Romosozumab is a biologic medication used to prevent fragile bones, also known as osteoporosis, and bone fractures. Romosozumab is a man-made protein that stops a molecule called sclerostin resulting in new bone growth and improvements in bone structure and strength.
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. The total treatment duration is 12 months.
Romosozumab works quickly – within 2 weeks of an injection, the effects on reducing bone turnover can be detected in the blood; the drug also stays in the blood for several months after stopping the medicine.
It should be taken with calcium (1000–1200 mg daily) and Vitamin D (at least 400 IU daily).
The most common side effects that patients experience are joint pain and headache.
Rarer but serious side effects include an increased risk for heart attacks, strokes, and death from heart or blood vessel disease. Other rare side effects include atypical femur fractures (also known as stress or insufficiency fractures involving the hip joint), infections (especially if you’re already taking medications that lower your immune system), loss of blood supply to the jawbone (called osteonecrosis of the jaw), and severe allergic reactions.
If you have any history of heart attack or stroke you should tell your doctor.
Some symptoms may occur normally while taking romosozumab; however, you should notify your rheumatology provider if you have these 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 July 2022 by Luke Barre, 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.