How should I take denosumab or Xgeva?

Denosumab injection comes as a solution to be injected under the skin in your upper arm, upper thigh, or stomach area. A doctor or nurse usually injects it in a medical office or clinic. The dose and treatment length may differ from patient to patient, depending on their medical conditions.

Your doctor may tell you to take supplements of calcium and vitamin D while being treated with a denosumab injection. Take these supplements exactly as directed to prevent low calcium levels and some of the other side effects.

You can help your doctor by tracking your side effects in Ankr.

What are the side effects of denosumab or Xgeva?

Denosumab injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online or by phone (1-800-332-1088).

Use the free Ankr platform or Ankr app to track your symptoms.

What special precautions should I follow?

Before taking denosumab or Xgeva

• tell your doctor about your allergies
• tell your doctor about other intakes, including corticosteroids
• tell your doctor if you are taking denosumab under a different brand name.
• tell your doctor if you have or have ever had a low calcium level in your blood. Your doctor may test the level of calcium in your blood. You should not receive a denosumab injection if the level is too low.
• tell your doctor about any other disease or symptom in the past or now

While you are on denosumab or Xgeva

• tell your doctor if you are pregnant, and plan to become pregnant. You should use a reliable method of birth control as denosumab may harm the fetus
• tell your doctor if you are breastfeeding. You should not breastfeed while on denosumab
• you should know that denosumab injection may cause a disease of the jaw bone, known as osteonecrosis. It will likely occur if you have dental surgery or treatment while receiving this medication. Be sure to brush your teeth and clean your mouth properly. Talk to your doctor before having any dental treatment

I forgot a dose. What should I do?

You should call your healthcare provider as soon as possible. The missed dose should be given as soon as it can be rescheduled.

Denosumab injection may also cause broken bones to heal slowly and may impair bone growth and prevent teeth from coming in properly in children. Talk to your doctor about the risks of receiving denosumab injection.

In case of an emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

How should I store & safely dispose of this medication?

Generally, you will get this medication in a clinic or a hospital. However, if you have a dose to keep for future use, keep the medication in the container it came in, tightly closed, and out of reach of children. Do not shake denosumab injection. Store it in the refrigerator and protect it from light. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Do not flush unneeded medication down the toilet. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

Brand names

• Prolia^®
• Xgeva^®
• Rozel^®
• Olimab^®

Last Revised – 02/28/2023, FDA updated-05/21/2018, SG