denosumab
denosumab
Pronunciation:
den-OH-sue-mab
Other Name(s):
Xgeva®, WyostTM
Appearance:
clear, colourless to slightly yellowish solution
This handout gives general information about this cancer medication.
You will learn:
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who to contact for help
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what the medication is
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how it is given
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what to expect while on medication
This handout was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.
This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.
My cancer health care provider is: _____________________________________________
During the day I should contact: _______________________________________________
Evenings, weekends and holidays: _____________________________________________
This page gives general information about this cancer medication.
You will learn:
-
who to contact for help
-
what the medication is
-
how it is given
-
what to expect while on this medication
This information was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.
This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.
Denosumab may:
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Help relieve bone pain and prevent broken bones in some types of cancer that arise from or spread to the bones
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Be used to treat giant cell tumour of bone in some patients
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Be used to remove excess calcium in the blood that is a problem with some types of cancer, if other treatments have not worked
Denosumab is available as a biosimilar medication. See our biosimilar pamphlet for more information.
Tell your health care team if you have or had significant medical condition(s), especially if you have / had:
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kidney problems,
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low calcium or vitamin D levels,
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any dental problems (including wearing dentures),
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any planned dental work, or
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any allergies.
If you take other medications (such as bisphosphonates or other denosumab products) for bone problems, talk to your health care team.
Tell your dentist that you are on denosumab.
Remember To:
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Tell your health care team about all of the other medications you are taking.
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Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
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This drug is given by injection under the skin, in the upper arm, upper thigh, or the abdomen.
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If your health care provider will be injecting the drug for you, ask about the drugs and supplies you will need to bring for your next visit.
To prevent your blood calcium level from going down while using this drug, your health care team may tell you to take calcium and vitamin D supplements. Do not take calcium or vitamin D if you have or had high calcium levels in the blood. Talk to your health care team before taking these supplements.
Rarely, some people may have jaw, teeth or mouth problems while using denosumab.
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DO look for teeth, mouth or jaw problems. You may have pain and swelling, poor healing of mouth sores, unusual discharge from gums, loosening of teeth, and the feeling of numbness or heaviness in the jaw.
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DO contact your health care team as soon as possible if you get any of these symptoms.
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DO check with your health care team before getting any dental procedures.
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DO maintain good dental hygiene and have regular checkups with your dentist, to prevent jaw problems.
- DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
- DO NOT stop using this drug without speaking to your doctor. There may be a higher risk of having broken bones in the spine after treatment ends, especially in people who have had bone thinning or broken bones.
Rarely, some people may have jaw, teeth or mouth problems while using denosumab.
-
DO look for teeth, mouth or jaw problems. You may have pain and swelling, poor healing of mouth sores, unusual discharge from gums, loosening of teeth, and the feeling of numbness or heaviness in the jaw.
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DO contact your health care team as soon as possible if you get any of these symptoms.
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DO check with your health care team before getting any dental procedures.
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DO maintain good dental hygiene and have regular checkups with your dentist, to prevent jaw problems.
- DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
- DO NOT stop using this drug without speaking to your doctor. There may be a higher risk of having broken bones in the spine after treatment ends, especially in people who have had bone thinning or broken bones.
Although this medication is unlikely to interact with other medications, vitamins, foods and natural health products, tell your health care team about all of your:
- prescription and over-the-counter (non-prescription) medications and all other drugs, such as cannabis/marijuana (medical or recreational)
- natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements
Check with your health care team before starting or stopping any of them.
Talk to your health care team about:
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How this treatment may affect your sexual health
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How this treatment may affect your ability to have a baby, if this applies to you
This treatment may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.
- If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until at least 5 months after your last treatment dose. Talk to your health care team about which birth control options are best for you.
- Do not breastfeed while on this treatment.
Keep in the refrigerator, but do not freeze. Keep out of sight and reach of children and pets.
Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
Before use, the medication vial (in its original container) can be brought to room temperature (usually takes 15-30 minutes). Once the drug is removed from the refrigerator, it must be kept at room temperature (up to 25°C) and used within 30 days. Do not warm the drug by other methods.
If you are receiving the injection at home, proper disposal of medication vials, needle covers, needles and syringes are very important. They should never be reused. These must always be disposed in a puncture-proof container. Ask your pharmacist for help on how to properly dispose of these items, including the filled container.
The following table lists side effects that have been seen in people using denosumab with other chemotherapy drugs, so some of these effects may also be related to chemotherapy. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.
Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on denosumab.
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Nausea and vomiting (Generally mild) May occur in hours to days after your treatment. If you have nausea or vomiting:
Also see Nausea & Vomiting pamphlet for more information. |
Contact your health care team if no improvement or if severe. | ||||
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Anemia (low red blood cells)
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Contact your health care team if no improvement or if severe. | ||||
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Fatigue (tiredness)
See our Fatigue pamphlet for more information. |
Contact your health care team if no improvement or if severe. | ||||
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Mild joint, muscle pain or cramps (common); headache (less common)
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Contact your health care team if no improvement or if severe. | ||||
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Low appetite
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Contact your health care team if no improvement or if severe. | ||||
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Constipation To help prevent constipation :
See the Constipation Pamphlet for more information. |
Contact your health care team if no improvement or if severe. | ||||
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Cough; feeling short of breath You may have cough and feel short of breath without any signs of infection, such as a sore throat or a stuffed nose. If you have chest pain, difficulty breathing or cough up blood, get emergency medical help right away. |
Contact your health care team if no improvement or if severe. | ||||
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Diarrhea May happen days to weeks after you get your treatment. If you have diarrhea :
See the Diarrhea pamphlet for more information. |
Contact your health care team if no improvement or if severe. | ||||
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Salt imbalances (may be severe) It may cause muscle twitching, severe weakness or cramping, confusion and irregular heartbeat. Rarely, some patients with giant cell tumour of the bone or with growing bones have developed high calcium levels in the blood, weeks to months after denosumab treatment ends. Your doctor may monitor your calcium levels after you stop treatment.
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Get emergency medical help right away. | ||||
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Flu-like symptoms You may feel like you have the flu for around 2 days after your denosumab treatment. These flu-like symptoms may not be signs of an infection. What to look for?
What to do?
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Contact your health care team if no improvement or if severe. | ||||
Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:
- Teeth, mouth or jaw pain and swelling, poor healing of mouth sores, unusual discharge from gums, loosening of teeth and the feeling of numbness or heaviness in the jaw.
- Severe pain in your back, hips, thighs, wrists or other bones that may be symptoms of broken bones
- Signs of a skin infection such as a swollen, red area on your skin that feels hot and tender, with or without fever
- Pain, swelling or hardening of a vein in your arm or leg
- Irregular heartbeat, fainting, swelling in your legs or belly
- Pain in your chest, belly or arm
- Sudden loss of vision, speech or the ability to use your arms or legs
- Signs of an allergy such as severe rash, swollen face, lip or tongue, chest or throat tightness
- Lower back pain, body swelling, passing little or no pee, yellow skin, eyes or recent weight gain
- Yellowish skin or eyes, unusually dark pee or pain on the right side of your belly
For more information on how to manage your symptoms ask your health care provider, or visit: https://www.cancercareontario.ca/symptoms.
October 2024 Updated "Other medications you may be given with this treatment" section
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.