EVENITY Injection: Uses, Dosing, Safety, and Cost
EVENITY Injection: How It Works, Dosing, Safety & Cost
EVENITY (romosozumab) is a once‑monthly prescription injection for postmenopausal osteoporosis at high fracture risk. It builds new bone and slows bone loss over a 12‑month course. After treatment, patients typically switch to an antiresorptive therapy. It carries a boxed warning for increased risk of heart attack, stroke, and cardiovascular death, which must be discussed with your healthcare provider. Most patients also take calcium and vitamin D during treatment, and insurance or manufacturer programs may lower out‑of‑pocket costs.
Quick facts
- What it is: A sclerostin‑blocking monoclonal antibody that both builds bone and slows bone loss in postmenopausal osteoporosis at high fracture risk (EMA EPAR).
- Dosing: 210 mg once monthly (two 105 mg injections) for 12 months, given by a healthcare provider (FDA label).
- Supplements: Correct low calcium before starting; ensure daily calcium and vitamin D as directed by your clinician (ACR patient guide).
- Boxed warning: Increased risk of heart attack, stroke, and cardiovascular death. Do not start within 1 year of a heart attack or stroke; stop if one occurs (FDA label).
- Efficacy: In the 12‑month, placebo‑controlled FRAME study, EVENITY reduced new spine fractures by 73% (EVENITY patient brochure).
Note: This guide is informational and not medical advice. Always decide on treatment with your clinician.
How EVENITY Works: The Dual‑Action Mechanism
Your bones are constantly remodeling—old bone is cleared away while new bone is laid down. After menopause, breakdown can outpace building. EVENITY targets a protein called sclerostin, which acts like a brake on bone formation. By blocking sclerostin, EVENITY:
- Stimulates bone formation (an anabolic effect)
- Reduces bone resorption (a catabolic‑slowing effect)
This combined—or “dual”—action both builds and preserves bone, which helps strengthen the skeleton and lower fracture risk in appropriate patients (EMA EPAR). Effects begin quickly: changes in lab bone‑turnover markers can be detected within about two weeks of an injection (ACR patient guide).
Who is a Candidate for EVENITY?
EVENITY (romosozumab) is indicated for postmenopausal women with osteoporosis who are at high risk for fracture—for example, those with a prior osteoporotic fracture, multiple fracture risk factors, or intolerance/failure of other therapies. Treatment is limited to 12 monthly doses (FDA label).
Your clinician may use a tool like FRAX to estimate your personal fracture risk. Learn more in our guide to using the FRAX tool to assess fracture risk.
How effective is EVENITY?
| Outcome (FRAME study; vs placebo) | EVENITY | Placebo | Relative Difference |
|---|---|---|---|
| New spine fractures at 12 months | 0.5% | 1.8% | 73% relative reduction |
| Anatomic Site | BMD Change vs Placebo at 12 Months |
|---|---|
| Lumbar spine | +12.7% |
| Total hip | +5.8% |
| Femoral neck | +5.2% |
Sources: EVENITY patient brochure; EMA EPAR.
A course of EVENITY followed by an antiresorptive helps maintain gains and support fracture‑risk reduction in studied populations (EMA EPAR).
Dosing and administration
What to expect (based on official labeling and patient guidance):
- Dose: 210 mg subcutaneously once a month (two 105 mg injections at each visit) for 12 months (FDA label).
- Who gives it: A healthcare provider administers the injections in the abdomen, thigh, or upper arm (FDA label).
- Supplements: Correct low calcium before starting; most patients are advised to take approximately 1,000–1,200 mg of calcium and at least 400 IU of vitamin D daily, personalized by your clinician (ACR patient guide).
- After 12 months: Transition to an antiresorptive (such as a bisphosphonate or denosumab) to maintain bone density gains (FDA label).
To stay on track, consider scheduling all 12 monthly visits at once and planning your follow‑up therapy ahead of time. This helps ensure you complete the course and maintain your results.
Tracking Bone Density During EVENITY Treatment
In clinical care, providers often use periodic DEXA scans and other assessments to monitor osteoporosis treatment and adjust plans as needed (ACR patient guide). BodySpec’s DEXA scans are non‑diagnostic and are not a substitute for medical testing, but they can offer precise, repeatable BMD and body composition trend data. This data can help you have more informed conversations with your clinician about your progress. Learn more about bone density testing and DEXA scan timing and frequency.
Safety profile and monitoring
EVENITY has important risks and isn’t right for everyone. Review these with your clinician.
