prolia meds: If you have to go off... - Osteoporosis Support

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prolia meds

Deb967 profile image
41 Replies

If you have to go off Prolia even after 1 shot and then you need a Rebound med. Doesn’t both Prolia and Bisphosphonate have the same ingredients? Im CONFUSED!!

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Deb967 profile image
Deb967
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41 Replies
Bet117 profile image
Bet117

Hi Deb,

My suggestion is to Google Prolia and scroll to Drugs.com as well as the entry put out by the drug company and Read the class, ingredients, side effects, etc.

I have had several successful doses of Re-Clast, a

Bisphosphonate given through IV once per year. Prior to taking this, I read about it and decided to give it a try with calcium supplements.

Remember that every person is different and what may be good for one, may not be best for another.

Please reach back and let me know what you come up with and if I can be of any support.

Promise that it will all work out.

Bet

Deb967 profile image
Deb967 in reply toBet117

But Im a Gastric Bypass patient. I cant just take anything that a person that never had Gastric bypass can take.

Screwed profile image
Screwed in reply toBet117

Can you tell me how the reclast has helped you? I’ve had 3 Prolia injections. Had several side effects and want off. My dexa scores only improved by .3 . Still -3.3. Going to try reclast in April . I am due for Prolia injection in May which I’m not going to do.

I have no other health conditions and take the vitamin d3, Vit K 2,M7, and 75 mg of boron. I drink almond milk, eat yogurt and cottage cheese for calcium. Sometimes I will add calcium pills.

Bet117 profile image
Bet117 in reply toScrewed

Hi Screwed,

Basically the Re-Clast has increased some bone density and stabilized bone loss. I'm not perfect but my osteo-endo is pleased.

I had this drug for 4 years running prior and was stable enough to give me a 5 year vacation.

In 2020 my bone density went down and we agreed that I would have 3 doses subsequently.

Last year my osteo-endo was pleased at my results and I don't see him until next year.

I haven't had a side effect from this drug other than initial dose; few cold sniffles after infusion which went away within a few hours.

I do ask for a one hour drip as it safer for the kidneys. I drink plenty of water prior to the infusion and after as well. That includes throughout the year.

I am plant based but do eat yogurt daily, green vegetables and some frozen yogurt so often.

I take calcium magnesium citrate liquid with D3 daily as well as 100mg of Olive Leaf Extract ( pill form) am and pm.

Walk when the weather is good.

I looked over the side effects/ possible side effects of Prolia via Drugs.com and also googled the medication and read the possible side effects.

I decided that if it were offered to me, which it wasn't, I decided that I would prefer not to take it.

I know the dilemma that you are in.

Bear in mind that not every drug is for every person.

Read and ask questions...

Know that I am here to support at any time.

Stay positive as it will all work out. Hope this helps.

Bet

Screwed profile image
Screwed in reply toBet117

Good eveningWhy do you take olive leaf? I have just had my blood pressure taken twice over the last few days and its higher than it's ever been for me. Before promised I was usually110/72, now its131/80 127/89, both high for me. Is that why you do olive leaf? What brand?

Bet117 profile image
Bet117 in reply toScrewed

Hi back!

I read this and several articles several years ago regarding Olive Leaf Extract and bone health.

I spoke to my doctor and nephrologist who agreed to let me try it.

Presently, I take Natures Way Olive Leaf Extract. It hasn't had an effect on my BP, but hopefully will on my osteoporosis.

ncbi.nlm.nih.gov/pmc/articl...

If you Google it, there are other articles.

Before taking any supplements, please discuss it with your PCP.

Hope this helps.

Speak Soon..

Bet

FrogLeg profile image
FrogLeg

Prolia is a specific drug in the class of monoclonal antibodies. Bisphosphonates are a class of drugs, of which there are numerous specific examples. The ingredients would not be the same. An explanation on the following page might begin to help to explain further:

health.harvard.edu/womens-h...

RubymyT profile image
RubymyT

no they are two totally different medications. You would be stunned to see how many different meds for Osteo there are. They all work differently and have different side effects

drugs.com/condition/osteopo...

stacylynnpelle profile image
stacylynnpelle

I took 3 doses of Prolia and stopped it about 8 years ago, I have only taken calcium supplements since, I have managed to stay boarder line Osteoporosis. I refuse to get on the pharmaceuticals. With other health issues Bisphosphonates are just not an option. There are so many other things out there, Dr Doug Lucas has a very informative channel on YouTube dedicated to bone health, you may be able to find some information there. Hope this helps.

Deb967 profile image
Deb967 in reply tostacylynnpelle

I had Gastric Bypass so I cant just take anything. I cant find anything on it neither. Maybe if I was in a better state of mine right now it would be different. I cry ALL the time Im so scared and I dont have anyone to help me find what I need. Im alone.

