Can Prolia Be Replaced With Bisphosphonate To Effectively Treat Osteoporosis?

Posted on Tue, 27 Mar 2018

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 27 Mar 2018 Answered on

Thu, 18 May 2023 Last reviewed on

Question : I've been told by 4 doctors that I need to start treatment for osteoporosis with Prolia. The reason Forteo is not an option is that I have monoclonal gammopathy of undetermined significance. I read the information from a Prolia package at the doctor's office, which said after the treatment period is done, I will revert back to the bone loss I have now if I don't take Forteo or another drug in that class. The doctors can't answer my question about another option that won't cause me to revert back to even more bone loss. Do you have any suggestions?

Answered by Dr. Dr. Gopal (6 hours later)

Brief Answer:

Try bisphosphonate like I/V Zoledronic acid.

Detailed Answer:

Hi,

You want to know if any alternative exists if you do not take Prolia.

First of all, there is generally no reversal of effects as such but positive effects of drugs, when withdrawn, no longer continue and some degree of rebound takes place but not complete reversal.

Forteo is an option only for 24 months maximum, in the current status.

In your case, I will suggest a bisphosphonate like Zolfos (Zolidronic acid) 5 mg once a year, with all precautions. I have some patients on this drug and they are doing well.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Gopal Goel, Orthopaedic Surgeon

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Gopal (16 hours later)

Dr. XXXXXXX
Can zolidronic acid be used as the first line of treatment for osteopooris? I am afraid of the possible side effects of Prolia, such as thigh fracture and jaw necrosis.

Answered by Dr. Dr. Gopal (6 hours later)

Brief Answer:

Yes

Detailed Answer:

Hi,

Being a bisphosphonate , zolidronic acid can be taken as first line treatment in osteoporosis.

Thigh fractures and jaw necrosis are not common side effects , but you have to give breaks in treatment to avoid these complications. We normally give for 3 yrs and then give a break for one year.

Hope I have answered your query.

Take care

Regards,
Dr Gopal Goel, Orthopaedic Surgeon

Above answer was peer-reviewed by : Dr. Yogesh D