Denosumab for osteoporosis

Sounds like 'den-OH-sue-mab'

Key points about denosumab for osteoporosis

Denosumab is used to treat osteoporosis.
Denosumab is also called Prolia.
Find out how to take it safely and possible side effects.

Woman on couch with broken arm looking at cell phone

Denosumab is used to treat osteoporosis. Osteoporosis is a condition that causes your bones to be thinner and weaker than normal. This means that they can break (fracture) easily, such as after a small bump or fall. Treatment with denosumab makes your bones stronger and less likely to break. Denosumab is generally only used when other medicines for osteoporosis are unsuitable or haven't worked well. Read more about osteoporosis and medicines for osteoporosis.

There are 2 denosumab products approved and available in Aotearoa New Zealand: Prolia and Xgeva.

The brand of denosumab used for osteoporosis is called Prolia. It's given as an injection under your skin.
Denosumab is also used for people with high calcium levels caused by cancer. The brand of denosumab used for this is called Xgeva.

The brand of denosumab used for osteoporosis is called Prolia. It's given as an injection under your skin.

The usual dose is 60 mg given once every 6 months (2 times a year).
It can be given into the abdomen (tummy), upper thigh or upper arm. The injection is usually given by a healthcare provider, such as a practice nurse or GP.
If you miss a dose, you should have it as soon as possible. From then on, it should be scheduled every 6 months from the date of the last injection.

Calcium and vitamin D supplements: Your doctor may prescribe calcium and vitamin D supplements (colecalciferol) to help prevent low calcium levels in your blood while you take denosumab. Denosumab can reduce the calcium levels in your blood and most people don’t get enough calcium and vitamin D from their diet alone, so supplements are often needed to support bone strength. Your doctor will advise you on the right amount of calcium and vitamin D to take in order to help maintain healthy levels while using denosumab.
Continue your treatment regularly every 6 months: It’s important to continue treatment with denosumab regularly, every 6 months. If you delay or stop it, there may be some increased bone loss. This is because the effects of the medicine wear off very quickly. It’s a good idea to make a note in your diary or set a reminder on your phone, to help you remember when your next dose is due.
If you want to stop taking denosumab, talk to your doctor beforehand and to plan ahead: Stopping denosumab suddenly can increase your risk of spinal fractures. This is because the effect of the medicine wears off quickly and bone loss can occur at a higher rate than before you started the medicine. This is known as the 'rebound effect'. To stop the effect, you’ll need to take another medicine around the time you were due to have your denosumab injection.
Pregnant or planning a pregnancy: You should avoid becoming pregnant while you are taking denosumab. If you are a woman of childbearing age, you should use an effective method of birth control (contraception) during treatment with denosumab and for at least 5 months after your last dose of denosumab. Discuss with your healthcare provider which types of contraception are suitable for you and tell your doctor straight away if you become pregnant while taking denosumab.
Dental treatment and take care with dental hygiene: Denosumab can cause a problem with the jaw called osteonecrosis of the jaw, which are ulcers in gums or tooth sockets. It rarely happens in people being treated for osteoporosis. It's more likely in people being treated for cancer who take higher doses. To reduce the risk of this problem, it's best to:
- Take good care of your teeth and mouth (such as brushing your teeth twice a day and regular flossing between your teeth).
- Have regular dental check-ups.
- Let your dentist know that you're having denosumab treatment.
- Talk to your doctor or dentist if you have any loose teeth, tooth pain, or swelling or numbness in your jaw.
Pain, weakness or discomfort in your thigh, hip or groin: It's rare, but denosumab can cause fractures in your thigh bone (upper leg bone). These are called atypical fractures because they appear as cracks on the bone and are not usually related to an injury. If you have pain, weakness or discomfort in your thigh, hip or groin, tell your doctor. These pains may be warnings that there's some weakness in your bones. You may need X-rays of both your legs.

Like all medicines, denosumab can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects	What should I do?
Signs of infection such as fever, chills, cough that won't go away, skin that looks red or swollen and is hot or tender to touch	Rarely, denosumab can increase your risk of getting infections, such as chest infections and skin infections. Tell your doctor immediately or phone Healthline 0800 611 116.
Loose teeth, tooth pain, or swelling or numbness in your jaw	Tell your doctor or dentist.
New or unusual pain, weakness or discomfort in your hip, thigh or groin	Tell your doctor.
Signs of low calcium such as spasms, twitches or cramps in your muscles, numbness or tingling in your fingers, toes or around your mouth	Tell your doctor immediately or phone Healthline 0800 611 116.
Signs of an allergic reaction such as muscle or joint pain, fever, rash, intense itching, swelling of your face or hands, sore throat, headache or difficulty swallowing	Tell your doctor immediately or phone Healthline 0800 611 116.