Denosumab Injection (Prolia)Treatment For Osteoporosis

What is osteoporosis?

• Osteoporosis is a thinning and weakening of the bones, which is common in women after the menopause. The earlier a woman reaches the menopause, the greater her risk of breaking bones due to osteoporosis.
• A broken bone following a simple fall after the age of 50 may be a sign of osteoporosis.
• Men with low testosterone levels are at an increased risk of developing osteoporosis.
• Many people with osteoporosis have no symptoms.

Why am I having this treatment?

• Denosumab makes bones stronger and less likely to break.
• Denosumab is prescribed to treat your osteoporosis as you have an increased risk of fractures.

What is Denosumab?

It is used to treat osteoporosis in postmenopausal women and in men at increased risk of fractures. Denosumab is administered once every 6 months, as a single injection under the skin into the thigh, abdomen or upper arm.

Who carries out this treatment?

The specialist nurse in endocrinology is responsible for carrying out this treatment.

Denosumab treatment may be delayed/not used if you have any of the following health issues:

• if you have or have had low calcium levels in the past, the doctor may wish to give you calcium supplements prior to commencement of the treatment.
• if you have or have ever had kidney problems, kidney failure or have needed dialysis, or if you have any other disease that may affect your kidneys.
• if you have vitamin D deficiency, this may need to be treated before you receive Denosumab. The doctor or the endocrine specialist nurse will make this decision and arrange for treatment if required.
• if you are undergoing or may require dental treatment, your dentist will need to be informed that you are going to be treated with Denosumab. Before you receive this treatment tell your doctor or dentist if you have, or have had pain, swelling or numbness in your gums, jaw or both, if your jaw feels heavy, or if you have recently lost a tooth.

Where is the treatment carried out?

You will be sent a letter with the details of the treatment and which department that you will need to attend at the Bradford Royal Infirmary. You can bring someone with you to this appointment if you wish.

What happens before the treatment?

• The endocrine specialist nurse will contact you asking for details of your dentist and other relevant information regarding your dental care.
• Before your appointment, a letter will be sent to your GP and dentist advising them of your forthcoming treatment. If you are undergoing or may require dental treatment, it may be wise to have your dental work before you start Denosumab.
• You should have a blood test on receipt of your appointment letter. The endocrine specialist nurse will advise you what tests are required and where you can have them taken.
• It is important to maintain good oral hygiene whilst being treated with Denosumab. It is recommended that a mouth wash should be used for 5 days before and 5 days after the treatment. You can buy this from any supermarket or chemist.
• You may eat and drink as normal.
• You may take all your medication as usual.

What happens during the treatment?

• You will meet the endocrine specialist nurse who is in charge of the treatment on your arrival on the department. The nurse will explain all about the treatment. You will be given the opportunity to ask questions prior to you giving consent for this procedure.
• Denosumab will be administered as a single injection under the skin into the upper arm, thigh or abdomen.

Are there any side effects?

• Like all medicines, Denosumab can cause side effects, although not everybody gets them.
• Very common side effects include: muscle pain.
• Common side effects include: skin irritation, urinary tract infection, upper respiratory tract infection, constipation and rash.
• Uncommon side effects include: cellulitis (skin infection).
• Rare side effects include: tingling and swelling of the face, lips and mouth.
• A very rare side effect is osteonecrosis of the jaw. This is a disease of the jawbone. If you get any problems with your teeth please see your dentist as soon as possible.
• A very rare side effect is osteonecrosis of the ear canal. If you get any ear problems following this treatment, please see your GP and inform the endocrine specialist nurse.
• Unusual fractures of the thigh bone may occur rarely. Contact your GP and inform the endocrine specialist nurse if you experience new or unusual pain in your hip, groin or thigh as this may be an early indication of a possible fracture of the thigh bone.

How long will the treatment take?

Please allow approximately 30 minutes.

What happens after the treatment?

• The endocrine specialist nurse will arrange an appointment in 6 months time for your next treatment.
• On completion of the treatment you will be safe to return home or to work alone.
• You may be asked to take calcium or vitamin D supplements while receiving Denosumab. If you are unable to do so, you should inform your doctor or the nurse.
• To get the most benefit from the treatment it is important to continue receiving the injections every 6 months for as long as your doctor says it is necessary.
• If you experience any of the side effects or if you notice any side effects not listed in this leaflet please tell your nurse or doctor/your dentist (if the side effect is related to your gums).

If you require more details please contact the Specialist Nurses in Endocrinology:
Tel: 01274 382019 Monday – Friday between 8.00am and 4.00pm except Bank Holidays