What is Evenity (Romosozumab)?
Evenity, also known by its generic name Romosozumab, is a prescription medicine used for the treatment of osteoporosis in postmenopausal women who are at high risk of fracture. Osteoporosis weakens bones and makes them fragile, leading to a higher chance of fractures.
This medicine is different from traditional osteoporosis drugs because it works in two ways:
- It builds new bone.
- It reduces bone breakdown.
That’s why doctors often recommend Evenity for women who have already had a fracture or are at high risk of fractures.
Table of Contents
How Does Evenity Work in Osteoporosis?
Role of Romosozumab in Bone Formation
Romosozumab belongs to a class of medicines called monoclonal antibodies. It works by blocking a protein called sclerostin, which normally slows down bone formation. By blocking sclerostin, Evenity allows bones to grow stronger and denser.
FDA Approval of Evenity in 2019
The U.S. Food and Drug Administration (FDA) approved Evenity in April 2019 for treating osteoporosis in postmenopausal women at high risk of fracture. Since then, it has become an important treatment option for women who need stronger and faster bone protection.
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Uses of Evenity Injection
Evenity (Romosozumab) is mainly prescribed for postmenopausal women with osteoporosis who are at a very high risk of fractures. Here’s where it is most useful:
Osteoporosis Treatment in Postmenopausal Women
After menopause, women’s estrogen levels drop, which leads to bone loss. This can result in osteoporosis, a condition where bones become weak and brittle. Evenity is given to:
- Women with a history of osteoporosis-related fractures.
- Women who have multiple risk factors for fracture.
- Women who failed or couldn’t tolerate other osteoporosis treatments.
Fracture Prevention Benefits
The biggest benefit of Evenity is its dual-action mechanism:
- It helps form new bone tissue.
- It reduces bone resorption (breakdown).
This makes bones stronger and significantly reduces the chance of fractures in areas like:
- Spine (vertebral fractures)
- Hip fractures
- Non-vertebral fractures (wrist, arm, leg)
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Dosage and Administration of Evenity
Standard Dosage Guidelines
- Dosage: The recommended dose is 210 mg once a month.
- Form: It is given as two consecutive injections of 105 mg each.
- Route: Administered under the skin (subcutaneous injection), usually in the abdomen, thigh, or upper arm.
Duration of Treatment
- Treatment duration is 12 months only.
- After 12 months, patients are usually switched to a different anti-resorptive medication such as Prolia (denosumab) or bisphosphonates like Fosamax (alendronate).
- This switch is important because Evenity’s effects wear off if not followed by another treatment.
Side Effects of Evenity
Like every medicine, Evenity has both common and serious side effects.
Common Side Effects
- Joint pain
- Headache
- Muscle pain
- Injection site redness or swelling
- Cold or flu-like symptoms
These side effects are generally mild and temporary.
Serious Side Effects & Risks
- Heart attack and stroke risk: Patients with a history of heart problems should be cautious.
- Severe allergic reactions: Rash, itching, or swelling may occur.
- Low calcium levels (hypocalcemia): Can be dangerous if untreated.
- Jaw bone problems (osteonecrosis of the jaw): Very rare but possible.
- Patients must report chest pain, shortness of breath, or severe allergic reactions immediately.
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Warnings and Precautions
Heart-related Risks
The FDA has warned that Evenity may increase the risk of heart attack, stroke, or cardiovascular death. That’s why it is not recommended for patients who:
- Had a heart attack or stroke in the past year.
- Have uncontrolled cardiovascular conditions.
Who Should Avoid Evenity?
- Pregnant or breastfeeding women.
- Patients with low blood calcium (hypocalcemia).
- Patients with serious dental/jaw problems.
- People allergic to Romosozumab or its ingredients.
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Evenity vs Prolia vs Fosamax
One of the most common questions patients ask is: “How does Evenity compare to Prolia and Fosamax?”
Comparison Table
| Feature | Evenity (Romosozumab) | Prolia (Denosumab) | Fosamax (Alendronate) |
|---|---|---|---|
| Type | Monoclonal antibody (dual action: builds bone + reduces breakdown) | Monoclonal antibody (reduces bone breakdown) | Bisphosphonate (slows bone breakdown) |
| Dosage | Monthly injection (210 mg) | Every 6 months injection | Weekly oral tablet |
| Duration | 12 months max | Long-term (as prescribed) | Long-term (as prescribed) |
| Main Use | High-risk postmenopausal osteoporosis | Postmenopausal osteoporosis | Osteoporosis prevention & treatment |
| Fracture Protection | Stronger bone formation + fracture prevention | Prevents fractures (but no bone building) | Prevents fractures but weaker compared to newer drugs |
| Side Effects | Possible heart risks, injection site pain | Muscle/joint pain, risk of low calcium | Stomach issues, acid reflux, jaw bone risk |
| Cost | High | Moderate | Low |
Cost of Evenity Injection
The cost of Evenity (Romosozumab) can be a big concern for patients. Since it’s a biologic medicine and relatively new, the price is quite high compared to traditional osteoporosis drugs.
Price in the USA
- The average cost of one monthly dose of Evenity (210 mg) is around $1,800–$2,000.
- Since the treatment lasts 12 months, the total annual cost can reach up to $21,000–$24,000.
- Insurance coverage varies. Many patients may get partial coverage if prescribed by their doctor for high-risk osteoporosis.
Global Price Range
- Canada & UK: Prices are lower, ranging between $1,200–$1,500 per dose.
- India & Asia: Availability is limited, but cost may range from ₹80,000–₹1,20,000 per month, depending on hospital and supplier.
- Europe: Around €1,400–€1,800 per dose.
