Romosozumab is used for treatment of osteoporosis. Learn how to use the medication, its common side effects, special precautions to watch out for, and more.

What is this medication for?

Romosozumab is used for treatment of osteoporosis, a condition where bone content is lost faster than replaced, leading to weak, brittle bones, and prone to fractures. Romosozumab is available as a prefilled injection syringe containing 105 mg of the medication.

Bones in the body are regularly broken down and rebuilt to maintain bone strength. Romosozumab works by reducing bone breakdown and increasing bone rebuilding, thereby increasing bone mass and lowering the risk of fracture. 
Romosuzumab needs to be taken regularly for a long period of time to get its benefits. You should have an adequate intake of Calcium and Vitamin D (from food or supplements) to strengthen your bones. Calcium is the major building block of bone, and Vitamin D helps in the absorption of Calcium by the body.
To reduce the risk of osteoporosis, you should engage in weight-bearing and muscle-strengthening exercises, stop smoking and consume alcohol in moderation. 

How should I take or use this medication?

• Two syringes are administered under the skin (subcutaneous) in the abdomen, upper arm or upper thigh, by a healthcare professional once every month.
  • The second syringe is administered immediately after the first one.
  • Do not rub or scratch the injection area.
• This medication will be continued for up to 12 months.

What should I do if I forget to take or use this medication?

If a dose is missed, reschedule your appointment with your clinic to administer as soon as possible. Thereafter, schedule doses every month from the date of last injection received. 

What precautions should I take when taking or using this medication?

Inform your healthcare professional if: 

• You are allergic to this medication or any of the other ingredients of this medication.
• You are pregnant, planning to become pregnant, or breastfeeding
• You have any existing kidney problems
• You have heart disease, if you have had heart attack or stroke before

What are some common side effects of this medication?

• Slight skin irritation over the injection region.
• Mild pain over the joints
• Skin rashes
  • Seek medical advice if rashes are serious and spread over your whole body 

What are some rare but serious side-effects that I need to seek medical advice immediately?

These rare but serious side-effects generally occur in less than 1% of users and measures are taken to reduce the risk (refer below).

• The symptoms of a drug allergy include one or more of the following:
  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body
• Due to low calcium levels, you may experience muscle cramps, numbness and tingling sensation in your lips or tongue, irregular heartbeat
  • Blood tests may be done to monitor your calcium levels
  • Ensure daily intake of calcium and vitamin D whilst undergoing treatment -these can be from dietary or supplement sources.
• You may experience jaw pain, toothache, gum ulceration, delayed wound healing in mouth
  • You will be referred to a dentist to assess whether you can be started on  romosozumab.
  • Ensure good oral hygiene and always inform your dentist that you are on this medication to avoid this rare but serious side effect.
• You may experience thigh or groin pain weeks or months with minimal or no injury to the area before the fracture occurs
  • You will be scheduled for bone scans every few years to assess the need to continue or temporarily stop denosumab 
     
• Increased risk of heart attack or stroke
  • Heart attack: Shortness of breath, chest pain or discomfort that may spread to the arms, back or jaws
  • Stroke: Face drooping, arm weakness, speech difficulty

If you experience any of the above symptoms, you should seek medical attention immediately. 

How should I store this medication?

Store in the refrigerator between 2-8°C. Do not freeze. Keep this medication away from children. 

What else should I know about this medication?

Store in the refrigerator between 2-8°C. Do not freeze. Keep this medication away from children. 

Disclaimer

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated July 2025