alternatives after 5 years of Fosamax

[Bogart0416]

This is my 5th year on Fosamax. I will be 70 this month.My DEXA scores have improved. Total lumbar spine -2.1, left forearm -2.3 and femoral neck -2.0. However, my rheumatologist is telling me I am still at risk for fracture and is recommending towards the end of this year that I start Prolia. I do not want to start Prolia. My question is whether anyone has experience ceasing Fosamax and then starting Evenity or any other recommendations. Thank you.

[PoohBear72]

Good morning. I had to stop Fosmax summer of 2023 and transition to Evenity for a year. Results were positive in my case as seen in my scan. I have since transitioned to Reclast infusions. Next scan Sept 2024. Treating osteoporosis is such a personal thing. I encourage everyone to find a doctor skilled in treating osteoporosis who will really listen to you and your concerns and work with you. This is not a one-size-fits-all condition. I was fortunate to find an endocrinologist who is willing to listen to. my considerations. That has made all the difference. Best of luck. Keep in touch!

[Bogart0416 in reply to PoohBear72]

Thank you so very much for your feedback. Yes osteoporosis is so individual. My best to you as well Joyce

[minori in reply to PoohBear72]

Hi, if you don't mind sharing, how long were you on Fosamax? Did you take a drug holiday before you started Evenity?

[PoohBear72 in reply to minori]

Hello. I was on Fosamax only 7 months. I suspected it was causing some of the slight gastric discomfort I was feeling, then I had a sacral fracture of insufficiency. My endocrinologist recommended I move to a bone builder so I started Evenity 1 month later and continued the course with no side effects. My spinal numbers had improved quite a bit at the end of the Evenity treatment. One month after finishing Evenity, I started infusions of Reclast. I'll see after my next scan in August if I have maintained. I had no reaction after the infusion, but I will add that I am doing 2 infusions (half dose each) the first year instead of one due to other medical considerations. I am here for any further questions regarding my personal experience. Everyone has their own laundry list of factors to consider and I respect that. Best of luck.

[minori in reply to PoohBear72]

Thank you for the reply. I'm sorry to hear your fracture; hope it has healed. I was wondering whether evenity would be affected by fosamax pretreatment. It looks like it worked well for you.

[Bogart0416 in reply to minori]

I’m now on my last year - year 5. No she did not recommend a drug holiday. I’ll get another Dexa before the end of the year is up.

[minori in reply to Bogart0416]

I see. Some people take a drug holiday after years' treatment of a bisphosphonate. Your current T score from dexa isn't that severe. Could it be that your doctor thinks your FRAX risk is still pretty high based on other factors? Have you done the online FRAX calculation yourself?

[UncleRoy]

Hi Bogart,

I just finished taking Prolia for 3 years and never had any side effects. I'm a nurse and was more than nervous about taking it after I read all the horror stories online. I went online to a US website drugs.com and looked up Prolia and then looked at each side effect listed and what percentage of people actually had that side effect - often less than 15% and decided it was worth trying it. It helped my bones and I am now switched to Reclast which I will start soon and see how that goes. These are problematic drugs and having osteoporosis is problematic also, we just have to gather our information and make the best decision we can. I wish you well.

[WarriorOne]

Mom was on prolia for many years and never had an issue.

[Arcadia10]

Is there any reason why your rheumatologist thinks you are still at risk of fracture? You no longer have osteoporosis according to your DEXA results.

[CM1671]

Your scores are good. Your endocrinologist may suggest a "drug holiday" and rescan, or starting a new drug. Reclast is another bisphosphonate, so probably wouldn't be indicated. Personally, I would want to try Evenity when my doc wants to discontinue Fosomax. Previously had bad experiences with Boniva and Prolia.

[Bogart0416 in reply to CM1671]

Very much appreciate your feedback. Thank you.

[Copper23]

I am 76 years old and I was on Prolia for 8 years when I needed a tooth extraction. I went off the Prolia for 2 years and then had 1 injection in March 2024. I have not had any more injections of Prolia for a year. I may need another extraction so I have not gone back on any medication. Since my last dexa scan 2 years ago my bone mass has decreased but still within the osteopenia range. My regular rheumatologist is recommending that I go back on the Prolia. I saw another rheumatologist who was head of rheumatology at a university hospital and very well known. He indicated that deciding whether to go on something or not was like asking an 8 ball yes or no. At first doctors thought that you could take something for osteoporosis for your entire life and be fine, but now they are finding that is not so. He also indicated that the reliability and validity of dexa scans is not that great and there can be a lot of variability between machines and technicians. At this point I don't know what to do. I live in the Villages in Florida and there is a program here called bone builders which supposedly is research based out of Boston to stop the progression of osteoporosis. It is over an hour in length and boring but they recommend it 3 times a week. I am going to try that for now but am not sure whether to continue with Prolia. AS of now I have not had any fractures but I say that gingerly because at my age everyday can bring a new health issue.

Copper23