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There is yet another new medication on the market to treat osteoporosis. The new injectable medication is called Prolia (denosumab). Prolia is a subcutaneous injection given just under the skin every 6 months. It is indicated for postmenopausal women who are at a high risk of bone fracture or patients who have failed other osteoporosis medications.
This medication decreases bone loss by decreasing bone breakdown in the body. Studies show it works about as well as Fosamax (alendronate) or Reclast (zoledronic acid) to decrease the risk of fracture. However, Prolia is associated with a higher risk of infections than these other two drugs. Prolia is also more expensive compared to its competition and may not be covered by insurance.
Prolia may be a good option for people who can’t tolerate other osteoporosis meds. Patients who take Prolia should take 1000mg of calcium and at least 400 IU of vitamin D daily.
People taking Prolia should immediately report any signs of infection including fever, rashes or changes in urinary habits. Like other osteoporosis meds, Prolia can also increase the risk of jaw osteonecrosis. This is a rare side effect where the bones of the jaw start to deteriorate. Other side effects include back pain, high cholesterol and possible pancreatitis. Skin rash and eczema have also been reported.
Expect drug manufacturer reps to be marketing this medication heavily to your physician. This means your physician may be more inclined to recommend the medication. Make sure your physician presents all of the options for osteoporosis treatment to you and is willing to work with you when deciding which medication will ultimately be right for you based on effectiveness, cost and convenience.
Author: Christi Larson, Pharm. D.
Dr. Larson is a pharmacist, author of Empowered Medicine; A Guide for Consumers and creator of Empowered Medicine. You can read more about her by visiting www.EmpoweredMedicine.com and clicking on the 'About Us' tab. EmpoweredMedicine.com is committed to providing evidence-based medical information from a pharmacist's point of view.
References
1. Product information for Prolia. Amgen Manufacturing Limited, a subsidiary of Amgen Inc. Thousand Oaks, CA 91320-1799. June 2010.
2. Cummings SR, San Martin J, McClung MR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 2009;361:756-65
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