Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
RANK Ligand Inhibitor (Anti-resorptive)

Denosumab

Brand names: Prolia (osteoporosis 60mg), Xgeva (oncology 120mg)

Used in: Osteoporosis

Denosumab is a monoclonal antibody given by subcutaneous injection (typically every 6 months) to treat osteoporosis and reduce fracture risk; higher-dose regimens are used in cancer-related bone disease.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Pregnancy must be ruled out prior to administration of Stoboclo. ( 2.1 ) Before initiating Stoboclo in patients with advanced chronic kidney disease, including dialysis patients, evaluate for the presence of chronic kidney disease mineral and bone disorder with intact parathyroid hormone, serum calcium, 25(OH) vitamin D, and 1,25(OH) 2 vitamin D. ( 2.2 , 5.1 , 8.6 ) Stoboclo should be administered by a healthcare provider. ( 2.3 ) Administer 60 mg every 6 months as a subcutaneous injection in the upper arm, upper thigh, or abdomen. ( 2.3 ) Instruct patients to take calcium 1000 mg daily and at least 400 IU vitamin D daily. ( 2.3 ) 2.1 Pregnancy Testing Prior to Initiation of Stoboclo …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2026-02-05. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It binds RANK ligand, inhibiting osteoclast formation and activity and so reducing bone resorption.

Prescribing in practice

  • Correct hypocalcaemia and ensure adequate calcium and vitamin D before and during treatment — check calcium before each dose, especially in renal impairment.
  • Stopping or delaying doses without follow-on bone therapy risks a rebound in bone turnover and multiple vertebral fractures — doses must be given on time and not simply stopped.
  • Osteonecrosis of the jaw and atypical femoral fractures can occur; a dental check before starting is advised.

Monitoring

Check calcium (and vitamin D) before each dose; plan continuation/transition therapy if it is to be stopped; review dental health.

Counselling the patient

  • It is an injection roughly every six months — keep to the schedule and do not stop without a plan.
  • Take your calcium and vitamin D as advised.
  • Report new thigh/groin pain or dental problems, or symptoms of low calcium (tingling, muscle cramps).

Evidence & guidelines

Recommended for osteoporosis fracture prevention (NICE TA204), with important cautions on hypocalcaemia and rebound fractures if stopped.

Reference: NICE TA204; FREEDOM Trial (NEJM 2009); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways