Evenity is a brand-name subcutaneous injection that’s prescribed for osteoporosis. Evenity contains the active ingredient romosozumab-aqqg.

Evenity is (FDA)-approved to treat osteoporosis in females* who’ve gone through menopause and:

  • have a high risk of fracture, or
  • have tried and stopped other osteoporosis treatments because the treatments either:
    • weren’t effective enough, or
    • caused side effects that were bothersome or severe

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

Drug details

You’ll find key information about Evenity below.

  • Drug class: monoclonal antibody
  • Drug form: subcutaneous injection given by a healthcare professional
  • Generic or biosimilar available? no
  • Prescription required? yes
  • Controlled substance? no
  • Year of FDA approval: 2019

Evenity can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Evenity. These lists do not include all possible side effects.

For more information about the possible side effects of Evenity, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you’d like to notify the FDA about a side effect you’ve had with Evenity, you can do so through MedWatch.

Mild side effects

Mild side effects of Evenity can include:*

  • joint pain†
  • headache†
  • muscle spasm (sudden, involuntary muscle tightening)
  • peripheral edema (swelling of the legs, ankles, or arms due to fluid buildup)
  • weakness
  • neck pain
  • insomnia (difficulty sleeping)
  • pins and needles, tingling, or burning sensations
  • injection site reactions, such as pain or discoloration†

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Evenity. To learn about other mild side effects, talk with your doctor or pharmacist or check Evenity’s prescribing information.
† For more information about this side effect, see “Side effect details” below.

Serious side effects

Serious side effects from Evenity aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Hypocalcemia (low blood calcium levels). Symptoms can include:
    • muscle cramps, spasms, or twitching
    • numbness or tingling in your fingers or toes or around your mouth
  • Osteonecrosis (death of bone tissue) in the jaw. Symptoms can include:
    • loosening of a tooth
    • pain in your jaw, teeth, or mouth
    • gum pain, swelling, or discharge
    • sores on your gums that don’t heal
    • numbness or a feeling of heaviness in your jaw
  • Atypical femur fracture (a thigh bone fracture that occurs after a minor injury or with no clear cause). Symptoms can include:
    • new or unusual thigh, hip, or groin pain
    • difficulty walking
  • Heart attack or stroke.*†
  • Allergic reaction.†

* Evenity has a boxed warning for these side effects. This is the most serious warning from the Food and Drug Administration (FDA).
† For more information about this side effect, see “Side effect details” below.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects are associated with it. Here’s some detail on certain side effects this drug may or may not cause.

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

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Evenity. This may also be called a hypersensitivity reaction.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • difficulty breathing

Call your doctor right away if you have an allergic reaction to Evenity, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening, or you think you’re having a medical emergency.

Heart attack and stroke

Evenity can increase your risk of heart attack and stroke. It can also increase your risk for death due to a cardiovascular (heart or blood vessel) problem. In fact, Evenity has a boxed warning for these side effects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Your doctor will not prescribe Evenity if you’ve had a heart attack or stroke in the past year. And if you have any risk factors for cardiovascular problems, talk with your doctor about whether Evenity is right for you. These risk factors include hypertension (high blood pressure), diabetes, smoking, and obesity.

Call 911 or your local emergency number if you have symptoms of a heart attack or stroke while taking Evenity. These symptoms may include:

  • chest pain or pressure, which may spread to your arm or jaw
  • shortness of breath
  • dizziness
  • a sudden fall
  • numbness or weakness on one side of your face or body
  • slurred speech
  • sudden vision changes, such as blurred vision or loss of vision

Joint pain

It’s possible to have joint pain as a side effect of Evenity. This is one of the more common side effects of the drug.

If you have new or worsening joint pain while taking Evenity, talk with your doctor about ways to manage this side effect.

Headache

Headaches may occur while taking Evenity. In fact, headaches are one of the more common side effects associated with this drug.

