All About Evenity
If you have osteoporosis, your doctor may suggest treatment with Evenity. It’s a brand-name prescription drug used to treat osteoporosis in certain females* who’ve gone through menopause.
Specifically, Evenity is used for postmenopausal females who either:
- have a high risk for bone fractures
- can’t use other osteoporosis treatments or have used other treatments before that didn’t work well
* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Evenity basics
Evenity comes as a liquid solution inside prefilled syringes. It’s given as an injection under the skin. You’ll receive the injections at your doctor’s office.
The active ingredient in Evenity is romosozumab-aqqg.* (An active ingredient is what makes a drug work.) Evenity is a biologic medication, which means it’s made from parts of living organisms. Evenity is not available in a biosimilar form. (Biosimilars are like generic drugs. But generics are made for nonbiologic drugs, while biosimilars are made for biologic drugs.) Instead, romosozumab-aqqg comes only as the brand-name drug Evenity.
Keep reading to learn more about Evenity, including the drug’s side effects, dosage, cost, and more.
* The reason “-aqqg” appears at the end of the drug’s name is to show that the drug is distinct from similar medications that may be created in the future.
Like most drugs, Evenity may cause mild or serious side effects. The lists below describe some of the more common side effects it may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Evenity. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects Evenity can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Evenity’s prescribing information.
Mild side effects of Evenity that have been reported include:
- joint pain
- headache
- muscle spasms
- swelling in your hands, lower legs, or feet
- weakness
- neck pain
- insomnia (trouble sleeping)
- numbness, itching, or feeling as if your skin is crawling, typically in your arms, hands, legs, or feet
- injection site reactions, such as pain or skin discoloration
- mild allergic reaction*
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
* To learn more about this side effect, see the “Allergic reaction” section below.
Serious side effects
Serious side effects from Evenity can occur, but they aren’t common. If you have serious side effects from Evenity, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Evenity that have been reported include:
- low levels of calcium in the blood
- osteonecrosis of the jaw
- unusual fractures in your thigh bone
- boxed warnings: risk of heart attack, stroke, or death due to cardiovascular problems*
- severe allergic reaction†
* For more information, see the “Boxed warning” section at the beginning of this article.
† To learn more about this side effect, see “Allergic reaction” just below.
- skin rash
- itchiness
- flushing (temporary warmth, redness, or deepening of skin color)
Evenity and denosumab (Prolia) are both used to treat osteoporosis in females* who’ve gone through menopause and have a high risk of bone fractures. In addition, Prolia may be used to treat osteoporosis in certain other people who have a high risk for bone fractures.
Evenity and Prolia are also both biologic medications, which means they’re made from living cells. They’re given as injections under the skin. You’ll receive the injections at your doctor’s office. Evenity injections are given once per month for 12 months. Prolia injections are given every 6 months for as long as your doctor recommends.
For more information about how Evenity compares with Prolia, see this article.
* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Your doctor will recommend the dosage of Evenity that’s right for you. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.
Form and strength
Evenity comes as a liquid solution inside prefilled syringes. It’s given as an injection under the skin. You’ll receive the injections at your doctor’s office.
Evenity comes in a strength of 105 milligrams per 1.7 milliliters of solution (mg/mL).
Recommended dosing
The dosing schedule for Evenity is one 210-mg dose given once per month for 12 months. Each dose is given as two injections.
Note: You should not receive more than 12 doses of Evenity. It’s not meant to be used for more than 1 year.
Questions about Evenity’s dosage
Below are some common questions about Evenity’s dosage.
- What if I miss a dose of Evenity? If you miss an appointment to receive your Evenity injection, call your doctor’s office right away. They can help reschedule your appointment as soon as possible. Using tools such as a calendar or a reminder on your phone can help you remember your appointments.
- Will I need to use Evenity long term? No, Evenity isn’t meant to be used as a long-term treatment. Your Evenity treatment will not last longer than 12 months.
- How long does Evenity take to work? Evenity begins working when you receive your first dose. But you likely won’t “feel” the drug working in your body. Your doctor can tell you more about how they’ll monitor how well Evenity is working for you.
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.
Evenity is not available as a biosimilar. (Biosimilars are like generic drugs. But generics are made for nonbiologic drugs, while biosimilars are made for biologic drugs.) Instead, romosozumab-aqqg* is only available as the brand-name drug Evenity.
If you have questions about Evenity injection costs and how to pay for your prescription, talk with your doctor or pharmacist.
The Evenity Co-pay Program may be available for people with commercial health insurance. And a program called Amgen Safety Net Foundation may be available for people without insurance. To learn whether you qualify for either of these programs, visit the drug’s website or talk with your doctor or pharmacist.