Bet117 profile image
Bet117

Deb,

You're not alone as we are all here for you.

As Frogleg and RubymyT have said, Prolia and any of the bisphosphonates, such as Re-Clast, Boniva and Fosamax are two entirely different class of drugs with different ingredients and side effects.

It can be very confusing and frustrating as there are many drugs and classes.

When Romosozumab became available, my osteo-endo suggested it to me. I looked it up on Drugs.com and read the site from the drug company.

I refused it as I have a family history of cardiac and stroke in my family.

Re-Clast was suggested to me years ago; as it is an IV drip and doesn't filter through the stomach. I refuse anything oral as Fosamax which can cause GI distress.

I am a kidney patient and cleared it with my nephrologist before taking it.

He suggested that they give it to me over an hour rather than the usual 15 minutes and follows up with a urine test two weeks after my treatment.

At this point, you may want to have a chat with your PCP and GI specialist and see what they think.

Again, remember that every person is different and what may be best for someone may not be so for another.

It will be resolved, I promise.

Please reach back and let us know the outcome.

You are among friends.

Bet

Meme50 profile image
Meme50 in reply toBet117

Great information. Thank you,

Deb967 profile image
Deb967 in reply toBet117

Hi Sorry Im just seeing this post. I have an appointment with a Rheumatologist in May. Because I had Gastric Bypass, I cant wean off Prolia but instead be switched to a different med. Im thinking maybe Reclast as I believe these are the only 2 that I can chose from and I don't want to stay on Prolia.

Bet117 profile image
Bet117 in reply toDeb967

Deb,

Speak to your doctor about the composition of the meds.

A positive thing about

Re-Clast is that it is given through an IV and you can request an hour drip which is safer.

You don't swallow anything.

Do your reading and ask.

Please reach out and let us know the outcome.

Bet

Deb967 profile image
Deb967 in reply toBet117

Hi. My PCP referred me to a Rheumatologist. I have an app in May. Hoping he can help me.

Bet117 profile image
Bet117 in reply toDeb967

Hi Deb,

Excellent! Take your labs/ bone density with you, a list of questions, especially on the various medications that you have taken and are discussed at the appointment. Don't leave the office without them answered.

If you can bring a family member with you to scribe for you; another set of ears, do so. I often bring my husband with me as a scribe.

Your notes will be a review point when you leave the office and serve as a review and start for your next appointment even if it's not with this physician.

Stay positive, Deb. It will work out.

Bet

Deb967 profile image
Deb967 in reply toBet117

My Primary Dr sent my reports and all my information to the Rheumatologist. They wanted to look over it before they made me an appointment.

Bet117 profile image
Bet117 in reply toDeb967

Sounds like a great and thorough professional. It will all go well.

B...

yogalibrarian profile image
yogalibrarian

Bisphosphonates are relatively simple chemical compounds.

Prolia (brand name)/Denosumab is a monoclonal antibody -- a very complex biologic compound.

Both slow bone breakdown -- resorption -- but in different ways.

Bisphosphonates stay in your system longer -- even after you stop taking them.

That's the very short version.

Arcadia10 profile image
Arcadia10

Deb, are you on Prolia and asking how to stop safely after just one shot? If so, you should be safe to just not have the second shot. You don't need a relay bisphosphonate after only one Prolia shot.

I had four Prolia shots (2 years) and had to be on a relay bisphosphonate for just over two years. It's a whole different ball game after more than a single shot.

Deb967 profile image
Deb967 in reply toArcadia10

Yes I do need a Relay. I had Gastric Bypass

Deb967 profile image
Deb967 in reply toArcadia10

I have to have a Relay med because I had Gastric Bypass and whatever Prolia did to my bones now when I stop the shot, and dont have a relay med I will get even more damage to my bones.

Arcadia10 profile image
Arcadia10 in reply toDeb967

Deb, you don't need a relay bisphosphonate if you stop Prolia after only one shot. The gastric bypass is a separate issue. I've just read a bit about the procedure and yes, it appears you need to be on a bone-strengthening drug after a gastric bypass as you don't have as much gastric area left to absorb the minerals you need for strong bones. That is probably why you were put onto Prolia in the first place.

If you can't tolerate Prolia, then you will have to explore other bone-strengthening drug options with your doctor. That is not called a relay drug though. A relay drug is used to transition you off Prolia without sustaining rebound fractures which affect about 10-15% of people who stop Prolia. It is usually a strong oral or intravenous bisphosphonate and is used for a limited time, usually around two years, after which time the risk of rebound fractures is negligible.

From what I've read, after a gastric bypass you will need to be on a bone-strengthening drug for the rest of your life because of your limited ability to absorb enough in the way of bone-strengthening minerals after the procedure, so you will risk losing bone density more than people who have not had a gastric bypass would.