Headaches can typically be relieved by taking over-the-counter (OTC) pain relievers, such as acetaminophen (Tylenol). Be sure to talk with your doctor or pharmacist before starting any OTC medications for headache.

If you have headaches that are bothersome or severe, talk with your doctor. They may suggest ways to manage this side effect.

Injection site reactions

It’s possible to have a reaction at the site where you have your Evenity injection. The most common symptoms of an injection site reaction in clinical trials were pain and skin discoloration. Other possible symptoms include swelling, hives, or itching at the site of injection.

When an injection site reaction occurs, it’s typically minor. Symptoms may occur immediately or a few hours after you receive an injection.

To help prevent injection site reactions, your healthcare professional should inject Evenity into a different site each time you have an injection. And injections shouldn’t be given in areas of skin that are tender, red, discolored, bruised, or hard.

Symptoms of an injection site reaction after a dose of Evenity usually improve after a few days. If you have symptoms that last longer than a few days or are severe, talk with your doctor.

Note: In some cases, skin discoloration, swelling, and certain other symptoms can indicate an allergic reaction. However, injection site reactions are specific to the area where you received an injection. In contrast, an allergic reaction tends to affect larger areas of the body where you may not have received an injection. See the section “Allergic reaction” above for details.

Weight gain (not a side effect)

Weight gain wasn’t a reported side effect in clinical trials of Evenity. However, some people had peripheral edema (swelling of the legs, ankles, or arms due to fluid buildup) while taking Evenity in clinical trials. Edema can lead to sudden water weight gain, which may be temporary.

If you have swelling in your feet, hands, ankles, legs, or arms while taking Evenity, talk with your doctor. They can recommend ways to manage this. And you can talk with your doctor if you’re concerned about weight gain with Evenity.

You may wonder how Evenity compares with other medications that are prescribed for similar uses. Here, we look at how Evenity and Prolia are alike and different. For further information, see this in-depth article.

Ingredients

Evenity contains the active drug romosozumab-aqqg. Prolia contains the active drug denosumab.

Both Evenity and Prolia are biologics (drugs made using living cells rather than chemicals). But the drugs work in these different ways in the body:

  • Prolia works to slow bone breakdown.
  • Evenity primarily works to rebuild bone. It also works to slow bone breakdown.

Uses

Evenity and Prolia are both approved to treat osteoporosis. (Osteoporosis is a condition that causes weak, brittle bones.) For this use, both drugs can be given to females* who’ve gone through menopause, and who have a high risk of bone fracture.

Prolia is also approved to treat osteoporosis and reduce bone loss in certain adults (including some males*) who have a high risk of fracture. For more information about Prolia’s approved uses, see the drug’s prescribing information.

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

Drug forms and administration

Evenity and Prolia are both given by healthcare professionals as a subcutaneous injection (an injection under the skin). You’ll get injections of either drug in your doctor’s office.

Evenity injections are given once per month for 12 months. Prolia injections are given once every 6 months for as long as your doctor recommends. And both drugs should be taken with a daily calcium and vitamin D supplement.

Side effects and risks

Evenity and Prolia both contain drugs that increase bone strength. This means that these medications can cause some similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, as well as mild side effects that both drugs may share.

Serious side effects

These lists contain examples of serious side effects that can occur with Evenity or Prolia, as well as serious side effects that both drugs may share.

  • Can occur with Evenity:
  • Can occur with Prolia:
    • serious infections, such as skin infections or urinary tract infections
    • severe pain in your joints, muscles, or bones
    • slowed bone formation, which may lead to slow healing of fractures
    • multiple fractures in your spine after stopping Prolia
    • pancreatitis (inflammation of the pancreas)
  • Can occur with both Evenity and Prolia:

* Evenity has a boxed warning for these side effects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see the “Evenity side effects” section above.

Effectiveness

Evenity and Prolia have different FDA-approved uses, but they’re both used to treat osteoporosis in certain females* who’ve gone through menopause. For this use, studies have found both Evenity and Prolia to be effective.

These drugs haven’t been directly compared in clinical studies. But a recent review of studies found that Evenity’s and Prolia’s active drugs† may be similarly effective in preventing spinal fractures. This review also found that Evenity may be more effective than Prolia for preventing hip fractures or other non-spinal fractures.

Also, the active drugs in both Evenity and Prolia are recommended in current treatment guidelines for osteoporosis in females who’ve gone through menopause.

If you’re interested in taking Evenity or Prolia, talk with your doctor about which drug might be the best option for you.

* Sex and gender exist on spectrums. Use of the term “female”in this article refers to sex assigned at birth.
† Romosozumab-aqqg is the active drug in Evenity. Denosumab is the active drug in Prolia.

Costs

The actual price you’ll pay for Evenity or Prolia depends on your insurance plan, your location, and the medical facility where you receive either drug.

Evenity and Prolia are both brand-name biologic drugs. There are currently no biosimilar forms of either drug. (A biosimilar is a drug that’s similar to a brand-name biologic medication. Biosimilars tend to cost less than the brand-name drugs they’re based on.)

Evenity is a biologic drug that’s available only as a brand-name medication. It doesn’t come in biosimilar form.

A biologic drug is made from living cells, while other drugs are made from chemicals. Drugs made from chemicals can have generics, which are exact copies of the active drug in the brand-name medication. Biologics, on the other hand, can’t be copied exactly. So, instead of a generic, biologics have biosimilars. Biosimilars are “similar” to the parent drug, and they’re considered to be just as effective and safe.

Like generics, biosimilars are often less expensive than brand-name medications.

As with all medications, the cost of Evenity can vary. The actual price you’ll pay depends on your insurance plan, your location, and the medical facility where you receive this drug.

It’s important to note that your doctor or healthcare professional will order Evenity for you. And you’ll receive doses of the drug in a medical facility. You won’t pick up this medication from a pharmacy or administer it to yourself.

Before approving coverage for Evenity, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Evenity, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Evenity, or if you need help understanding your insurance coverage, help is available.

Amgen, Inc., the manufacturer of Evenity, offers several ways to help lower the cost of this drug. For more information and to find out if you’re eligible for support, visit the manufacturer’s website.

Generic or biosimilar version

Evenity is only available as a brand-name medication. It’s not currently available in biosimilar form. (Biosimilars are like a generic version of a biologic medication. Like generics, biosimilars are often less expensive than brand-name medications.)

The following information describes the dosing schedule of Evenity that’s commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Drug form and strengths

Evenity comes as a solution inside a single-use, prefilled syringe. It comes in a strength of 105 milligrams per 1.17 milliliters (105 mg/1.7 mL).

Evenity is given by a healthcare professional as a subcutaneous injection.

Dosage for postmenopausal osteoporosis

Evenity’s recommended dosage for treating osteoporosis is 210 mg (which is two injections), given once every month for 12 months.

What if I miss a dose?

If you miss an appointment to get your Evenity injections, call your doctor’s office right away to reschedule your appointment. You should get your missed dose as soon as possible. And your next appointment should be 1 month from the date that you received your missed dose.

It’s important to keep your appointments with your doctor for your Evenity injections. To help make sure you don’t miss a dose, try setting a reminder for your appointments on your phone.

Will I need to use this drug long term?

Evenity is meant to be used for 12 months only. After 12 months, the drug becomes less effective at rebuilding bone. (Evenity works to treat osteoporosis by rebuilding bone and slowing bone breakdown.)

If you still need treatment for osteoporosis after stopping Evenity, your doctor can recommend a different treatment for you.

Other drugs are available that can treat osteoporosis. Some may be a better fit for you than others. If you’re interested in finding an alternative to Evenity, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are prescribed off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is prescribed to treat a different condition.