Serious warnings and contraindications
- Boxed cardiovascular warning: Increased risk of heart attack, stroke, and cardiovascular death. Do not initiate if you’ve had an MI or stroke within the past year; stop treatment if these occur (FDA label).
- Do not use if you have hypocalcemia (low calcium) or a known allergy to romosozumab. Correct low calcium before starting (FDA label).
Other important risks and precautions
- Osteonecrosis of the jaw (ONJ): A dental exam is recommended before starting; maintain good oral hygiene and inform your dentist you’re receiving romosozumab (FDA label).
- Atypical femoral fractures: Report new hip, thigh, or groin pain promptly (FDA label).
- Hypocalcemia: Risk is higher with severe kidney disease or dialysis; watch for muscle cramps or tingling and follow your provider’s plan (FDA label; ACR patient guide).
- Allergic reactions: Severe reactions including angioedema and hives can occur; seek urgent care for swelling or trouble breathing (Mayo Clinic).
Common side effects: Joint pain and headache are most common; injection‑site irritation may occur (FDA label).
Call your clinician urgently if you experience any signs of a serious reaction, such as chest pain, shortness of breath, sudden weakness or trouble speaking, vision changes, severe headache, new jaw pain, or symptoms of low calcium like muscle spasms or tingling (ACR patient guide).
Cost, insurance, and support programs
- Medicare Part B: After the deductible, Part B may cover 80% for drugs given in a doctor’s office; supplemental insurance may cover some or all of the remainder, and eligible patients may pay as little as $0 per dose (EVENITY patient brochure).
- Commercial insurance: Eligible patients may pay as little as $25 per dose through Amgen’s co‑pay program (criteria and limits apply) (EVENITY patient brochure).
- Uninsured/underinsured: The Amgen Safety Net Foundation may help eligible patients (EVENITY patient brochure).
Pro Tip: Ask your clinic whether they bill the medication under the medical benefit (Part B/buy‑and‑bill) or the pharmacy benefit (specialty pharmacy delivery). This distinction can significantly affect your out‑of‑pocket costs.
What to expect at monthly injection visits
- Two quick subcutaneous injections (abdomen, thigh, or upper arm) given back‑to‑back by a healthcare professional (FDA label).
- Check‑in on your plan: Your team may review symptoms, medications, dental work, and calcium/vitamin D intake; they may monitor labs if you have kidney disease or other risk factors (ACR patient guide).
To ensure treatment adherence, use calendar reminders for appointments. Weight‑bearing and resistance exercise can complement bone‑building therapy—confirm an exercise plan with your clinician. See our guide to strength training for bone density.
After 12 months: Maintaining bone density improvements
EVENITY’s bone‑building effect is time‑limited. The standard plan is to transition promptly to an antiresorptive medication after the 12th dose to maintain gains; delaying this step can allow BMD to drift back down (FDA label).
Practical checklist to start EVENITY
- Confirm you meet high‑risk criteria and discuss alternatives.
- Review cardiovascular history; do not start within 1 year of a heart attack or stroke.
- Correct low calcium; plan calcium and vitamin D intake.
- Schedule a dental exam; address planned extractions before treatment.
- Book all 12 monthly injection appointments.
- Set a reminder to select and schedule follow‑on antiresorptive therapy by month 10–11.
- Schedule regular DEXA scans with your provider to monitor your progress.
FAQs
Can I self‑inject EVENITY?
No. EVENITY is administered by a healthcare provider in the clinic (FDA label).
What are the most common side effects?
Joint pain and headache; injection‑site reactions can occur. Serious allergic reactions are rare but possible (FDA label).
Who should not take EVENITY?
People with hypocalcemia or a heart attack or stroke within the last year should not start. Those with severe kidney disease need closer monitoring for low calcium (FDA label).
How soon does it start working?
Lab markers can shift within about two weeks; fracture‑risk reduction is seen over months (ACR patient guide).
Will I need another medicine after EVENITY?
Typically, yes. Most treatment plans involve transitioning to an antiresorptive to maintain gains (FDA label).
How can I support bone health during treatment?
- Ensure adequate calcium and vitamin D intake (confirm targets with your clinician) (ACR patient guide).
- Do regular weight‑bearing and resistance exercise—see our strength training for bone density.
- Learn the basics of D and K vitamins: Vitamin D3 + K2 guide.
EVENITY can be a powerful, time‑limited boost for building stronger bones when the fracture risk is high. Understanding the 12‑month plan, safety profile, and follow‑up steps helps you and your care team make the most of treatment.
Interested in tracking your bone health between clinic visits? You can book a quick, low‑radiation BodySpec DEXA scan and share your results with your clinician for context. Book now.
