Prolia
(Denosumab SQ)
Provider Summary
Primary Uses
Osteoporosis and bone loss indications in adults per label/payer criteria.
Mechanism of action
RANKL inhibitor decreases osteoclast formation/function, reducing bone resorption.
Pre-treatment / baseline requirement
Baseline calcium/vitamin D; correct hypocalcemia; consider renal function; dental evaluation for ONJ risk; pregnancy avoidance (contraindicated in pregnancy).
Common side effects
Musculoskeletal pain, hypercholesterolemia, injection site reactions.
Serious adverse effects / key risks
Severe hypocalcemia (risk higher in CKD), serious infections, dermatologic reactions, osteonecrosis of the jaw, atypical femur fracture, rebound vertebral fractures if stopped without alternative therapy.
Referral requirements
Standard infusion referral form + drug-specific checklist
Discontinuation planning
Do not stop or delay doses without an alternative osteoporosis plan; discontinuation can be associated with rapid bone loss and rebound vertebral fractures.
Patient & Caregiver Education
What it treats
Osteoporosis and bone loss indications in adults
How it works
Blocks RANKL to slow bone breakdown.
Before treatment
Tell your clinician if you have an active infection/fever, are pregnant/planning pregnancy, or have major heart/nerve problems. Depending on the medication, you may need labs or screening tests (e.g., TB/hepatitis) and a vaccine review.
Common side effects
Musculoskeletal pain, hypercholesterolemia, injection site reactions.
Get urgent help for
Severe hypocalcemia, serious infections, dermatologic reactions, osteonecrosis of the jaw, atypical femur fracture, rebound vertebral fractures if stopped without alternative therapy.
On treatment day
Plan to stay for monitoring. If you feel dizzy, drowsy, or unwell afterward, do not drive and follow your clinician’s instructions.