Examples of other drugs that may be used to treat osteoporosis* include:

  • drugs that help rebuild bone, such as:
  • drugs that slow bone breakdown, such as:

* Evenity is only approved to treat osteoporosis in certain females who’ve gone through menopause. But some of the drugs listed above are used to treat osteoporosis in other situations. For more information about how Evenity is used, see the “Evenity for postmenopausal osteoporosis” section above.

You may wonder how Evenity compares with other medications that are prescribed for similar uses. Here, we look at how Evenity and Forteo are alike and different.

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

Ingredients

Evenity contains the active drug romosozumab-aqqg. Forteo contains the active drug teriparatide. The drugs work in these different ways in your body:

  • Forteo works to rebuild bone.
  • Evenity also works to rebuild bone. It also works to slow bone breakdown.

Uses

Here is a list of conditions that the Food and Drug Administration (FDA) has approved Evenity and Forteo to treat.

  • Both Evenity and Forteo are approved to treat:
  • Forteo is also approved to treat:
    • osteoporosis in males
    • osteoporosis (in males or females) that’s caused by taking certain corticosteroid drugs

For these uses, both Evenity and Forteo are approved for use in certain people who have a high risk of fracture.

Drug forms and administration

Evenity and Forteo are both given as a subcutaneous injection.

Evenity will be administered by your healthcare professional in their office. On the other hand, Forteo will be administered by your healthcare professional when you first start taking the drug. But you (or a caregiver) may be able to learn how to give yourself Forteo injections at home over time.

Evenity is taken once per month for 12 months. Forteo is taken once per day for up to 2 years. Evenity should be taken with a daily calcium and vitamin D supplement. But Forteo doesn’t need to be taken with these other treatments.

Side effects and risks

Evenity and Forteo both contain drugs that increase bone strength. This means that these medications can cause some similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

  • Can occur with Evenity:
    • muscle spasm (sudden, involuntary muscle tightening)
    • insomnia
    • pins and needles, tingling, or burning sensations
    • peripheral edema (swelling of the legs, ankles, or arms due to fluid buildup)
    • injection site reactions, such as pain, redness, or discoloration
  • Can occur with Forteo:
    • body pain
    • nausea
    • hypertension (high blood pressure)
    • dizziness
    • a runny or stuffy nose
    • cough
  • Can occur with both Evenity and Forteo:

Serious side effects

These lists contain examples of serious side effects that can occur with Evenity or Forteo, as well as serious side effects that both drugs may share.

* Evenity has a boxed warning for these side effects. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see the “Evenity side effects” section above.
† Forteo has a boxed warning for this side effect. For more information, see Forteo’s prescribing information.

Effectiveness

Evenity and Forteo have different FDA-approved uses. But they’re both used to treat osteoporosis in certain females who’ve gone through menopause.

The use of Evenity and Forteo in treating postmenopausal osteoporosis has been directly compared in clinical studies. These studies compared the effect of the drugs on bone mineral density (BMD). BMD is a measurement of how strong your bones are. But it’s worth noting that these studies didn’t compare how effective the drugs were in preventing fractures.

One clinical study looked at females with low BMD who took either Evenity’s active drug (romosozumab-aqqg) or Forteo’s active drug (teriparatide). In this study, Evenity’s active drug was more effective than Forteo’s at increasing BMD in certain parts of the spine and hip.

Another clinical study looked at females who’d been through menopause and had previously taken a bisphosphonate drug* for osteoporosis. In this study, Evenity’s active drug increased hip BMD more than Forteo’s active drug did (on average).

A recent review of studies has indirectly compared the effectiveness of these active drugs in preventing fractures. Researchers found that Evenity’s active drug may be slightly less effective than Forteo’s in preventing spinal and non-spinal fractures. But they also found that Evenity’s active drug may be more effective than Forteo’s in preventing hip fractures.

Both Evenity’s and Forteo’s active drugs are recommended in current treatment guidelines for osteoporosis in females who’ve been through menopause. If you’re interested in taking Evenity or Forteo, talk with your doctor about which drug might be the best option for you.

