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Reclast vs. Prolia
cjyap posted:
I have been taking Osteoporosis medicines for several years, and have never had any side effects. I started with Evista, and quickly was changed to Fosamax, probably due to menopause? I took Fosamax for several years, and didn't see much change in my numbers. I have misplaced my scores, but the levels were: severe osteopenia in the wrist and spine area and Osteoporsis in the hip) . Apparently I was absorbing fosamax even less efficiently expected. My doctor recommended Reclast 2 years ago. I read everything I could about it, and was very, very nervous about taking it. The side effect were frightening, especially the necrosis of the jaw, as my teeth aren't great.
Happily I had absolutely no side effects at all from the Reclast and have had two infusions. My doctor recommended taking extra calcium a few days prior and after the treatment, maybe that's the trick. At my last visit, he mentioned that in his opinion Prolia offers all the benefits of Reclast, minus the necrosis of the jaw issue. Reading the material on it isn't very reassuring. I could use some advice: Continue with the Reclast, after all I know I don't have any side effects see what next year's bone scan says, and then maybe switch to Prolia (the necrosis does worry me) or switch to Prolia, and hope it's side effects don't effect me, but have less worry about the jaw issue.
I'm 51, 5'2", 105 lbs, exercise daily, postmenopausal for at least 5 years, in good health, and (knock on wood) no tooth extractions pending.
Thank you
bonebabe responded:
First off, just to clarify - you have osteoporosis. The diagnosis is given based on the lowest site. Forget about the ostopenia (FYI - there is no such thing as severe osteopenia.) Now, how best to treat your osteoporosis.

If the Reclast is working for you, and that is determined either by an increase in your T-scores or having them remain stable, I'd stick with it. Don't obsess over the jaw necrosis. It's numbers are few and far between.

The goal is for your T-scores not to decrease significantly (determined by your testing center's precision study) but to remain in the margin of error, maybe even increasing.

The Prolia is a drug that is to be given ONLY when all other medication choices have failed. It is not just another choice. It should be given very judiciously.

If you're doing fine with the Reclast, have not had any fractures or unbearable side effects - why change?
cjyap replied to bonebabe's response:
Thanks that was my gut impression, but the Doctor told me of this alternative, and asked me if I wanted to consider it.
adelante03 replied to bonebabe's response:
In your opinion, is Reclast safer than Prolia?
bonebabe replied to adelante03's response:
Comparing apples to oranges. Two different kinds of meds. All medications have side effects on some people. I can tell you though, that our medical director who is an osteoporosis expert and on the board of the ISCD, says that Prolia should only be used when all other osteo meds have been tried. It is not an equal option - just like Forteo is not an equal option.
undefined responded:
The literature I downloaded earlier this week (6-17-14) lists the jaw issue for both.
bonebabe replied to 34338988's response:
Yes, they have too even if there's only one case of necrosis. As with every medication. Tylenol lists liver damage. Antidepressants list death. Prednisone lists heart attack. But the vast majority of people never experience these side effects,yet they're listed. I can tell you that to date - the ONLY DOCUMENTED cases of bisphosphonate related necrosis have been with nursing home patients who had cancer, were bed ridden and on IV bisphosphonates. There's a lot of press and fear about jaw necrosis, but not much verified.

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