Evenity (romosozumab-aqqg) is a brand-name injectable medication that’s prescribed for osteoporosis in certain people. Specifically, this medication is used to treat postmenopausal osteoporosis in people with a high risk of fracture. As with other drugs, Evenity can cause side effects, such as joint pain and headache.

Evenity is a biologic and belongs to a drug class called sclerostin blockers. The drug is not available in a biosimilar version.

Read on to learn about potential common, mild, and serious side effects of Evenity. For a general overview of the drug, including details about its uses, see this article.

Evenity can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Evenity in clinical trials:

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Evenity use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Evenity’s prescribing information.

Mild side effects that have been reported with Evenity include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while receiving Evenity and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.

Evenity may cause serious side effects. Although serious side effects aren’t common, they may occur. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Evenity’s prescribing information.

If you develop serious side effects during Evenity treatment, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

* Evenity has a boxed warning for this side effect. This is a serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effect specifics” section below.
† To learn more, see the “Side effect specifics” section below.

Evenity may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

How do side effects of Evenity compare with those of Prolia?

Evenity and Prolia (denosumab) are both prescribed to treat osteoporosis in certain people. Specifically, both medications are approved to treat postmenopausal osteoporosis in females* with a high risk of bone fracture. Prolia is also approved to treat osteoporosis in certain males.*

Evenity and Prolia may cause similar side effects. For example, both Evenity and Prolia can cause fatigue or insomnia. In addition, both medications may cause more serious side effects, such as unusual femur fractures, hypocalcemia (low blood calcium level), and osteonecrosis of the jaw.

However, Evenity and Prolia may also cause different side effects. For example, Evenity can cause joint pain, headache, and swelling of the arms or legs. Prolia isn’t known to cause these side effects.

Prolia can cause high cholesterol, back pain, and muscle or bone pain. Evenity isn’t known to cause these side effects. For more information about Prolia’s side effects, see this article.

To learn more about how Evenity compares with Prolia, refer to this article. If you have additional questions, talk with your doctor or pharmacist. You and your doctor can work together to determine the best treatment option for you.

Is hair loss a side effect of Evenity?

No, you shouldn’t notice hair loss from Evenity treatment. Hair loss wasn’t a reported side effect in the drug’s clinical trials.

However, other medications prescribed for osteoporosis may cause hair loss. For example, it’s possible for Fosamax (alendronate) and Prolia (denosumab) to cause hair loss.

If you notice hair loss while receiving Evenity injections, talk with your doctor. They can help determine what may be causing it. In addition, they may be able to recommend ways to manage this side effect.

Does Evenity cause weight gain?

No, you shouldn’t experience weight gain from Evenity treatment. In clinical trials of Evenity, weight gain was not a reported side effect.

However, Evenity may cause swelling in the arms or legs. This swelling may cause weight gain.

If you notice weight gain during your treatment with Evenity, talk with your doctor. They can help determine the cause and the best ways to manage it.

* Sex and gender exist on spectrums. Use of the terms “female” and “male” in this article refers to sex assigned at birth.

Learn more about some of the side effects that Evenity may cause, including its boxed warning. To find out how often side effects occurred in clinical trials, see Evenity’s prescribing information.

Stroke, heart attack, and cardiovascular death

Evenity has a boxed warning for the risk of stroke, heart attack, and cardiovascular death. A boxed warning is the most serious warning recommended by the Food and Drug Administration (FDA). It alerts patients and prescribers about the risks of a medication.

What you can do

Although rare, Evenity can increase your risk of these conditions. Due to this risk, it’s important to contact your doctor right away if you develop certain symptoms, such as:

Some risk factors for these conditions may include high blood pressure, smoking, or diabetes. If you have any of these risk factors, talk with your doctor. They can help determine whether Evenity is safe for you.

If you have a history of heart attack or stroke, tell your doctor before starting Evenity treatment. If either has occurred within the past year, your doctor will likely recommend a different treatment option.

Headache

It’s possible to experience a headache from receiving Evenity injections. In clinical trials, headache was one of the most commonly reported side effects.

What you can do

If you notice a headache during treatment, talk with your doctor. They can help determine what may be causing it. In most cases, a headache can be treated with an over-the-counter (OTC) pain medication, such as Tylenol (acetaminophen) or Advil (ibuprofen).

In rare cases, a severe headache may also be a symptom of a stroke. Evenity treatment may increase your risk of this side effect. In addition to a headache, symptoms of a stroke may include numbness or weakness, trouble talking, or vision changes.