* Bisphosphonate drugs are a group of medications that work to slow bone breakdown. Bisphosphonate drugs belong to a different group of medications than Evenity or Forteo.

Costs

The actual price you’ll pay for Evenity or Forteo depends on your insurance plan, your location, and the pharmacy you use or the medical facility where you receive the medication.

Evenity and Forteo are both brand-name biologic drugs. There are currently no biosimilar forms of either drug. (A biosimilar is a drug that’s similar to a brand-name biologic medication. Biosimilars tend to cost less than the brand-name drugs they’re based on.)

The Food and Drug Administration (FDA) approves prescription drugs such as Evenity to treat certain conditions. Evenity may also be prescribed off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is prescribed to treat a different condition.

Evenity is FDA-approved to treat osteoporosis in females who’ve gone through menopause, and:

  • have a high risk of bone fracture, or
  • have tried and stopped other osteoporosis treatments because the treatments either:
    • weren’t effective enough, or
    • caused side effects that were bothersome or severe

Note: Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth. (There is ongoing research about the risk of osteoporosis in people who are transgender. However, it’s not known how hormone or surgical transitions might affect osteoporosis risk. For more information, talk with your doctor.)

What happens with postmenopausal osteoporosis?

Osteoporosis is a condition that causes your bones to become weak and brittle. It can also cause your bones to fracture easily. Osteoporosis develops when bone is broken down more quickly than it’s rebuilt.

Throughout your life, your body breaks down old bone and forms new bone. This process of remodeling keeps your bones strong. Bone can also be broken down to release calcium into your bloodstream. (This can happen if you don’t get enough calcium in your diet.)

As you age, your body breaks down old bone more quickly than it forms new bone. This is especially true for females who’ve been through menopause. This is because estrogen (a female reproductive hormone) helps regulate bone breakdown and keep your bones strong. And as you go through menopause, your estrogen levels decrease. This decrease in estrogen can weaken your bones after menopause. And this can eventually lead to osteoporosis.

For details about this condition, you can refer to this list of osteoporosis articles.

What Evenity does

Evenity works to increase the formation of new bone and slow the breakdown of old bone. It can be given to certain females who have a high risk of fracturing a bone.

With osteoporosis after menopause, you have a high risk for fracture if you:

Evenity works to strengthen your bones by increasing your BMD. And having higher BMD lowers your risk for fracture. (See “How Evenity works” below for details.)

BMD is a measurement of how strong your bones are. It’s measured using a test called a DEXA scan. The result of this test is called your T-score.

The lower your T-score, the lower your BMD and the higher your risk for fracture. According to the National Institutes of Health (NIH), a T-score of -2.5 or lower means that you have osteoporosis. Evenity is approved for use in certain females with a T-score of -2.5 or lower. The drug works to increase your T-score, which can lower your risk for fracture.

Effectiveness for postmenopausal osteoporosis

Evenity has been shown to be effective in lowering fracture rates and increasing BMD.

In clinical trials, people who received Evenity had fewer spinal fractures after 12 months than people who received a placebo (a treatment with no active drug ).

In another trial, people who took Evenity had fewer fractures and higher BMD after treatment than people who took a different osteoporosis drug called alendronate (Fosamax, Binosto).

Evenity and children

Evenity is not approved for use in children. It’s only approved for use in certain females who’ve been through menopause and have osteoporosis.

Taking Evenity can sometimes lower your calcium levels.* For this reason, your doctor will prescribe a daily calcium and vitamin D supplement for you to take with Evenity. Calcium and vitamin D are nutrients that help your body build and maintain strong bones.

If you have questions about taking calcium and vitamin D supplements while you’re taking Evenity, talk with your doctor.

* To learn more about low blood calcium levels and other side effects, see the “Evenity side effects” section above.

Evenity is administered by a healthcare professional as a subcutaneous injection. You’ll get Evenity injections at your doctor’s office or clinic.