Deb967 profile image
Deb967 in reply toArcadia10

I was on Evista since 2009 before Prolia. But it stopped working. Can you PLEASE send me to the place where you found this information?

Arcadia10 profile image
Arcadia10 in reply toDeb967

Which specific bit of the information?

Deb967 profile image
Deb967 in reply toArcadia10

The site about Gastric Bypass that you sent in your message.

Arcadia10 profile image
Arcadia10 in reply toDeb967

I didn't find information on a single site. Just Google "gastric bypass osteoporosis medication" (without the quotation marks) and you will find lots of relevant information on various sites. It appears that intravenous zoledronic acid is recommended after a gastric bypass to maintain bone density.

Your doctor should really be discussing this with you and guiding you as to your medication options.

Deb967 profile image
Deb967 in reply toArcadia10

I had Gastric Bypass 22 yrs ago. I was on Evista for the past 9 yrs and now my Osteoporosis has gotten worse.

Deb967 profile image
Deb967 in reply toArcadia10

Could you send me the link where you read this? TY

Screwed profile image
Screwed in reply toArcadia10

How is going after switching from Prolia to reclast, any issues?

Arcadia10 profile image
Arcadia10 in reply toScrewed

I didn't use Reclast after Prolia - only oral risedronate (Actonel) mainly, and alendronate (Fosamax) for a few months when I wanted to push my bone turnover down quickly.

Screwed profile image
Screwed in reply toArcadia10

any fractures as a result of not doing a reclast. Did risedronate help with the rebound possibilities of fractures?

Arcadia10 profile image
Arcadia10 in reply toScrewed

Risedronate is not efficacious enough to prevent rebound fractures. Because of an ignorant GP, I fractured my sacrum in two places, my pelvis and also two ribs. Not happy 😠

You have to use oral alendronate or intravenous zoledronate for at least two years. You also should have your bone turnover markers (CTx and P1NP) tested every 2-3 months so that you can modify treatment if necessary.

Screwed profile image
Screwed in reply toArcadia10

No one has offered bone turnover markers. I’ve asked.

Arcadia10 profile image
Arcadia10 in reply toScrewed

I requested the bone turnover marker tests once I found a new GP. She was the first to admit that she didn't know how to manage me off Prolia, so was happy for me to do the research and then ask for scripts, referrals, etc. I read everything I could lay my hands on, so found out about CTx and P1NP testing. The people on this site were an enormous help and pointed me in the right direction.

Unfortunately the first GP had put me onto risedronate and it was only after I fractured my sacrum 18 months after stopping Prolia that I found out by contacting the Swiss professor who had compiled the definite guide to stopping Prolia that risedronate isn't efficacious enough. He also told me that your CTx should remain below 400 ng/L on the oral alendronate, otherwise you should switch to IV zoledronate. I didn't know that at the time, and my CTx climbed to 925 ng/L just before I fractured my sacrum. Neither my new GP or an endocrinologist I consulted became alarmed as my CTx climbed steadily and then spiked just before I had the fractures. It should have been a warning to switch to a more potent medication, i.e. zoledronate.

As you can see, bone turnover markers are critical in the process of stopping Prolia safely, so try to find a GP who will order them - and insist!

Deb967 profile image
Deb967 in reply toArcadia10

Hi I’m going to see a Rheumatologist in May to tell him I want off Prolia. Next shot is due Aug 12th. So I have to be on a Bisphosphorous due to Gastric Bypass. Do I have to wait till Aug 12th to get on the med? Also when would I have to have the CTX and P1NP done?

Arcadia10 profile image
Arcadia10

Deb, a relay drug is a bisphosphonate you have to take after stopping Prolia if you've had more than one shot of Prolia. I don't see how a gastric bypass procedure has anything to do with this - perhaps you could explain your concern.

Who told you that you need a relay drug - and why?

Deb967 profile image
Deb967 in reply toArcadia10

I found out I cant relay after Prolia because of Gastric Bypass. I can switch to a different med but I cant relay. Have to stay on something forever now.

Deb967 profile image
Deb967 in reply toArcadia10

I found out by reading on here. But I didn't realize this site is for ppl who hadn’t had Gastric Bypass.

Deb967 profile image
Deb967 in reply toArcadia10

Another site I’m on. They said it doesn’t matter even if you only had 1 shot it will still do the same thing to your bones. Rebound

Anonimoveneziano profile image
Anonimoveneziano

Bisphosphonates bind to the bone mineral, are taken up by the osteoclasts in the process of bone resorption, and inhibit the osteoclasts' activity. Denosumab is a human monoclonal antibody, binding to receptor activator of nuclear factor kappa-B ligand (RANKL) 29 Nov 2022

They are 2 different meds altogether, definitively not the same ingredients.

ncbi.nlm.nih.gov/pmc/articl...

bmcmusculoskeletdisord.biom....

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