Thursday 24 December 2009

denosumab


Generic Name: denosumab (Xgeva) (den OH sue mab)

Brand Names: Xgeva


What is denosumab (Xgeva)?

Denosumab is a monoclonal antibody. Monoclonal antibodies are made to target and destroy only certain cells in the body. This may help to protect healthy cells from damage.


The Xgeva brand of denosumab is used to prevent bone fractures and other skeletal conditions in people with tumors that have spread to the bone. Xgeva is not for use in people with multiple myeloma (bone marrow cancer).


This medication guide provides information about the Xgeva brand of denosumab. Prolia is another brand of denosumab used to treat osteoporosis in postmenopausal women who have high risk of bone fracture.


Denosumab may also be used for purposes not listed in this medication guide.


What is the most important information I should know about Xgeva?


This medication guide provides information about the Xgeva brand of denosumab. Prolia is another brand of denosumab used to treat osteoporosis in postmenopausal women who have high risk of bone fracture.


You should not receive denosumab if you are allergic to it, or if you have low levels of calcium in your blood (hypocalcemia).

Before you receive this medication, tell your doctor if you have kidney disease or if you are on dialysis.


Some people using denosumab have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums. You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.


If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are receiving denosumab. You may need to stop using the medicine for a short time.

What should I discuss with my healthcare provider before receiving Xgeva?


You should not receive denosumab if you are allergic to it, or if you have low levels of calcium in your blood (hypocalcemia).

To make sure you can safely use Xgeva, tell your doctor if you have kidney disease or if you are on dialysis.


FDA pregnancy category C. It is not known whether denosumab will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of denosumab on the baby. It is not known whether denosumab passes into breast milk or if it could harm a nursing baby. However, this medication may slow the production of breast milk. You should not breast-feed while receiving denosumab.

Some people using denosumab have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums. You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.


How is Xgeva given?


Denosumab is injected under the skin of your stomach, upper thigh, or upper arm. A healthcare provider will give you this injection.


Xgeva is usually given once every 4 weeks. Follow your doctor's instructions.


Your doctor may have you take extra calcium and vitamin D while you are being treated with denosumab. Take only the amount of calcium and vitamin D that your doctor has prescribed.


Pay special attention to your dental hygiene. Brush and floss your teeth regularly while receiving this medication. You may need to have a dental exam before you begin treatment with Xgeva. Follow your doctor's instructions.


If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are receiving denosumab. You may need to stop using the medicine for a short time. If you keep your medication at home, store it in the original container in a refrigerator. Protect from light and do not freeze.

You may take the medicine out of the refrigerator and allow it to reach room temperature before giving the injection. Do not heat the medicine before using.


After you have taken Xgeva out of the refrigerator, you may keep it at room temperature and use it within 14 days. Store in the original container away from heat and light. Do not shake the medication bottle or you may ruin the medicine. Prepare your dose in a syringe only when you are ready to give yourself an injection. Do not use the medication if it looks cloudy or has particles in it. Call your doctor for a new prescription.

Each single use vial (bottle) of this medicine is for one use only. Throw away after one use, even if there is still some medicine left in it after injecting your dose.


What happens if I miss a dose?


Call your doctor for instructions if you miss an appointment for your Xgeva injection.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving Xgeva?


Follow your doctor's instructions about any restrictions on food, beverages, or activity.


Xgeva side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

  • numbness or tingly feeling around your mouth or in your fingers or toes, fast or slow heart rate, muscle cramps or contraction, overactive reflexes; or




  • trouble breathing.



Less serious side effects may include:



  • feeling weak or tired;




  • diarrhea, nausea; or




  • headache.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Denosumab Dosing Information


Usual Adult Dose for Osteoporosis:

For the treatment of postmenopausal women with osteoporosis at high risk for fracture, defined as a history of osteoporotic fracture, or multiple risk factors for fracture; or patients who have failed or are intolerant to other available osteoporosis therapy, treatment to increase bone mass in women at high risk for fracture
receiving adjuvant aromatase inhibitor therapy for breast cancer, and treatment to increase bone mass in men at high risk for fracture receiving androgen deprivation therapy for nonmetastatic prostate cancer:

60 mg administered as a single subcutaneous injection in the upper arm, the upper thigh, or the abdomen once every 6 months. All patients should receive calcium 1000 mg daily and at least 400 IU vitamin D daily

Usual Adult Dose for Hypercalcemia of Malignancy:

For the prevention of skeletal related events in patients with bone metastases from solid tumors:

120 mg as a subcutaneous injection in the upper arm, upper thigh, or abdomen every 4 weeks.

Administer calcium and vitamin D as necessary to treat or prevent hypocalcemia.


What other drugs will affect Xgeva?


There may be other drugs that can interact with Xgeva. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More denosumab resources


  • Denosumab Side Effects (in more detail)
  • Denosumab Use in Pregnancy & Breastfeeding
  • Denosumab Drug Interactions
  • Denosumab Support Group
  • 0 Reviews for Denosumab - Add your own review/rating


Compare denosumab with other medications


  • Hypercalcemia of Malignancy
  • Osteolytic Bone Metastases of Solid Tumors
  • Osteoporosis


Where can I get more information?


  • Your doctor or pharmacist can provide more information about denosumab (Xgeva).

See also: denosumab side effects (in more detail)


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