For each monthly dose, you’ll have two injections. The second injection is given immediately after the first. The injections may be given into your abdomen, thigh, or upper arm. Within these areas of the body, each injection should be given at a different site.

Injections shouldn’t be given in areas of skin that have scars or stretch marks, or are tender, red, discolored, bruised, or hard.

When to take

Evenity is taken once every month for 12 months.

It’s important to keep your appointments with your doctor for your Evenity injections. To help make sure you don’t miss a dose, try setting a reminder for your appointments on your phone.

Evenity isn’t known to interact with alcohol. However, regularly drinking large amounts of alcohol can increase your risk of osteoporosis and fractures. Doing this can also worsen osteoporosis, which Evenity is used to treat.

Alcohol can affect how well your body absorbs calcium. This decreased absorption can lead to a lack of calcium, which can weaken your bones. (Calcium helps your body build and maintain strong bones.)

If you drink alcohol, talk with your doctor about how much may be safe for you to drink while taking Evenity.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Evenity and other medications

There aren’t any known medication interactions with Evenity. However, before taking Evenity, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you while taking Evenity, ask your doctor or pharmacist.

Evenity and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Evenity. But you should still check with your doctor or pharmacist before using any of these products while taking Evenity.

Evenity and foods

There aren’t any foods that have been specifically reported to interact with Evenity. If you have any questions about eating certain foods with Evenity, talk with your doctor.

Evenity is used to treat osteoporosis after menopause. It works to rebuild bone and slow bone breakdown.

How are bones formed and maintained?

Throughout your life, your body breaks down old bone and replaces it with new bone. This process of remodeling keeps your bones strong. It also helps maintain the required amount of calcium in your blood.

Specifically, cells called osteoclasts break down old bone, and cells called osteoblasts form new bone. Osteoclasts can also break down bone to release calcium into your bloodstream. This can happen if you don’t get enough calcium in your diet. (Calcium is a nutrient that helps your body build and maintain strong bones.)

What happens with postmenopausal osteoporosis?

As you age, your body forms new bone more slowly. As a result, forming new bone may take longer than breaking down old bone. This imbalance can lead to a loss of bone mineral density (BMD). BMD is a measurement of how strong your bones are.

When you lose BMD, the hard outer layer of your bones may become thin. The spaces inside of your bones may also become larger. These changes can make your bones weaker, and this can lead to osteoporosis.

Females* who’ve gone through menopause have a higher risk of osteoporosis. This is because estrogen (a female reproductive hormone) helps regulate bone breakdown and keep your bones strong. And as you go through menopause, your estrogen levels decrease. This decrease in estrogen can weaken your bones. And this can eventually lead to osteoporosis.

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

What does Evenity do?

Evenity works to increase the formation of new bone and slow the breakdown of old bone.

Evenity is a type of drug called a monoclonal antibody. Monoclonal antibodies work on specific proteins in the body. Evenity works to block the function of a protein called sclerostin. Sclerostin helps regulate bone breakdown and repair in the body.

By keeping sclerostin from functioning properly, Evenity stimulates osteoblasts to form new bone. To a lesser extent, Evenity also works to stop osteoclasts from breaking down old bone. As a result, Evenity can increase your BMD. This increases the strength of your bones, both inside and out. Having higher BMD also makes your bones less likely to fracture.

How long does it take to work?

Evenity starts working to treat osteoporosis within about 2 weeks after your first injections. However, it takes longer than this for Evenity to strengthen your bones. You’ll need to take Evenity for 12 months for the drug to be most effective.

It’s unlikely that you’ll notice Evenity working, because it works over time to strengthen your bones. To make sure that the drug is treating your osteoporosis, your doctor may check your BMD. BMD is checked with a test called a DEXA scan, which is similar to an X-ray.

It’s not known if Evenity is safe to take during pregnancy. However, Evenity is only approved for use in females* who’ve gone through menopause, meaning that they can no longer become pregnant.

