Denosumab is an osteoporosis medication prescribed to help strengthen your bones and reduce your risk of breaking a bone. It is available as a six-monthly injection.

Denosumab is an antibody that slows down the natural rate your bones are broken down. It works by blocking a protein and suppressing the cells that break down bone.

Denosumab doesn't reduce the pain caused by broken bones. But don't worry - if you're experiencing pain after breaking a bone, there are medications and treatments for pain that can help you.

Who should take denosumab?

Denosumab is usually prescribed for postmenopausal women, men and occasionally younger women.

Denosumab doesn't suit everyone. It may not be the best treatment for you if:

  • you have a low blood calcium level
  • you are intolerant to fructose
  • you are allergic to latex
  • you are pregnant or breast feeding

If you're prescribed denosumab

Be informed

Talk to your doctor about your medication, its side-effects and any risks. You can read the information on this page and in your patient information leaflet, so you know what to expect.

You can ask your doctor for a copy of the patient information leaflet.

Our specialist nurse Helpline is here for you, if you have any questions or concerns.

Getting your injection

It’s important that you have adequate levels of calcium and vitamin D when you’re taking denosumab. For this reason, your doctor takes a blood test before the infusion, to check your levels.

If you’re not getting enough calcium from your diet or enough vitamin D from sunlight exposure, you can consider supplements.

How long to take it

Denosumab is generally prescribed long term, so you need to be happy it is the right option for you. 

To get the full benefits, denosumab should be taken regularly as instructed by your doctor or pharmacist.

There’s no formal guidance on how long you should continue to take denosumab. In some cases it can be prescribed for a decade or even longer. It’s a good idea for you to review your treatment with your doctor, every so often, to check it’s still the best option for you.

Ending your treatment

The effects of denosumab wear off quickly, as little as six months after the last injection.

Usually, another medication is prescribed for at least a year after you come off denosumab, to help keep your bones strong.

If your risk of breaking a bone is considered low, you might be advised to stop taking denosumab without a follow-on treatment. In this case, you should be referred to a specialist to discuss further assessment and monitoring.

Possible side effects

It’s unlikely you’ll experience any side effects. But if you do, they shouldn't last for long.

Known side effects include:

  • Skin infections
  • Low blood calcium levels*, causing:
    • Numbness or tingling in your fingers, toes or around you mouth
    • Muscle spasms, twitches or cramps

*if you experience these problems, please contact your doctor immediately.

As research progresses, the list of known side effects may change. You can find more information on each side effect and how to reduce the symptoms on the denosumab factsheet. 

You may have seen other symptoms and side effects in your patient information leaflet. These side effects are listed because they were reported by patients in research trials, but it’s unclear if they were directly caused by denosumab. They were also reported by patients taking the placebo (dummy treatment).

If you experience side effects

It's perfectly natural to be concerned by side effects although, in most cases, they do pass. 

The best thing to do is speak to your doctor or pharmacist. They can assess if there's a better treatment for you. They can also help you work out whether denosumab is causing the symptoms, or if something else is the cause, such as another medication.

Health risks

There are some more-serious but very rare health conditions associated with denosumab:

If you are prescribed denosumab, your doctor has decided the benefit of taking the treatment outweighs any risks.

It's perfectly natural to feel concerned and unsure, but be reassured that your risk of these is very small. Our specialist nurses are here for you, if you need to talk through your concerns and find out more about your risk.