. In the beginning we spoke about side effects of Prolia and the interactions with my dialysis, parathyroid issues, calcium etc and he reassured me multiple times it would have no effect. Turns out it dropped my blood calcium levels to dangerously low to the point I needed IV calcium and this was after I had a fractured tibia, humerus and finger. Then was told without the PTH med I would have more fractures. For someone who already had hyperparathyroid issues with levels at 900 (normal is under 100) this would have been a nightmare and would have pulled more and more calcium out of my bones resulting in horrific bone loss and fractures. Obviously this guy had no clue what he was talking about. I consulted with my nephrologist (also a professor at Vanderbilt University) and we chose the best course was to discontinue any meds for my osteoporosis. There have been virtually NO studies done on the effects of any of these meds on End Stage Renal Disease (dialysis). So what I'm saying is that this may be the standard protocol but each person needs care that is individualized. I haven't taken anything in 2 years? and have had NO new fractures. They may recommend a protocol but one still has the choice to say NO, not for me. To tell someone they MUST or HAVE TO or its REQUIRED is manipulation, forcing and a lie. JMHO. Blessings

[Met00 in reply to KidneyCoach]

From what I've read, you can take one injection of Prolia and then have no further ones without a risk of rebound fractures, but if you have more than one injection, there's a very high risk of rebound fractures if you stop without starting another osteoporosis med.

[Mark_ABH]

Hi smtamt, there is a lot to cover here. Have you and your mother discussed these questions with her physician?

Mid-thigh fractures: This is a tricky issue. A task force found no clear cause-and-effect relationship between bisphosphonates and such fractures and said this concern should not discourage patients from taking the drugs, which have been shown to be effective in reducing fracture risk. Read about it here: americanbonehealth.org/medi...

Osteonecrosis of the jaw is associated more with chemotherapy doses than with lower doses give to osteoporosis patients. Still, it's important to notify your dentist and oral surgeon before you get on bisphosphonates if you're planning on having work done. Read this article for more tips on lowering your risk of this rare adverse event. americanbonehealth.org/medi...

Latest guidelines from the U.S. Endocrine Society recommend that women having taken bisphosphonates for 3-5 years get a new fracture risk assessment, and if they are a low-to-moderate risk, they should take a "drug holiday." americanbonehealth.org/bone...

Patients reporting their experience with Prolia on this forum have reported experiences similar to the documented side effects: flu-like symptoms that last two or three days. It's very important not to discontinue Prolia (denosumab) without replacing it with another medication to prevent rebound effects. The U.S. Endocrine Society also covers this in their new guidelines: americanbonehealth.org/bone...

[KidneyCoach]

Personally I wouldn't and do not take any of those meds. I only had fractures while taking those meds. Once I stopped the fractures stopped and bone density is stable. Blessings

[Hidden]

they say Jaw bone deteroration is a big problem when you take the bone drugs and many loose teeth some even lose their jaw bone . There are thousands of stories online of dangers of these drugs

why not try natural methods? diet and exercise