Evenity hasn’t been studied in pregnant females. But in animal studies, Evenity caused congenital anomalies (commonly known as birth defects) when given to pregnant animals. However, animal studies don’t always predict what will happen in humans.

If you’re pregnant or planning to become pregnant and you have osteoporosis, talk with your doctor about your treatment options. And if you’re taking Evenity and become pregnant or think you could be pregnant, contact your doctor right away.

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

It’s not known if Evenity is safe to take during pregnancy. But the drug is only approved for use in certain females* who’ve gone through menopause, which means that they can no longer get pregnant. Talk with your doctor if you have questions about your birth control needs while you’re taking Evenity.

For more information about taking Evenity during pregnancy, see the “Evenity and pregnancy” section above.

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

It’s not known if Evenity is safe to use while breastfeeding. But keep in mind that the drug is only approved for use in certain females* who’ve gone through menopause. So, it’s not likely that someone using this drug would be breastfeeding.

Although Evenity hasn’t been studied in females who are breastfeeding, in animal studies, Evenity has been shown to pass into breast milk. The drug’s potential effects on children who are breastfed aren’t known. Keep in mind that animal studies don’t always predict what will happen in humans.

If you’re breastfeeding, talk with your doctor about your treatment options for osteoporosis.

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

Here are answers to some frequently asked questions about Evenity.

Can I use Evenity if I have kidney problems?

Yes, you typically can. But if you have severe kidney problems (such as kidney failure that requires dialysis), you’re more likely to have hypocalcemia while taking Evenity. Hypocalcemia refers to low blood calcium levels. Calcium is a mineral that helps your body build and maintain strong bones.

If you have kidney problems, you may have frequent blood tests to check your calcium levels while you take Evenity. And to help prevent hypocalcemia, Evenity should be taken with a daily calcium and vitamin D supplement. (Vitamin D helps your body absorb calcium.) Be sure to take your supplement as prescribed your doctor.

For more information about hypocalcemia while taking Evenity, see the “Evenity side effects” section above.

Is it safe to have dental procedures while I’m taking Evenity?

It depends.

Rarely, Evenity can cause a severe side effect called osteonecrosis of the jaw. This is a serious condition in which bone cells in your jawbone die, causing damage to the jawbone. And having invasive dental procedures (such as dental surgery or tooth extraction) while taking Evenity increases your risk for this side effect. But having less invasive procedures (such as scaling and polishing) may not increase your risk for osteonecrosis of the jaw.

You should have a dental checkup before you start treatment with Evenity. That way, if you need any invasive dental work, it can be completed before you start Evenity. And if you need any dental work during Evenity treatment, be sure to tell your dentist that you’re taking Evenity.

Also, keep in mind that having gum disease or infections in your mouth can also increase your risk of osteonecrosis of the jaw with Evenity. So, it’s important to practice good oral hygiene while you’re taking Evenity. To do this, brush and floss your teeth regularly. And use mouthwash as recommended by your dentist.

Can Evenity be used by males with osteoporosis?

Prolia could be prescribed by a doctor for use in males* with osteoporosis. This would be an off-label use of the drug. Off-label drug use is when a drug that’s approved by the Food and Drug Administration (FDA) is prescribed for a purpose other than what it’s approved for. In some countries with approval from organizations other than the FDA, Evenity is approved for use in males.

Evenity is currently only FDA-approved to treat osteoporosis in certain females* who’ve been through menopause. But a 2018 clinical study found that Evenity’s active drug, romosozumab-aqqg, may also be effective in treating osteoporosis in males.

This study looked at bone mineral density (BMD), which is a measurement of how strong your bones are. In males who took romosozumab-aqqg, BMD in the spine and hip increased more than it did in males who took a placebo. (A placebo is a treatment with no active drug.)

Note: This 2018 study didn’t look at whether Evenity’s active drug reduced fracture rates in males with osteoporosis.

If you’re a male with osteoporosis and you’re interested in taking Evenity, talk with your doctor about your treatment options.

