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I am finally ending Forteo; had to have a tooth extracted. Oral surgeon suggested waiting three months before starting a bisphosphonate so I just stayed on the Forteo until now.

Does anyone know whether you can just stop Forteo one day and start Actonel (or whatever) the next? Forteo leaves the system quickly which is why we take it everyday so I don't see a problem but I could be missing something.
Hi StarSong: I took Actonel for over a year and again when I was taken off of Forteo and I didn't have to wait in between taking the two. I took Actonel and then started Forteo, the next day two different times. So if you are ending the Forteo and going on Actenol, you don't have to wait.

Since your Dr wants you to wait on the Actonel for dental reasons, wait till you get the go ahead to start it.

How are your scores doing since you've been on the Forteo? I hope you are doing well...:wave:
DesertBloom:

Thanks for the reply. I had the tooth extracted back in January so my three months are up.

After two years on Forteo my bone density went up 16.7%; from a -4.8 to -4.0. It's still low but a whole lot better than it was. This is the reason for going on a bisphosphonate the density is just too low to fool around with. But I am keeping track of new therapies that are coming along. I just don't think the bisphosphonates are a good long term solution.

So you were taking Forteo cyclically? The data on that from the Cosman paper around 2004 looked pretty good. How did or how is it working for you?
Hi StarSong: Your increases are really good!! Has anyone ever suggested that you stay on Forteo? Some people are able to do this somehow, but I can't find a Dr that will consider letting me stay on it beyond the 24 months. I heard that the 24 mo. treatment of Forteo was about to change, but I haven't been able to verify this. I'm waiting to hear from a lady who was told this and hopefully the Dr will give her the source of this info, for the extended use of it. I hope this statement is accurate, and the Dr knows what he's talking about. Some others here are able to go beyond the 24 mos. but I guess it just depends if you can find a Dr willing to rx it longer. Eli Lily claims that it's only approved for 24 mos. but individual Drs may rx it to their patients if they so choose, based on some clinical criteria (have no idea what that is).

I'm not taking Forteo cyclically. What happened was my Calcium level went up and they took me off the Forteo for a month to see if my Ca would go down, which it didn't, plus my Ca was elevated slightly before I started Forteo, so they were monitoring my scores. The month I was off Forteo I went back on Actonel and then returned to Forteo. I'm finishing up the 24 mos, of Forteo, at the end of June. I'm trying to find out if I can stay on it, because I've improved a lot going from -3.6to my lowest-2nd score-of -2.6.

Good Luck with the bisphosphonates and the dental healing... Keep us posted how things are going for you. Your increase was *almost* a whole standard deviation point, so that's fantastic, I really hope the BP's (bisphos') retain your improved score and increase them as well.
Hello DesertBloom:

I actually took Forteo for an additional 4.5 months. My regular dr suggested if there were problems with the actonel that I might consider taking Forteo cyclically. Maybe 6 months on 6 months off; something like that. Since reading your reply, maybe she heard that Forteo maybe taken in a different manner. My new osteo dr seems pretty amenable to my reasoning on treatment. As long as my insurance will pay for it; Forteo is really expensive. I'll just have to wait and see how the actonel goes.

After reading up on all the current treatments I'm not convinced that a straight bisphosphonate forever is a good option. Though I am told the research on fosamax dosen't seem too bad. In my opinion, and it is only mine I figure if you need to be on an osteoporosis drug for the duration of your life you will have to rotate treatments with a bone builder not just one that kills off the osteoclasts.

Unfortunately, with my low density I have to take something. I'll just keep up on treatments that are in development and see where it takes us.:)
Hi StarSong... You make an excellent point about the need to treat resorption and formation to restore or strengthen our bone density. Actually you are the first person I've heard say this, and you are absolutely right!!!

Since bisphosphonates are the main treatments used for osteoporosis, we need to find more formation meds. I'm glad your dr believes this and is going along with *your* thinking.

I'm only aware of two bone formation drugs (Forteo and SR) and both have their limitations. Forteo has the 2 year treatment recommendation and Strontium Ranelate isn't available in the US. Hopefully something new will come along that falls into this category because I agree we can't just treat bone resorption and not formation. Doing this seems like a really lopsided approach, even though it's the norm for front line treatment. We have the other antiresorptives like hrt, and serms, but again they only treat one area of bone remodeling. What's your thinking on the OTC Strontium Citrate? I've been thinking about it, but I need more research that proves it's efficacy. I know many with good results in bmd taking this, but my dr has come up with a long list of reasons why it may not work. However in the end the decision is mine alone, so we'll see what happens. The dxa labs need to get on the ball and figure out what the actual adjustments are for those taking SC, so we can see what the improvements are in bmd.

Thanks for your very insightful response, and I hope you find something else to use along with the BP's in the near future. Good luck to you and your continued increases in bmd.:wave:
DesertBloom:

Question for you did you have any problems with the Actonel. The first time I took it I felt OK but the next day I felt a little nauseous I took a nap and it passed. My stomach has been a little, I don't know, 'burpy' like it wanted to have indigestion but didn't. It isn't a real problem, just curious if you had anything similar since you went on and off Forteo to actonel.

I'm seeing a doc today about something else but I plan to ask her. I suspect there are a large degree of responses to the BPs some really bad that I don't really want to hear about and others that just go away with time (and hopefully stay away). It took Fosamax in the early days before forteo and had no problems with it at all. The only reason I considered actonel because it has a significantly shorter half life in the body than fosamax.
Hi StarSong: I didn't have any gi issues with actonel. The only problem I had was some bone pain in the legs, but it was tolerable, because it only lasted about 10 seconds. It came and went almost every day while on actonel, and went away completely when I stopped taking it.

If you were able to tolerate fosomax I would think actonel would be a good choice, as far as side effects go. You said it caused some problems with nausea so you might want to get something to counteract that *if* you think that will return. The half life on actonel is a lot shorter than fosomax, so if you have to choose one of the BP's I think actonel is probably a better choice, but that's just my opinion.

Good luck with it...:)





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