Denosumab
Say it: den-OH-sue-mab · Brand names: Xgeva, Prolia
Denosumab is a shot that helps keep bones strong and lowers the chance of bone problems from cancer.
What it is
Your body is always breaking down old bone and building new bone. Cancer in the bone, and some cancer treatments, can speed up bone breakdown. Denosumab is an antibody that blocks a protein called RANKL, which slows the cells that break down bone.
Often used for
- preventing fractures and other bone problems from cancer that has spread to the bone
- multiple myeloma
- high calcium caused by cancer
- a bone tumor called giant cell tumor of bone
- bone loss from hormone therapy for prostate or breast cancer
- thin bones (osteoporosis)
How you get it
It is a shot under the skin, in the upper arm, thigh, or belly. For cancer in the bone it is often given every 4 weeks. For bone loss it is often given every 6 months. Your schedule may be different.
Common side effects and what helps
- Feeling tired or weak. Rest when you need to.
- Joint, back, arm, or leg pain. Ask your team which pain medicine is safe.
- Nausea or diarrhea. Eat small meals and drink fluids.
- Feeling short of breath. Tell your team if it is new.
- Low calcium or phosphate on blood tests. Take calcium and vitamin D if your team tells you to.
Call your care team right away if you have
- Muscle cramps, twitching, or tingling in the fingers, toes, or around the mouth. These can be signs of low calcium.
- Jaw pain, swelling, loose teeth, or a sore in the mouth that does not heal
- New pain in the thigh, hip, or groin
- Signs of an allergic reaction, like a rash all over, swelling of the face or throat, or wheezing
- Signs of a skin infection, like a red, warm, swollen, painful area
Before you start, tell your team
- If you have low calcium or kidney problems
- If you have dental problems or plan to have teeth pulled or dental implants
- All medicines you take, including other bone medicines
- If you are pregnant, may become pregnant, or are breastfeeding. It can harm an unborn baby.
- If you are allergic to latex. Some needle covers contain latex.
Good to know
- It can cause low calcium, which can be serious, especially in people with kidney disease. You will have blood tests to check your calcium.
- A rare but serious jaw bone problem can happen. See a dentist before starting and keep good dental care.
- Rarely, unusual thigh bone fractures can happen.
- Stopping it can lead to fast bone loss and a higher chance of spine fractures. Do not stop unless your team tells you to.
- Xgeva and Prolia are the same medicine. You should not get both.
At home
- Take calcium and vitamin D exactly as your team tells you.
- Brush and floss every day and keep your dental visits.
- If you give the shot at home, keep it in the refrigerator. Let it warm to room temperature before the shot.
- If you miss a dose, ask your team when to reschedule.
Questions to ask
- Should I see a dentist before I start?
- Do I need calcium and vitamin D, and how much?
- How long will I need this medicine?
- What happens if I need to stop it?
Side effect guides
Sources
Quick answers
- What is Denosumab?
- Denosumab is a shot that helps keep bones strong and lowers the chance of bone problems from cancer. Brand names: Xgeva, Prolia.
- What is Denosumab used for?
- preventing fractures and other bone problems from cancer that has spread to the bone; multiple myeloma; high calcium caused by cancer; a bone tumor called giant cell tumor of bone; bone loss from hormone therapy for prostate or breast cancer; thin bones (osteoporosis).
- How is Denosumab given?
- It is a shot under the skin, in the upper arm, thigh, or belly. For cancer in the bone it is often given every 4 weeks. For bone loss it is often given every 6 months. Your schedule may be different.
- What are the common side effects of Denosumab?
- Feeling tired or weak. Joint, back, arm, or leg pain. Nausea or diarrhea. Feeling short of breath. Low calcium or phosphate on blood tests.
- When should I call my care team while taking Denosumab?
- Muscle cramps, twitching, or tingling in the fingers, toes, or around the mouth. These can be signs of low calcium; Jaw pain, swelling, loose teeth, or a sore in the mouth that does not heal; New pain in the thigh, hip, or groin; Signs of an allergic reaction, like a rash all over, swelling of the face or throat, or wheezing; Signs of a skin infection, like a red, warm, swollen, painful area.
Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.