* Sex and gender exist on spectrums. Use of the terms “male” and “female” in this article refers to sex assigned at birth. (There is ongoing research about the risk of osteoporosis in people who are transgender. However, it’s not known how hormone or surgical transitions might affect osteoporosis risk. For more information, talk with your doctor.)

Is Evenity a long-term treatment?

Evenity is meant to be used for 12 months, and no longer than 12 months. This is because after 12 months, Evenity becomes less effective at helping your body build new bone.

If you still need treatment for osteoporosis after you stop taking Evenity, your doctor will likely prescribe a different drug.

Why do I need to take calcium and vitamin D supplements with Evenity?

Calcium and vitamin D are minerals that help your body build and maintain strong bones. Evenity also works to strengthen your bones. But the drug can sometimes cause hypocalcemia (low blood calcium levels). So, taking a daily calcium and vitamin D supplement helps prevent your calcium levels from getting too low. (Vitamin D helps your body absorb calcium.)

Make sure to take your supplements as prescribed by your doctor while you’re taking Evenity.

How do I know if I have a high risk for fracture with osteoporosis?

Evenity is given to certain females* who’ve gone through menopause. Specifically, it’s approved for use in females who’ve tried and stopped other osteoporosis treatments or have a high risk of fracture.

With osteoporosis after menopause, you have a high risk for fracturing a bone if you:

  • have had a fracture in the past
  • are of an older age
  • have a high risk of falling
  • are taking corticosteroid drugs, such as prednisone (Rayos)
  • have very low bone mineral density (BMD)

BMD is a measurement of how strong your bones are. It’s measured using a test called a DEXA scan. The result of this test is called your T-score. The lower your T-score, the lower your BMD and the higher your risk for fracture. If your T-score is -2.5 or lower, you have osteoporosis. Evenity works to increase your T-score, which can lower your risk for fracture.

If you have questions about your risk for fracturing a bone, talk with your doctor.

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

This drug comes with several precautions.

FDA warnings

This drug has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Risk of heart attack, stroke, and cardiovascular death: Evenity can increase your risk for heart attack and stroke. It can also increase your risk for death due to a cardiovascular (heart or blood vessel) problem. Don’t take Evenity if you’ve had a heart attack or stroke during the past year.

For more information about this boxed warning, see the “Evenity side effects” section above.

Other precautions

Before taking Evenity, talk with your doctor about your health history. Evenity may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Allergic reaction. If you’ve had an allergic reaction to Evenity or any of its ingredients, your doctor will not prescribe Evenity. Ask your doctor what other medications may be better options for you.
  • Hypocalcemia (low blood calcium levels). Evenity can lower the level of calcium in your blood. If you already have low calcium levels, you’ll need treatment to correct this before you start taking Evenity.
  • Severe kidney problems. If you have severe kidney problems (such as if you’re having dialysis for kidney failure), you’re more likely to develop hypocalcemia while taking Evenity. If you have severe kidney problems and are taking Evenity, take a daily calcium and vitamin D supplement, as prescribed your doctor. You’ll have frequent blood tests to check your calcium levels during Evenity treatment.
  • Dental problems or upcoming dental work. Evenity can sometimes cause a side effect called osteonecrosis (death of bone tissue) in the jaw. Your risk for this side effect increases if you have gum disease or infections in your mouth. Your risk also increases if you have invasive dental procedures, such as dental surgery or tooth extraction, while taking Evenity. If you need any dental work during Evenity treatment, be sure to tell your dentist that you’re taking Evenity. Also be sure to get a dental checkup before starting Evenity. For more information, see “Common questions about Evenity” above.
  • Pregnancy. Evenity should not be taken during pregnancy. For more information, see the “Evenity and pregnancy” section above.
  • Breastfeeding. Evenity should not be taken while breastfeeding. For more information, see the “Evenity and breastfeeding” section above.

Note: For more information about the potential negative effects of Evenity, see the “Evenity side effects” section above.

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.