You can also check out this article to learn more about saving money on prescriptions.
* The reason “-aqqg” appears at the end of the drug’s name is to show that the drug is distinct from similar medications that may be created in the future.
Find answers below to some commonly asked questions about Evenity.
Can Evenity cause dental side effects?
Yes, Evenity can cause dental side effects. Specifically, it can cause a rare but serious side effect called osteonecrosis of the jaw.
With this condition, cells in your jawbone die. Symptoms include:
- pain or swelling in your mouth
- loose teeth
- exposed bone in the mouth
- numbness or a heavy feeling in your jaw
- gum infection
Your doctor will recommend a dental exam before you start treatment with Evenity. And it’s important to practice good oral hygiene during your treatment. This may help prevent osteonecrosis of the jaw.
Before having dental work completed during your Evenity treatment, it’s important to let your dentist know that you’re using Evenity. Certain types of dental work (such as having a tooth removed) can raise your risk of osteonecrosis of the jaw from Evenity.
If you have questions about Evenity and your dental health, talk with your doctor.
Are Tymlos, Reclast, and Fosamax considered alternatives to Evenity?
Abaloparatide (Tymlos), zoledronic acid (Reclast), alendronate (Fosamax), and romosozumab-aqqg* (Evenity) are all drugs used to treat osteoporosis in females† who have gone through menopause and have a high risk of bone fractures.
Reclast and Fosamax may also be prescribed to prevent or treat other conditions.
The following table briefly compares these medications. To learn more about possible treatments that may be options for you, talk with your doctor.
| Drug | Form and administration | How often it’s used to treat osteoporosis |
| Evenity | liquid solution inside prefilled syringes that’s given as an injection under the skin | once per month for 12 months |
| Tymlos | liquid solution inside prefilled pen that’s given as an injection under the skin | once daily for up to 2 years |
| Reclast | liquid solution that’s given as an intravenous (IV) infusion | once per year for up to 3 to 5 years |
| Fosamax | tablet that’s swallowed | once per week for up to 3 to 5 years |
* The reason “-aqqg” appears at the end of the drug’s name is to show that the drug is distinct from similar medications that may be created in the future.
† In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
How long does Evenity stay in your system?
Evenity stays in your body for about 64 days (just over 2 months) after you take your last dose. If you have problems with your kidneys or liver, it can take longer for the drug to be cleared from your system.
If you have questions about how long Evenity stays in your system, you can talk with your doctor or a pharmacist.
What is Evenity’s mechanism of action?
Evenity’s mechanism of action (how it works) is that it blocks a certain protein that signals your body to break down bones. This breaking down of bone is a process that happens in everyone, but in people with osteoporosis, it can cause problems. By blocking this protein, Evenity helps your body form new bone and stop breaking down old bone. This can increase the strength of your bones, which makes them less likely to fracture.
To learn more about how Evenity works, talk with your doctor or pharmacist.
Does Evenity cause weight gain?
No, Evenity doesn’t cause weight gain. This side effect wasn’t reported in the drug’s studies.
Keep in mind that weight gain is common during menopause. Because Evenity is used after menopause, it’s possible that you may gain weight after you start using the drug. But it’s not likely that Evenity would be the cause of your weight gain.
If you have concerns about weight gain, talk with your doctor.
Evenity is used to treat osteoporosis in certain females* who’ve gone through menopause.
Specifically, Evenity is used for postmenopausal females who meet one of the following criteria:
- Have a high risk of bone fractures, which may be caused by certain risk factors. Examples of these include:
- having a past fracture caused by osteoporosis
- having low body weight
- using certain medications long term, such as corticosteroids or proton pump inhibitors
- having a low level of physical activity
Osteoporosis is a condition that affects your bones. Inside your bones are small spaces (like a honeycomb). Osteoporosis causes these spaces to get bigger. This results in your bones losing density and strength, making them more likely to fracture. Osteoporosis also causes the outside of your bones to become thinner and weaker.
Although osteoporosis can occur at any age, it’s much more common in older adults. And if you’ve gone through menopause, you have a higher risk for osteoporosis. Menopause leads to lower levels of estrogen (a reproductive hormone). Estrogen works to keep your bones strong, so having lower estrogen levels can cause weak bones and may even lead to osteoporosis.
Evenity treats osteoporosis by slowing the breakdown of old bone and increasing new bone growth.
Note: You should not receive more than 12 doses of Evenity. It’s not meant to be used for more than 1 year.
* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article. (Ongoing research is being done about the risk of osteoporosis in transgender individuals. However, it’s not known how hormone or surgical transitions might affect osteoporosis risk. For more information, talk with your doctor.)
Both Evenity and teriparatide (Forteo) are used to treat osteoporosis in females* who’ve gone through menopause and have a high risk of bone fractures. In addition, Forteo may also be used to treat:
- osteoporosis in males*
- osteoporosis caused by taking corticosteroids
Both Evenity and Prolia are given as an injection under the skin. You’ll receive Evenity injections at your doctor’s office. With Forteo, your doctor may give you your first injection at their office. But for the remaining doses, they’ll likely show you (or a caregiver) how to give yourself these injections at home.
For more information about Evenity vs. Forteo, see this article.
* In this article, we use the terms “female” and “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Before starting treatment with Evenity, there are important considerations for you to discuss with your doctor. This includes your complete health history, such as any other medical conditions you may have.
Interactions
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Evenity isn’t currently known to interact with other medications. There also aren’t any vitamins, supplements, or foods known to interact with Evenity.
Still, before taking Evenity, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can check for any new interactions that may be recognized during your Evenity treatment.
For information about drug-condition interactions, see the “Other warnings” section below.
Boxed warning
Evenity has a boxed warning . This is a serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.
Risk of heart attack, stroke, or death due to cardiovascular problems. Evenity may raise your risk of heart attack, stroke, or death due to cardiovascular (heart and blood vessel) problems. To learn more, see the “Boxed warning” section at the top of this article.
Other warnings
Evenity may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Evenity is a good treatment option for you.
Talk with your doctor about your health history before you take Evenity. Factors to consider include those in the list below.
- Low blood calcium levels. Evenity can cause low levels of calcium in the blood. If you already have this condition, Evenity is contraindicated. (A contraindication is a factor or condition that could prevent your doctor from prescribing a drug due to risk of harm.) Due to this risk, doctors usually will not prescribe Evenity without first treating your low calcium levels. Talk with your doctor to learn more.
- Kidney problems, including receiving dialysis. If you have kidney problems, for example, if you’re receiving dialysis for kidney failure, you’re more likely to develop low blood calcium levels from Evenity. If you have kidney problems, talk with your doctor before you start treatment with this drug.
- Unable to take a calcium and vitamin D supplement. Evenity is meant to be used along with a calcium and vitamin D supplement. If you can’t take this supplement, it’s important to let your doctor know. They can determine whether Evenity is the right treatment for your osteoporosis.
- Allergic reaction. If you’ve had an allergic reaction to Evenity or any of its ingredients, your doctor will likely not prescribe Evenity. Ask them what other medications are better options for you.
Evenity and alcohol
There’s no known interaction between alcohol and Evenity. But your doctor may recommend that you limit or avoid alcohol during your Evenity treatment. Alcohol can worsen osteoporosis, which Evenity is used to treat. Alcohol can also affect how well your body absorbs calcium. (Calcium helps your body build and maintain healthy bones.) So drinking alcohol may weaken your bones.
If you drink alcohol, talk with your doctor about how much (if any) may be safe for you to drink with your condition and treatment plan.
Pregnancy and breastfeeding
It isn’t known whether it’s safe to use Evenity while pregnant or breastfeeding. But Evenity is only approved for use in females* who’ve gone through menopause. (This means they can no longer become pregnant.)
If you have questions, talk with your doctor.
* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Your doctor will explain how you’ll receive Evenity. They’ll also explain how much you’ll be given and how often.
Receiving Evenity
Evenity is given as an injection under the skin. You’ll receive the injections at your doctor’s office.
Receiving Evenity with other drugs
During your Evenity treatment, your doctor will likely recommend you also take a calcium and vitamin D supplement. This helps keep your calcium levels from becoming too low.
Evenity should not be used in people with low levels of calcium in the blood. For more information, see the “What should be considered before taking Evenity?” section above.
- Before your appointment, write down questions such as:
- How will Evenity affect my body, mood, or lifestyle?
If you’re considering treatment with Evenity, talk with your doctor. Ask questions that help you feel comfortable with Evenity and other possible treatment options for your condition. Some examples to help get you started include:
- Do I have a high risk for any side effects of Evenity?
- If Evenity isn’t working for me, will my dosage be adjusted?
- How do Evenity’s side effects compare with those of other similar drugs?
To learn more about Evenity, see this article:
- Evenity vs. Prolia: What You Should Know
To get information on different conditions and tips for improving your health, subscribe to any of Austra Health’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.
Disclaimer: Austra Health has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.