Evenity (Romosozumab-Aqqg) for Osteoporosis After Menopause

Evenity (romosozumab-aqqg) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat osteoporosis in women after menopause who are at high risk of breaking a bone.

Bone loss speeds up in the years around menopause as estrogen levels drop, which is why osteoporosis becomes more common after menopause. Evenity is one of the treatments for people who already have osteoporosis and a high chance of fracture.

Evenity is only for women who have finished menopause. It is not approved for people in perimenopause or anyone who can still become pregnant.

How Evenity Works and How It’s Taken

Evenity is a type of medicine called a sclerostin inhibitor. It blocks sclerostin, a protein that helps control how bone is formed and broken down. Evenity helps the body make more new bone and also slows bone breakdown.

Doctors prescribe Evenity for people after menopause who have osteoporosis and are at high risk of breaking a bone. This includes women who:

Have had an osteoporosis-related fracture
Have several fracture risk factors
Could not tolerate other available osteoporosis treatments
Did not respond well to other available osteoporosis treatments

Evenity treats osteoporosis that has already developed. It is different from treatments used to prevent bone loss. For example, hormone therapy is FDA-approved to help prevent osteoporosis after menopause. Ask your doctor which approach fits your bone health and fracture risk.

Evenity is given by a healthcare provider as an injection under the skin. The injections can be given in the abdomen, thigh, or upper arm.

Typical Dosing for Osteoporosis

The recommended dose of Evenity is 210 milligrams once every month for 12 monthly doses. Each full dose is given as two separate injections, one after the other.

Treatment is limited to 12 monthly doses because the bone-building effect of Evenity decreases after this time. Calcium and vitamin D are also taken while receiving Evenity, as directed by your healthcare provider.

After the 12 doses, most people switch to another osteoporosis medicine, such as alendronate or denosumab, to help keep the bone they gained. Ask your doctor about the plan for after Evenity before you start.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Evenity Side Effects

In clinical studies of Evenity, the most common side effects occurred in about 5 percent to 13 percent of people. These include:

Joint pain
Headache

Serious Side Effects and Warnings

Evenity has a boxed warning, the FDA’s most serious type of warning, for heart attack, stroke, and death from heart or blood vessel problems.

Evenity can cause serious side effects that may require immediate medical attention. These include:

Heart attack, stroke, or cardiovascular death — Evenity may increase the risk of these heart and blood vessel events. This is the risk covered by the boxed warning.
Serious allergic reactions — These reactions can include rash, hives, and swelling of the face, lips, mouth, tongue, or throat.
Hypocalcemia — Blood calcium levels can drop and may cause muscle spasms or cramps or numbness or tingling.
Osteonecrosis of the jaw — Severe jaw bone problems can happen after dental problems or dental procedures.
Atypical femur fracture — An unusual thigh bone fracture can cause new or unusual hip, groin, or thigh pain.

Get medical help right away if you think you are having a serious reaction.

How To Save on Evenity

Amgen Inc, the manufacturer of Evenity, offers the Amgen SupportPlus Co-Pay Program. Eligible people with commercial insurance may pay as little as $0 out of pocket per dose.

The Amgen SupportPlus Co-Pay Program also offers a copay card that can be applied to the deductible, coinsurance, and copayment.

To learn more, visit the Amgen SupportPlus Co-Pay Program website or call 866-264-2778.

What To Know Before Taking Evenity

Before starting Evenity, your doctor will check your blood calcium level. If it is low, it must be treated and corrected before you receive Evenity.

Before receiving Evenity, tell your doctor if you:

Have had a heart attack or stroke, especially in the past year
Have a history of other heart or blood vessel problems
Have low blood calcium
Cannot take calcium and vitamin D every day
Have kidney problems or receive kidney dialysis
Plan to have dental surgery or teeth removed

Take good care of your teeth and gums while receiving Evenity. Tell your dentist that you are receiving Evenity before you have dental work.

Tell your doctor if you have any allergies to romosozumab-aqqg or any ingredients in Evenity.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Do not take Evenity if you:

Have low blood calcium
Are allergic to romosozumab or any of the ingredients in Evenity

If you miss a dose of Evenity, contact your doctor as soon as possible to reschedule it. After that, your next dose can be scheduled every month from the date of your last dose.

Community FAQs

These answers are fact-checked by our editorial staff.

Can I take Evenity during perimenopause?

No. Evenity is approved only for people who have gone through menopause. It is not indicated for anyone who can still become pregnant, which includes people in perimenopause. If you’re concerned about bone loss during perimenopause, ask your doctor about bone density testing and ways to protect your bones.

How effective is Evenity for osteoporosis?

In a study of women after menopause with osteoporosis, 0.5 percent of women who received Evenity had a new spinal fracture by month 12, compared with 1.8 percent of women who received placebo. This was a 73 percent relative reduction in risk.

At month 12, Evenity also increased bone mineral density compared with placebo. The treatment differences were 12.7 percent at the lower spine, 5.8 percent at the total hip, and 5.2 percent at the femoral neck, which is the upper part of the thigh bone near the hip.

In another study of women at high risk of fracture, 9.7 percent of women who received Evenity followed by another osteoporosis medicine called alendronate had a clinical fracture, compared with 13.0 percent of women who received alendronate alone. The median follow-up was 33 months.

Evenity followed by alendronate also lowered the risk of fractures outside the spine compared with alendronate alone.

How long does Evenity take to work for osteoporosis?

Clinical studies measured important benefits of Evenity at month 12. In one study, women who received Evenity had fewer new spinal fractures by month 12 than women who received placebo. This benefit remained through month 24 after they switched to denosumab.

Evenity also increased bone mineral density by month 12. Its bone-building effect decreases after 12 monthly doses, so treatment with Evenity is limited to 12 monthly doses.

Can Evenity cause heart-related problems?

Yes. Evenity has a boxed warning because it may increase the risk of heart attack, stroke, and death from heart or blood vessel problems.

Evenity should not be started if you had a heart attack or stroke within the past year. If you have a heart attack or stroke while receiving Evenity, treatment should be stopped.

Get medical help right away if you have symptoms such as: