There isn't one single drug "better" than Prolia; rather, different osteoporosis medications work differently, and the best choice depends on your fracture risk, medical history, and tolerance, with options like oral bisphosphonates (Fosamax, Actonel), Reclast (IV), bone-builders (Evenity, Forteo), or even its biosimilar (Jubbonti) being considered, often after or instead of Prolia if it's not ideal for you. Prolia (denosumab) is a good option when bisphosphonates aren't suitable, but bone-building drugs like Evenity might offer greater density gains, while Reclast is an annual infusion.
In general, bisphosphonates like Boniva and Fosamax are well-tolerated. The most common side effects are mild and GI-related, like indigestion, nausea, and diarrhea or constipation.
Effective Sept. 1, 2025, Jubbonti® and Wyost® now replace Prolia® and Xgeva®, respectively, as interchangeable biosimilar products for UnitedHealthcare® Medicare Advantage plans, Medicare Prescription Drug Plan and most employer group Medicare Advantage plans.
Constipation was also reported as a side effect in females using Prolia for osteoporosis. Nausea can sometimes be a symptom of severe constipation.
EVENITY is a one-of-a-kind osteoporosis treatment—the first and only one that works both ways by building new bone and helping to slow bone loss.
Bisphosphonates are often the first choice for osteoporosis treatment. These include: Alendronate (Fosamax), a weekly pill. Risedronate (Actonel, Atelvia), a weekly or monthly pill.
The prescription device is a wearable belt that includes a motor designed to transmit low amplitude, high frequency vibration to the spine and hips; it received clearance from the Food and Drug Administration (FDA) in January 2024.
Actonel is often considered a first-line treatment option for postmenopausal women at high risk for fracture. In contrast, Prolia is typically used as an alternative therapy for those who cannot take or do not respond to other medications such as bisphosphonates like Actonel.
Prolonged immobility or inactivity can affect intestinal motility, which in turn can affect intestinal mucosal integrity and collagen synthesis. In this study we hypothesized that patients with reduced bone mineral density, particularly osteoporosis, are at higher risk of gastrointestinal perforation.
How Prolia Is Given: As a subcutaneous injection in the upper arm, upper thigh, or abdomen. A subcutaneous injection is a shot into the layer of skin directly below the outer skin layer. There is no pill form of Prolia.
Exercise. In addition, your medical provider may advise exercises for osteoporosis, such as: Weight-Bearing Exercises - Activities such as walking, jogging, and dancing help maintain bone density. Strength Training - Lifting weights or using resistance bands strengthens muscles and bones.
Jubbonti® and Prolia® are biosimilar - they are both denosumab. Biosimilar medications are medications that are highly similar to a medication that has already been approved for use by Health Canada. There are no significant differences in effectiveness nor safety between biosimilar products.
Weight-bearing aerobic activities
Examples include walking, dancing, low-impact aerobics, elliptical training machines, stair climbing and gardening. These types of exercise work directly on bones in the legs, hips and lower spine to slow bone loss. They also improve blood flow and are good for the heart.
Add calcium to your diet.
For adults 19 to 50 and men 51 to 70, the recommended dietary allowance (RDA) is 1,000 milligrams of calcium a day. The recommendation increases to 1,200 milligrams a day for women 51 and older and for men 71 and older. Look for calcium in dairy products, almonds, broccoli, kale and tofu.
Are there alternatives to Reclast and Prolia for osteoporosis?
In the osteoporosis group, the most common symptoms were lower back pain, upper back pain and leg pain, followed by shoulder pain, neck pain, arm pain, arm numbness and leg numbness.
Low-fat dairy products, such as milk or yogurt, are rich in bone-building nutrients such as vitamin D, calcium, protein, potassium, zinc and phosphorus. Try to get three servings a day.
In general: If bone loss is linked to hormones, aging, or metabolism, start with an endocrinologist. If bone loss is linked to autoimmune disease or steroid use, a rheumatologist may be best.
I often feel bloated and uncomfortably full when I'm eating. Why is this and what can I do about it? This problem can often occur when height loss or a curvature caused by your fractures means that there is less room in your abdomen for your stomach to expand as you eat.
Calcium supplements and calcium-, aluminum-, and magnesium-containing medications may interfere with the absorption of ACTONEL and should be taken at a different time of the day. ACTONEL is not recommended for use in patients with severe renal impairment (creatinine clearance <30 mL/min).
Risedronate sodium 5 mg tablet (Actonel®) was first listed on the PBS in February 2001 for the treatment of established postmenopausal osteoporosis in patients with fracture due to minimal trauma on a cost-minimisation basis, with risedronate 5 mg daily being similar to alendronate sodium 10 mg daily.
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome): Cough. Diarrhea. Fatigue.
Although Osteoboost is newly FDA-cleared, it is not yet covered by insurance or Medicare, and their review process can take several years. Our team is actively working toward coverage. In the meantime, Osteoboost is eligible for reimbursement under HSA/FSA accounts with proof of prescription.
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Vibration therapy was initially developed by scientists involved in space travel. The studies revealed that astronauts who spent months in space stations lost 1 to 2% of bone each month. It was found that they can regain such bone loss by standing on a lightly vibrating plate for 10 to 20 minutes each day.