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.

Denosumab and coronavirus

Your immune system

Denosumab is an antibody-based medication, but it doesn't suppress your immune system. This means it doesn't increase your risk of complications from the coronavirus.

This is unlike other antibody-based medications used to treat diseases like rheumatoid arthritis.

You don’t need to take special measures to protect yourself from infection. You can and should continue to take your medication.

Delayed injection

It’s important that your next injection isn’t delayed for more than four weeks, as the benefits wear off quickly. This causes a sudden drop in bone density and increases your risk of spinal fractures. You can have repeat injections up to four weeks early, so you have some flexibility.

The NHS is recommending to hospitals and GPs that they make sure you still get your treatment on time.

If you're reluctant to go into hospital for your injection, Amgen, the manufacturer of Prolia® (denosumab), has made resources available to help with self-administration.

A decision on whether you're able to self-administer should be made by your healthcare professional, together with you. Your healthcare professional then enrols you in the Prolong patient support programme.

If you're accepted, you can collect your injection from a pharmacy. You can self-administer the injection or, if you have a carer, they can do it for you. To help you do the injection, you can watch a video tutorial on

Healthcare professionals are being contacted and asked to enrol people who they feel would benefit from the scheme.

Coronavirus and osteoporosis

With the ongoing outbreak, it’s understandable if you have questions. Find out more about coronavirus and managing your osteoporosis and bone health.

Side effects

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.

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

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).

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 pregnant or breastfeeding.

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

When you come to the end of your treatment, you should start taking another osteoporosis treatment straight away.

This is because stopping denosumab causes a sudden drop in bone density and increases your risk of spinal fractures. Following denosumab with another osteoporosis treatment has been found to stop this from happening. Spinal fractures caused by this sudden drop in bone density are called rebound fractures.

In rare cases, you might be advised to stop taking denosumab without a follow-on treatment. This happens if your risk of breaking a bone is very low, and the decision should always made by an osteoporosis specialist.

If you're unsure about ending your denosumab treatment, our Specialist Helpline Nurses are here to answer your questions. Find out more about our free osteoporosis Helpline

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.

If you experience:

  • Numbness or tingling in your fingers, toes or around you mouth
  • Muscle spasms, twitches or cramps

please contact your doctor immediately. 

Health risks

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

Osteonecrosis of the jaw - when the mouth fails to heal quickly, usually following invasive dental procedures
Atypical (unusual) broken bones in the thigh - a break to the thigh bone that occurs with little or no force after taking the medication for a long time
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.

Useful download: Denosumab (Prolia) fact sheet

Content reviewed: October 2017 (Updated: March 2022)

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