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Romosozumab (Evenity)

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What Is It?

Romosozumab is a humanized monoclonal antibody that inhibits a molecule called sclerostin. Sclerostin normally inhibits bone formation, therefore, by inhibiting sclerostin, romosozumab increases bone formation overall.

How to Take It

Romosozumab is given as an injection just under the skin. It is given by your rheumatology provider or nursing staff. The usual dose is 210 mg once a month, given as two separate injections of 105mg, one after the other, to administer the total dose. You should be taking adequate calcium and vitamin D supplements while on this medicine.

Romosozumab works quickly – within 2 weeks of an injection, the effects on bone metabolism markers can be detected in the blood; the drug also stays in the blood for several months after stopping the medicine.

Side Effects

The most common side effects that patients experience are joint pain and headache.

Romosozumab can cause hypocalcium, or low calcium levels in the blood.

Rarer side effects include atypical femur fractures (also known as stress or insufficiency fractures involving the hip joint), loss of blood supply to the jawbone (called osteonecrosis of the jaw), and severe allergic reactions.

Finally, romosozumab may increase the risk of heart attack, stroke, cardiovascular death and should not be used if you had a heart attack or stroke within the previous year. Talk to your rheumatology provider if you have other cardiovascular risk factors and discontinue use if you develop a heart attack or stroke during therapy.

Tell Your Rheumatology Provider

Some symptoms may occur normally while taking romosozumab, however, you should notify your rheumatology provider if you have the following symptoms while taking this medication: chest pain, shortness of breath, headaches, changes in vision, feeling lightheaded, difficulty talking, numbness or tingling of the hands or around the mouth, new pain in the jaw, or fevers or other signs of infection.

Make sure to notify your other providers while you are taking this drug. If you are pregnant or considering pregnancy, let your provider know before starting this medication. Women should discuss birth control with their primary care providers or gynecologists. Breast-feeding should be avoided while taking romosozumab because the drug can enter breast milk.

Written March 2023 Kristen Lee, MD, and reviewed by the American College of Rheumatology Communications and Marketing Committee.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.

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