If you develop worsening headaches or any stroke symptoms, be sure to contact a doctor or go to the hospital right away.

Joint pain

It’s possible to develop joint pain from receiving Evenity injections. In fact, joint pain was one of the most common side effects reported in clinical trials of Evenity.

What you can do

If you develop joint pain during your treatment with Evenity, tell your doctor. They may recommend an OTC pain medication, such as Tylenol (acetaminophen) or Advil (ibuprofen), to help manage your joint pain.

Insomnia

It’s possible to develop insomnia during treatment with Evenity. This is when you have difficulty falling asleep or staying asleep. While this side effect was reported in clinical trials of Evenity, it wasn’t very common.

What you can do

If you develop insomnia while receiving Evenity injections, tell your doctor. They can recommend ways to manage this side effect. For example, they may suggest avoiding caffeine late in the day or following a consistent sleep schedule. They may also recommend an OTC sleep aid, such as melatonin.

Allergic reaction

As with most drugs, Evenity can cause an allergic reaction in some people. However, this side effect wasn’t common in clinical trials. Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep receiving Evenity. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Before you start Evenity, tell your doctor about any medical conditions that you have. They can help determine whether Evenity may be safe for you.

Boxed warning: Risks of stroke, heart attack, and cardiovascular death

This drug has a boxed warning for the risks of stroke, heart attack, and cardiovascular death. This is a serious warning from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you receive Evenity. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:

Low blood calcium level. Evenity may cause hypocalcemia, which is a low blood calcium level. If you already have this condition, receiving Evenity may make it more severe. If you have low blood calcium, talk with your doctor before receiving Evenity. They’ll likely want to raise your calcium level before you start treatment with this drug.

Kidney problems. Before starting treatment with Evenity, tell your doctor if you have any kidney problems or receive dialysis treatment. Both Evenity and certain kidney problems can lower your blood calcium level. If you have kidney problems, receiving this drug may increase your risk of developing side effects. If you have a kidney condition, your doctor can help determine whether Evenity is a safe treatment option for you.

Allergic reaction. If you’ve had an allergic reaction to Evenity or any of its ingredients, your doctor will likely not prescribe Evenity. Ask your doctor what other medications may be better options for you.

Upcoming dental surgery. Evenity may cause osteonecrosis of the jaw, which is bone death due to a lack of blood flow. Having dental work or dental surgery during treatment may increase your risk of this side effect. If you receive Evenity injections, let your dentist know. If you need dental surgery, they can decide what treatments are safe for you.

Alcohol with Evenity

There aren’t any known interactions between Evenity and alcohol. However, it’s possible that drinking alcohol may worsen symptoms of osteoporosis. If you have osteoporosis and drink alcohol, your doctor may recommend limiting your alcohol intake.

In addition, alcohol and Evenity can cause a headache and lower your blood calcium level. Drinking alcohol may increase your risk of these side effects from Evenity.

If you have questions about drinking alcohol during treatment with Evenity, talk with your doctor or pharmacist.

Pregnancy and breastfeeding while receiving Evenity

It’s not known whether Evenity is safe to receive during pregnancy or while breastfeeding.

There haven’t been clinical trials to show whether Evenity treatment is safe for humans during pregnancy. In animal studies, Evenity caused congenital anomalies (also known as birth defects). However, animal studies don’t always predict what can happen in humans.

There also haven’t been clinical trials to show whether Evenity treatment is safe for humans while breastfeeding. It’s not known whether Evenity passes into breast milk or how it may affect a child who’s breastfed. In animal studies, Evenity did pass into the milk of lactating animals. However, animal studies don’t always predict what can happen in humans.

At this time, Evenity is only approved to treat postmenopausal osteoporosis in females.* Once you’ve gone through menopause, you can’t become pregnant.

If you’re pregnant or can become pregnant, talk with your doctor. They can help determine the best treatment option for you.

Also, let your doctor know if you’re breastfeeding or planning to breastfeed. They can advise on safe feeding options for your child.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

In most cases, side effects of Evenity are mild. However, serious side effects can also occur. If you’d like to learn more about Evenity, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from receiving the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Evenity. For details about other aspects of Evenity, refer to this article.
  • Drug comparison. To learn how Evenity compares with Prolia, read this article.
  • A look at osteoporosis. For details about osteoporosis, see our list of osteoporosis articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.