What does it do?

Denosumab is used to treat osteoporosis (weak bones). It helps make your bones stronger and less likely to break.

Before you start

• Denosumab must be used long term. If you stop or miss a dose of denosumab you can increase your risk of a spine fracture, especially if this has happened to you before. Tell your doctor if you do not think you can manage 6-monthly injections.
• You will need a blood test 1 to 2 weeks before you have each denosumab injection, to check the amount of calcium and vitamin D in your blood, and to check how well your kidneys are working. Calcium may be checked again, 1 to 2 weeks after each dose.
• Tell your doctor if you have dental problems.
• If there is a chance you could get pregnant, use reliable contraception while taking denosumab and for up to 5 months after stopping. Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.

How is it given?

Denosumab is given as an injection under the skin on your stomach, thigh, or upper arm. To make the injection more comfortable, you can take it out of the fridge at least 30 minutes before it is injected.

Do not stop having denosumab without talking to your doctor first.

What if you forget a dose?

Inject the missed dose as soon as you remember. Your next dose is then due 6 months from this day.

Can you take other medicines?

Tell your pharmacist or doctor about all medicines or treatments that you may be taking, including vitamins, herbal products or recreational drugs.

What side effects might you notice?

Side Effects	Recommended action
Symptoms of a skin infection called cellulitis, such as a red, painful, swollen area of skin, fever, and chills	Tell your doctor immediately
Symptoms of low calcium in your blood, including: tingling or numbness, muscle spasms, short of breath	Tell your doctor
Skin rash	Tell your doctor if troublesome

If you notice any other effects, discuss them with your doctor or pharmacist.

Other information:

• Before you have any dental work, tell your dentist you are taking denosumab.
• Rarely, denosumab can cause an unusual thigh bone fracture. Discuss this with your health professional. Tell your doctor if you have any new thigh, hip, or groin pain.
• Store denosumab in the fridge.