I have noticed more and more of my clients using the osteoporosis medication Prolia. Many of them were on bisphosphonates (like Fosamax) but are now receiving a twice a year Prolia injection.
I was curious about this recent change and asked Kent MacLeod, Clinical Pharmacist and Owner of NutriChem Compounding Pharmacy and Clinic in Ottawa, to provide a balanced assessment of this drug. (There is a transcript of the video interview at the end of this article).
While I have my reservations about the frequent use of bisphosphonates and other osteoporosis drugs, I believe that they play an important (and essential) role for clients who are at a significant risk of fracture.
As Kent explains in the video, Prolia is a new drug. It is an immune globulin monoclonal antibody and unlike a bisphosphonate, it works on the immune system. It interferes with the protein RANK ligand (RANKL) and prevents the formation, maturation and survival rates of osteoclasts.
It has been shown to be very effective when compared to bisphosphonates, but it is not as strong a medication as Forteo.
Prolia Side Effects
Kent’s major concern is the newness of the medication. It has not been around long enough to truly know its long term effects.
Prolia is working in a new way (compared to bisphosphonates). It is interfering with the immune system and affecting important cells called T lymphocytes.
AMGEN, the manufacturer of Prolia, states that the drug is for women with postmenopausal osteoporosis at high risk for fracture.
Kent’s concern is that women with low bone density or osteopenia start to use the drug as a means to prevent osteoporosis. His suggestion is that you should make sure that your health provider complete a thorough fracture risk assessment before prescribing this or any osteoporosis medication.
The NutriChem Approach
NutriChem is a compounding pharmacy, laboratory and clinic that uses research, individual testing and education to provide people with science-based solutions to their health problems. When clients with bone health issues visit NutriChem they receive a thorough health assessment and a balanced treatment program.
Kent makes sure that clients who are on osteoporosis medications, such as Prolia, receive a fracture risk assessment to ensure that their medication is appropriate for their fracture risk.
I frequently work with Kent and encourage my clients who need this level of assessment to visit Kent at NutriChem.