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Romosozumab

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Romosozumab is an osteoporosis treatment prescribed to help strengthen your bones and reduce your risk of breaking a bone. It's prescribed for 12 months as two monthly injections, which you do yourself.

The treatment works by stimulating the cells that build bone (osteoblasts), and slowing down the cells that break down bone (osteoclasts). This helps to prevent bone loss.

Romosozumab is a relatively new drug, and is currently only available through private practices. It is not yet available for prescription through the NHS.

The National Institute for Health and Care Excellence (NICE) hasn't published guidance on who should be prescribed romosozumab through the NHS yet. The coronavirus pandemic has delayed the work that NICE needs to do before releasing their guidance on romosozumab. 

Romosozumab is usually prescribed for women who've been through the menopause and have a high risk of breaking a bone. Occasionally, romosozumab is prescribed for younger women too.

Romosozumab isn't used as a first treatment option. It's considered by your doctor if you've had several broken bones and have already tried other osteoporosis treatments.

Romosozumab may not be suitable if:

  • You can't take other osteoporosis treatments because of side effects. This is because romosozumab must be followed by another osteoporosis treatment to maintain its bone-strengthening effects.
  • You have low levels of calcium in your blood (hypocalcaemia). This is because it can rarely cause blood calcium levels to drop.

Romosozumab isn't suitable if you:

  • Have had a heart attack
  • Have had a stroke
  • Hypersensitivity
  • Injection site reactions

If you have side effects when taking romosozumab, in most cases, they do pass.

If side effects don't go away, tell your doctor or pharmacist. They can assess whether romosozumab is causing the symptoms, and if there's a better osteoporosis treatment for you.

Other side effects

You may read about other romosozumab side effects in your patient information leaflet, or online. The side effects listed above are thought to be the 'true side effects' of romosozumab.  

A 'true side effect' means research trials found that symptom in more people taking the real treatment than those taking a placebo (dummy) treatment. 

Drug research trials always have a group of people taking the real treatment and a group taking a dummy treatment. Sometimes, a side effect is reported by the same number of people in both groups. These side effects are often still included in your patient information leaflet.

If you need more information to help you decide whether romosozumab is right for you, our free Helpline is here for you. Speak to a specialist nurse by calling Freephone 0808 800 0035, or emailing nurses@theros.org.uk.

Romosozumab is given as two monthly injections, which you do yourself, just under the skin.

If you're prescribed romosozumab, you're trained how to give yourself the injections.

A family member or carer can do the injections for you instead, but only if they're trained how to first.

The injections must be taken one after the other, on the same day, in the:

  • Stomach area
  • Thigh
  • Outer, upper arm (only if someone else is doing the injection for you)

The second injection must be given at a different injection spot. For example, if the first injection was in the stomach area, the second could be in the thigh, or a different part of the stomach area.

Closely following the instructions for storing and taking your romosozumab helps you get the most benefit for your bones, and reduces your risk of side effects.

Calcium and vitamin D

You may be prescribed calcium and vitamin D before and during your romosozumab treatment, to help prevent low calcium levels in your blood. This is because romosozumab can rarely cause blood calcium levels to drop.

Romosozumab is prescribed for one year only. During this time, it reduces your risk of broken bones.

To sustain the bone-strengthening effects of romosozumab, it must be followed by another osteoporosis treatment. The decision about which treatment is right for you depends on your individual circumstances.

There are some serious health risks associated with romosozumab. Some are more likely then others.

Heart attack

This affects 1 in every 125 people.

If you've had a heart attack, you shouldn't be prescribed romosozumab.

Stroke

This affects 1 in every 166 people.

If you've had a stroke, you shouldn't be prescribed romosozumab.

Osteonecrosis of the jaw (ONJ)

ONJ is when your mouth doesn't heal properly. For example, after invasive dental treatment.

Be reassured that this is very rare.

Find out more about ONJ

Atypical thigh fracture

This is when you break your thigh bone with little or no force.

Be reassured that this is very rare. Your risk increases the longer you take a treatment.

Find out more about atypical thigh fractures.


If you're prescribed romosozumab, your doctor has decided the benefit of taking it outweighs the long-term health risks.

Our specialist nurses are here for you, if you need to talk through your concerns and find out more about your risk.

Get support from a Specialist Nurse

Contact our free Helpline for tailored information about osteoporosis and bone health:

0808 800 0035

Or online, through live chat

About the Helpline

Benefiting from romosozumab

Taking the time to read the instructions carefully and adjust your routine and lifestyle can help your bones get maximum benefit - and minimise unwanted side effects.

Here's some helpful pointers, to help you succeed.

More osteoporosis treatments

Decisions about treatment

Osteoporosis treatments are usually prescribed if your risk of breaking a bone is significantly higher than normal.

With a wide range of osteoporosis medications available, it's understandable to wonder which one is best for you. The decision about which treatment is right for you, and how long you need to take it, depends on your personal circumstances. 

Short-term treatment may be all you need. If your risk of breaking a bone is high, it's likely you need to take a treatment for a longer period of time.