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PNR-Prednisone-osteoporosis

Posted , 14 users are following.

Poupe
Poupe

Has anyone been diagnosed with osteoporosis after being on prednisone?   If so what has the doctor prescribed?

1 like, 35 replies

35 Replies

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  • jan_37704
    jan_37704 Poupe

    Posted

    Unfortunately I had osteopenia before starting prednisone and have been on Fosamax weekly for years and Vitamin D monthly. 

    • Poupe
      Poupe jan_37704

      Posted

      Thanks Jan.  Have you had any issues taking Fosamax and the Prednisone together?   Has the Fosamax helped with your bones?
    • jan_37704
      jan_37704 Poupe

      Posted

      No problems with Fosamax and prednisone to my knowledge and my bones are not getting worse but only had 3 days of prednisone so far so time will tell
    • EileenH
      EileenH Poupe

      Posted

      There are unlikely to be problems taking them together - it is standard practice to prescribe alendronic acid (Fosamax) to patients on long term corticosteroids to avoid loss of bone density. 

      Whether it is a good idea to use them as a preventative/just in case is debatable due to long term issues with bisphosphonates that are just coming to light after being in use for about 15-20 years. I have never taken any and my bone density has barely changed in 7 years on pred just taking calcium and vit D. But monitoring is essential to know your status - some people are already osteopeneic before pred and a dexascan is needed to establish that.

      They definitely should not be taken for more than 3 years at a time, 5 years is the absolute maximum.

  • bjmoen
    bjmoen Poupe

    Posted

    I have osteopenia and am on Prolia.  It's an injection given twice a year.  I improved with the Prolia so my Dr took me off it but when I was diagnosed with PMR my Dr said I had to go back on it.  I've been on prednisone 1 yr 4mo and have had no issues.  

    • pam48607
      pam48607 bjmoen

      Posted

      bjmoen,

          Do you know if Prolia is considered a bisphosphonate drug?   Years ago when I was was diagnosed as osteopenic, my OB put me on a bisphosphonate monthly dose, and after only three months, I began to have terrible muscle problems in my legs and always felt very flu-like while on it.   Needless to say, I stopped taking it.

          My rheumatologist has now recommended Prolia to  me because my density has gotten slightly worse, but not because of the Pred. because I have only been on it 4 months.   This was from my last bone density.   I told her I had to think about it because I really don't need any drugs making me worse.  I am a daily walker and have been for at least 40 years, but it just goes to show you that sometimes heredity trumps environment.

    • EileenH
      EileenH pam48607

      Posted

      Prolia is a different mechanism of action to the bisphosphonates. 
    • bjmoen
      bjmoen pam48607

      Posted

      Per Dr. Sharon Orange (from internet) Proli works differently from the biophosphonates. Prolia is what is called a monoclonal antibody (hint, a medication whose generic name ends in mab is a monoclonal antibody).  Prolia inhibits the activation of osteoclasts which break down bone. 
  • Reeceregan
    Reeceregan Poupe

    Posted

    Funny you should ask that. Well..not really. Just today I had to have a bone density scan. Report says “BMD measured at Femur Total Left is 0.518 g/cm2 with a T-score of -4.0. Patient is considered  osteoporotic. With a Z-score of -2.5, patient has very low BMD for their age and sex. Causes of secondary bone loss should be investigated”. I started on 50mg of pred 31.5.17 and stayed on that for 7 weeks due to PMR and GCA. Have managed to reduce to 11mg, inflammation rate down from 53 to 2 so I thought I was going great guns. As this test was only today I have still to see the GP and rheumy to get their take on this. I’m 62 and only 46 kls, (was 49kls pre illness but lost   9 Kls in 5 months pre diagnosis.) I have managed to put on 6 kls but a lot of that is puffiness. I have always been small and have always taken calcium, and bumped it up to the recommended higher dose, plus included vitamin D supplements, plus get out in the sun as often as possible when I started pred. If fact, just came in from a few hours in the pool. Like you I’m interested to hear others reaction or side affects to further medication while taking pred, as this is mentioned on the report ( fosamaz, Actonel, Miacalcin, Evista, and Forteo). 
    • EileenH
      EileenH Reeceregan

      Posted

      See my post above - it is good practice to do a dexascan within a short time of starting pred and then standard practice to prescribe one of the bisphosphonates in tandem with the corticosteroids to reduce the risk of loss of bone density. With readings like yours and having been on pred only since May I doubt your very low readings are due entirely to pred. You were at risk anyway with such a low body weight even though you were taking calcium.

      I would imagine your doctor will recommend Forteo - it is the only drug that actively builds bone, the others change the turnover to stop bone loss. There are side effects to them all - no drug that doesn't have some - but some people have none. Just like with steroids.

    • Poupe
      Poupe EileenH

      Posted

      Eileen and others.....thank you for your comments and insight.   
    • Reeceregan
      Reeceregan EileenH

      Posted

      Yes, on reflection I remember my sister, a nurse, always commenting on my being “small boned”. My mother was the same, tiny little thing she was, 6.5 stone when she got married at 25. Mind you, she lived till she was 99 with only one fracture all her life, her hip. Tripped over the leg of a walker at the hostel at the grand age of 95! So there’s hope for me yet . 💪 Thanks again for your insight Eileen, always valued. 

    • EileenH
      EileenH Reeceregan

      Posted

      One of the consolations of being a buxom wench! More deformation of your bones as you walk encouraging the formation of new bone tissue!!!!! And even pred-associated weight gain isn't ALL bad - saves wearing a weighted vest...

    • Reeceregan
      Reeceregan EileenH

      Posted

      Dr rang this morning and wants to see me first thing Monday morning. I’m not sure if I’m apprehensive or happy that he’s onto it so soon. 😌

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