Romosozumab | Medications

➨ What is romosozumab?

  • Romosozumab is an injectable medication that helps to build bone and slow bone loss. It keeps your bones strong and prevents them from thinning.
  • Using it consistently can lower your risk of having a fracture (broken bone).

➨ What is the typical dose?

  • 210 milligrams injected under the skin (subcutaneously) once monthly for up to 12 months. Each monthly dose is given as two separate 105 milligram injections administered immediately one after the other.

➨ How does Romosozumab work?

  • In osteoporosis, your body removes more bone than it replaces – eventually bones become thin and brittle and are more likely to break. Some medications, such as corticosteroids (e.g. prednisone), can increase this bone loss. Romosozumab indirectly increases the rate at which your body builds bone. It also plays a role in slowing bone breakdown. This allows your body to overcome the increase in bone removal seen in osteoporosis.
  • Your doctor may send you for a bone mineral density (BMD) test, an exam that measures the density of your bones. This is one of the tests used to determine if you need romosozumab and if it is working for you.

➨ What are the possible side effects of romosozumab?

  • Common Side Effects
    • Side Effect
      • Sore Joints
    • Ways to Reduce Side Effects
      • Tell your doctor or pharmacist if it is interfering with your ability to do regular activities
  • Less Common Side Effects
    • Side Effect
      • Headache
    • Ways to Reduce Side Effects
      • Tell your doctor or pharmacist if it is interfering with your ability to do regular activities.
    • Side Effect
      • Allergic reaction leading to hives, tongue swelling (angioedema)
    • Ways to Reduce Side Effects
      • The health professional administering romosozumab to you should monitor you following administration of the injections and be prepared to manage sudden allergic reactions.
  • Rare Side Effects
    • Side Effect
      • Unusual break in your thigh bone (“atypical femur fracture”)
    • Ways to Reduce Side Effects
      • Talk to your doctor if you have new or unusual pain in your hip or thigh.
    • Side Effect
      • Low calcium levels (numbness, tingling, muscle spasms)
    • Ways to Reduce Side Effects
      • Discuss your calcium intake with your doctor, pharmacist, or dietitian. They can help you manage this. Ensure you are taking vitamin D.
    • Side Effect
      • Wounds in your jaw from limited blood supply (“osteonecrosis of the jaw”)
    • Ways to Reduce Side Effects
      • Tell your dentist that you are using romosozumab prior to having dental work done. Tell your doctor if you have persistent pain in your mouth or jaw.
    • Side Effect
      • Blood clot leading to heart attack or stroke
    • Ways to Reduce Side Effects
      • Seek immediate help and call Emergency Medical Services if you have symptoms of a heart attack (chest pain/discomfort which could radiate to your arms, jaw, neck or back, sweating, nausea, trouble breathing) or stroke (weakness on one side, slurred speech, loss of balance, loss of vision in one eye).

➨ What do I do if I miss a dose?

  • It is important not to miss scheduled doses once treatment has started.
  • If you forgot or missed a romosozumab injection, arrange to have it injected as soon as you can.

➨ Are there medications I should avoid when using romosozumab?

  • There are no known drugs that directly interact with romosozumab. It is still important to have a pharmacist or doctor assess your medication list to ensure you are not on multiple medications that lower calcium, or aggravate other side effects or romosozumab.

➨ How long will I have to be on romosozumab?

  • Romosozumab is used for a maximum of 1 year, but your treatment period may be shorter. Each patient is different and this is something you should discuss with your doctor or pharmacist.

➨ References:

  1. Lexi-Drugs In: Lexicomp [Internet]. Hudson, (OH): UpToDate, Inc. c2013 –. Romosozumab; [updated 2021 Nov 23; cited 2021 Nov 29]. Available from: https://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/6798426?cesid=59CEfeLLNLW&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dromosozumab%26t%3Dname%26va%3Dromosozumab#
  2. DRUGDEX In: Micromedex [Internet]. Greenwood Village (CO): IBM Watson Health. c1974 – . Romosozumab; [updated 2021 Nov 6; cited 2021 Nov 29]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch?navitem=headerLogout#
  3. Health Canada. Drug Product Database (DPD) [Internet]. Ottawa (ON): Government of Canada. c1996 – . (PrEVENITYTM); 2019 Jun 18 [cited 2021 Nov 29]. Available from: https://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=97967)
  4. Hanley D., Billington E. Osteoporosis 2021 Mar 1 [revised 2021 May 3; cited 2021 Nov 29]. Compendium of Therapeutic Choices In: RxTx [Internet]. Ottawa (ON): Canadian Pharmacists Association. c2015 - . Available from: https://www.e-therapeutics.ca/search