Key points
What is this drug and how does it work?
Denosumab blocks the cells that break down bone. When cancer has spread to the bone, this lowers the risk of fractures, pressure on the spinal cord and the need for radiotherapy to the bone [1].
For physicians
A human anti-RANKL antibody; inhibits osteoclast formation, function and survival [1].
Which cancers is it used for?
For physicians
| Disease | Use | Key evidence |
|---|---|---|
| Bone metastases from solid tumours and myeloma | Prevention of skeletal-related events [1] | In breast cancer, delayed time to first skeletal-related event by 18% compared with zoledronic acid [2] |
| Hypercalcaemia of malignancy refractory to bisphosphonates | [1] | — |
| Giant cell tumour of bone | [1] | — |
How it is taken and dosing
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One injection under the skin of the upper arm, thigh or abdomen every 4 weeks at the clinic. Take calcium and vitamin D every day as your doctor directs, unless your blood calcium is high [1].
For physicians
Standard dosing (FDA label)
Denosumab
Bone metastases and myelomaCycle length: Every 4 weeks
Bone metastases and myeloma
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Denosumab | 120 mg | Subcutaneous | Every 4 weeks |
Giant cell tumour and hypercalcaemia: 120 mg every 4 weeks with additional doses on days 8 and 15 of the first month. Calcium and vitamin D supplements; correct baseline calcium before starting [1].
Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.
Side effects
The most common side effects: tiredness, weakness, low blood phosphate and calcium, nausea, diarrhoea and shortness of breath [1].
For physicians
Common adverse reactions in solid tumours: fatigue/asthenia, hypophosphataemia, nausea; in myeloma: diarrhoea, nausea, anaemia, back pain, thrombocytopenia [1].
Serious side effects
For physicians
When should I call my doctor?
- Tingling around the mouth or in the fingers, muscle cramps (low calcium)
- Pain, swelling or a sore in the jaw or gums, a loose tooth
- New pain in the thigh or groin
Interactions, pregnancy and precautions
- Teeth: have a dental check before starting; tell your doctor if you need a tooth taken out [3].
- Stopping the drug: do not stop without a plan from your doctor; after stopping, the risk of spinal fractures goes up [1].
- Pregnancy: this drug may harm an unborn baby; use effective contraception during treatment and tell your doctor straight away if you become pregnant. Do not breastfeed during treatment [1].
Frequently asked questions
What is the difference between Xgeva and Prolia?
Both are denosumab, but Xgeva (120 mg every month) is for cancer and Prolia (60 mg every 6 months) is for osteoporosis [1].
Related cancer types
References
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Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1
- 2
- 3
This page is based on reputable scientific sources and was last updated on 27 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
Printed from the website; the full and up-to-date version: https://drdabiri.com/en/drugs/denosumab/