Ask the Doctor

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What is postmenopausal osteoporosis?

Postmenopausal osteoporosis can occur in women after menopause when estrogen levels drop. It is a disease that makes your bones thinner and weaker—so that they are more likely to fracture or break. In fact, 1 in 2 women over age 50 will have a fracture due to osteoporosis in their lifetime.

Postmenopausal osteoporosis is often called a "silent disease." This is because it can develop without you knowing it. You don't feel your bones getting weaker, nor can you see them getting weaker. Many women have no idea they have postmenopausal osteoporosis until the day a bone breaks.

Talk to your doctor about ways you can find out whether you have postmenopausal osteoporosis. The most commonly used test is called a DXA scan. It's a test your doctor can arrange for you.

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What should I discuss with my doctor?

If you have postmenopausal osteoporosis, be sure to talk to your doctor regularly to ensure you're doing everything you can to help strengthen your bones and reduce the risk of a fracture.

Here are some questions you can discuss together to help manage your postmenopausal osteoporosis.

  • What is my T-score? What does my T-score mean?
  • How often do I need a DXA to give me an updated T-score?

You might also ask:

  • What are my treatment options?
  • What are the benefits and risks of these options?
  • Which treatment do you think is right for me?
  • How much calcium and vitamin D should I take?
  • Could Prolia® be right for me?

Please see Prolia® Important Safety Information, full Prescribing Information, and Medication Guide.

What positive changes can I make in my daily life to help manage my postmenopausal osteoporosis?

There are some steps you can take to help manage postmenopausal osteoporosis. Here are some of the most important:

  • Get enough calcium and vitamin D every day. You can do this by eating calcium and vitamin D-rich foods, or by taking calcium and vitamin D supplements or a combination of the two. Ask your doctor how you can get more calcium and vitamin D.
  • Exercise is another important way to help strengthen your bones. Certain kinds of exercise can actually increase your bone density—like weight-bearing exercise. Exercise can also improve your balance so you have less risk of falling. Talk to your doctor before you start a new exercise regimen.

Keep talking to your doctor. Make regular appointments. Be sure to ask your doctor if you're doing all you can to help strengthen your bones.

If you are taking Prolia®, you can sign up to receive reminders and helpful lifestyle information at Prolia.com.

Please see Prolia® Important Safety Information, full Prescribing Information, and Medication Guide.

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Why should I keep taking Prolia®?

Prolia® can help protect bones from fracture, but should be received every 6 months in order to continue to help strengthen bones. Be sure to schedule your next shot after each shot you receive. Your doctor’s office can help make sure you know everything you need to help strengthen your bones. You should take calcium and vitamin D as your doctor tells you to while you receive Prolia®. Prolia® can cause serious side effects, including low calcium levels in your blood, serious infections, skin problems, and severe jaw bone problems. Ask your doctor if Prolia® might be right for you. Please see additional Prolia® Important Safety Information, full Prescribing Information, and Medication Guide.

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How much does Prolia® cost?

Your cost depends on the type of insurance or medical coverage you have and whether you buy Prolia® at your doctor's office or pick it up at your pharmacy to bring to the office. Ask your doctor or pharmacist—he or she can give you information that may be helpful.

How can I get started on Prolia®?

Prolia® is a shot given two times a year in your doctor's office. You should take calcium and vitamin D as your doctor tells you to while you receive Prolia®. Ask your doctor about your bone strength and if Prolia® is right for you. Use our Doctor Discussion Guide to help plan your visit.

Please see additional Prolia® Important Safety Information, full Prescribing Information, and Medication Guide.

How can I know if my postmenopausal osteoporosis management plan is working?

If you have a postmenopausal osteoporosis management plan, it is important to regularly talk to your doctor about all aspects of your management plan, especially your bone density.

The most commonly used test to measure bone density is called a DXA scan, which can help your doctor assess your bone strength. The National Osteoporosis Foundation recommends that you have a DXA scan every two years, or more often as recommended by your doctor, if you're taking a prescription medication for your postmenopausal osteoporosis. It is an X-ray test that is fast, painless, and accurate. It may have been used to initially diagnose your postmenopausal osteoporosis. Ask your doctor when you should next have a DXA scan. It is one of the key measures your doctor can use to help monitor your postmenopausal osteoporosis management plan.

The results of a DXA scan are reported as a T-score, which compares your bone density to the bone density of a healthy, young adult woman. A T-score of minus 2.5 or lower is defined as osteoporosis. Your doctor periodically monitors your T-score to provide information as part of your treatment management plan.

Why do I need to get a bone density test?

There's lots of evidence to show that your bone density and your fracture risk are closely related. The most common—and perhaps the most useful test for tracking bone density over time—is the DXA scan, which is fast, accurate, painless, and uses very little radiation. For women who are taking an osteoporosis medication, the National Osteoporosis Foundation recommends that bone density testing should be repeated every two years (or more frequently, as recommended by your doctor).

What does my T-score tell me about the strength of my bones?

The results of a bone density (DXA) scan are reported as a T-score. The lower your T-score is, the weaker your bones, and the greater the risk for fractures can be.

Indication  Prolia® (denosumab) is a prescription medicine used to treat osteoporosis in women after menopause who:
  • are at high risk for fracture, meaning women who have had a fracture related to osteoporosis, or who have multiple risk factors for fracture
  • cannot use another osteoporosis medicine or other osteoporosis medicines did not work well
Important Safety Information

Do not take Prolia® if you: have low blood calcium; or are pregnant or plan to become pregnant, as Prolia® may harm your unborn baby; or are allergic to denosumab or any ingredients in Prolia®.

What is the most important information I should know about Prolia®?

If you receive Prolia®, you should not receive XGEVA®. Prolia® contains the same medicine as XGEVA® (denosumab).

Prolia® (denosumab) can cause serious side effects:

Low blood calcium (hypocalcemia). Prolia® may lower the calcium levels in your blood. If you have low blood calcium, it may get worse during treatment. Your low blood calcium must be treated before you receive Prolia®.

Take calcium and vitamin D as your doctor tells you to help prevent low blood calcium.

Serious infections in your skin, lower stomach area (abdomen), bladder, or ear may happen. Inflammation of the inner lining of the heart (endocarditis) due to an infection may also happen more often in people who take Prolia®. You may need to go to the hospital for treatment.

Prolia® is a medicine that may affect your immune system. People who have weakened immune systems or take medicines that affect the immune system may have an increased risk for developing serious infections.

Skin problems such as inflammation of your skin (dermatitis), rash, and eczema have been reported.

Severe jaw bone problems (osteonecrosis) may occur. Your doctor should examine your mouth before you start Prolia® and may tell you to see your dentist. It is important for you to practice good mouth care during treatment with Prolia®.

Unusual thigh bone fractures. Some people have developed unusual fractures in their thigh bone. Symptoms of a fracture include new or unusual pain in your hip, groin, or thigh.

Before taking Prolia® (denosumab), tell your doctor if you:

  • Take the medicine XGEVA® (denosumab).
  • Have low blood calcium.
  • Cannot take daily calcium and vitamin D.
  • Had parathyroid or thyroid surgery (glands located in your neck).
  • Have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome).
  • Have kidney problems or are on kidney dialysis.
  • Plan to have dental surgery or teeth removed.
  • Are pregnant or plan to become pregnant.
  • Are breast-feeding or plan to breast-feed.

What are the possible side effects of Prolia®?

It is not known if the use of Prolia® over a long period of time may cause slow healing of broken bones. The most common side effects of Prolia® are back pain, pain in your arms and legs, high cholesterol, muscle pain, and bladder infection.

These are not all the possible side effects of Prolia®. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.