Denosumab Print Page

What is denosumab?

  • Denosumab is an injectable medication that helps to slow bone loss. It keeps your bones strong and prevents them from thinning (osteoporosis).
  • Using it long-term can decrease your risk of having a broken hip or a spine fracture.

What is the typical dose?

  • 60 mg injected under the skin (subcutaneously) every 6 months

How does denosumab work?

  • In osteoporosis, your body removes more bone than it replaces – eventually bones become thin and brittle and are more likely to fracture. Some medications, such as corticosteroids (e.g. prednisone), can increase this bone removal. Denosumab slows down the cells in your body responsible for removing bone, slowing or even reversing this process.
  • Your doctor may send you for a bone mineral density (BMD) test, an exam that measures the thickness of your bones. This is one of the tests used to determine if you need denosumab and if it is working for you.

What are the possible side effects of denosumab?

Side Effect Ways to Reduce Side Effects
Common Side Effects
  • Pain in muscles or joints
  • Rash
  • More common around the time of injection, but can last longer in some cases
  • Talk to your doctor or pharmacist if it is interfering with your ability to do regular activities
Less Common Side Effects
  • Low calcium levels (numbness, tingling, muscle spasms)
  • Your doctor may order blood tests to check the amount of calcium in your blood
  • Increased risk of infection
  • Tell your doctor if you notice signs of any infection, such as fever or feeling unwell, or signs of a skin infection (cellulitis) such as redness and heat
Rare Side Effects
  • Wounds in your jaw from limited blood supply
  • Tell your dentist that you are using denosumab prior to having dental work done
  • Tell your doctor if you have persistent pain in your mouth or jaw
  • Unusual break in your thigh bone
  • Tell your doctor if you have new or unusual pain your hip or thigh

What do I do if I miss a dose?

  • It is important not to miss scheduled doses once treatment has started. Tell your doctor or pharmacist if you have delayed or missed a scheduled dose of denosumab.
  • If you forget a denosumab injection, book an appointment to have it injected as soon as you remember. Your next dose after that should be 6 months later.

Are there medications I should avoid when using denosumab?

  • If you are using another biologic or immune-suppressing medication, be sure to discuss this with your physician or pharmacist before starting denosumab.

How long will I have to be on denosumab?

  • Most patients remain on denosumab long term as the effect of the medication wears off quickly once discontinued. Stopping denosumab has been associated with an increase in bone loss and an increased risk of fracture. If denosumab needs to be stopped, it should be replaced with an alternative osteoporosis medication. Talk to your doctor or pharmacist before deciding to stop your medication.


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