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Actonel vs. Prolia

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Risedronate (Actonel) and Prolia (denosumab) are both used to treat osteoporosis, but they work in different ways and have different dosing schedules. Risedronate is a bisphosphonate that you take orally, with options for daily, weekly, or monthly dosing. It helps slow down bone breakdown and is available in a lower-cost generic form. Prolia, on the other hand, is a monoclonal antibody given as an injection by a healthcare professional once every six months. It blocks a protein that signals bone breakdown. While risedronate can cause stomach pain and requires you to stay upright for 30 minutes after taking it, Prolia can lead to dangerously low calcium levels and requires regular blood work. Prolia is not safe during pregnancy, whereas risedronate is not recommended for people with severe kidney disease. Both medications can cause bone, joint, or muscle pain, but Prolia also has a risk of serious infections and allergic reactions.

Risedronate

(Actonel)

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Prolia

(denosumab)

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Summary for Actonel

Prescription only

Risedronate (Actonel) is a first-choice medication used to treat osteoporosis (bone loss or weakening). It can help improve bone mineral density (BMD) and lower the risk of bone fractures. There are several dosing options and a delayed-release form in case a particular dosing schedule is more convenient for some people.

Indications for Actonel

  • Osteoporosis in women who have gone through menopause (postmenopause)
  • Osteoporosis in men
  • Osteoporosis caused by long-term corticosteroid use
  • Paget's disease

Pros and Cons for Actonel

Pros

  • Can be used for many types of osteoporosis
  • Many available dosing options (daily, weekly, monthly) for postmenopausal women
  • Also comes as a delayed-released form that's taken after breakfast for postmenopausal women
  • Available in a lower-cost generic form

Cons

  • Risk of many side effects, including stomach pain and severe jaw problems
  • Not recommended for people with severe kidney disease

Common Side Effects for Actonel

Note: For once-daily dosing

  • Infection (31%)
  • Back pain (28%)
  • Joint pain (24%)
  • Constipation (13%)
  • Stomach pain (12%)
  • Heartburn (11%)
  • Nausea (11%)
  • Diarrhea (11%)
  • Flu-like symptoms (11%)
  • Urinary tract infection (11%)
  • Arthritis (10%)
  • Headache (10%)
  • Bronchitis (10%)

Warnings for Actonel

  • Stomach and esophagus irritation and ulcers
  • Breakdown of the jawbone (osteonecrosis)
  • Severe bone, joint, or muscle pain
  • Leg bone fractures
  • Low calcium in the blood

Summary for Prolia

Prescription only

Prolia (denosumab) is an injection that's used to treat osteoporosis in adults at high risk of fracture. It's also for those at high risk of fractures from certain cancer medications. It works as a monoclonal antibody called a RANKL inhibitor to strengthen your bones. Prolia (denosumab) is a convenient option because you only need an injection every 6 months. It's injected under the skin by a healthcare professional at a medical office. Side effects include back and muscle pain. It also has a risk of causing dangerously low calcium levels.

Indications for Prolia

Pros and Cons for Prolia

Pros

Cons

  • Must go to the medical office to get the injection
  • Must take with calcium and vitamin D supplements
  • Can cause bone and muscle pain
  • Not safe during pregnancy

Common Side Effects for Prolia

Warnings for Prolia

  • Dangerously low calcium levels
  • Risk of fractures in the thigh bone
  • Risk of spine fractures after stopping Prolia (denosumab)
  • Risk of serious infections
  • Risk of problems in the jawbone
  • Serious allergic reactions and skin reactions
  • Severe bone, muscle, or joint pain
  • Don't take with Xgeva (denosumab)

Prices with our coupons for Actonel vs. Prolia

Price Card Drug Icon
Risedronate3 dose packs / 1 tablet of 150mg
$47.14$483.05
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Price Card Drug Icon
Prolia1 syringe / 1ml of 60mg/ml
$1,870.20$2,497.09
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