Muscle Pain, Low Calcium, and More: 7 Prolia Side Effects You Should Know About
Prolia (denosumab) is a medication that promotes bone health. Here are seven side effects to know before receiving it and when to consult your prescriber.
Jubbonti
Used for Osteoporosis
Used for Osteoporosis
Jubbonti (denosumab or denosumab-bbdz) is a RANKL inhibitor used to treat osteoporosis and certain types of bone loss caused by treatment. It’s approved for adults at high risk of fractures, including after menopause, during long‑term steroid use, and during some prostate or breast cancer treatments. The medication is injected under the skin by a healthcare professional once every 6 months. Common side effects can include back pain, joint or muscle pain, and higher cholesterol.
Jubbonti (denosumab) is an interchangeable biosimilar to Prolia (denosumab).
What is Jubbonti (denosumab)?
What is Jubbonti (denosumab) used for?
- Osteoporosis in women who've gone through menopause and at high risk of fracture
- Osteoporosis in men at high risk of fracture
- Osteoporosis caused by steroid medications in people at high risk of fracture
- Bone loss in men at high risk of fracture taking certain medications for prostate cancer
- Bone loss in women at high risk of fracture taking certain breast cancer medications
How Jubbonti (denosumab) works
Jubbonti (denosumab) is a RANKL inhibitor. It works by blocking a protein in your body called RANK ligand (RANKL). This protein plays a role in breaking down bones. When too much bone is broken down, your bones can become weak.
By blocking RANKL, Jubbonti (denosumab) slows bone breakdown and helps your bones become stronger over time.
When does Jubbonti (denosumab) start working?Time passed since treatment started:
Drug facts
| Common Brands | Jubbonti |
|---|---|
| Drug Class | RANKL inhibitor |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Jubbonti (denosumab)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Postmenopausal women with osteoporosis:
- Back pain (35%)
- Pain in the arms or legs (12%)
- Muscle pain (8%)
- High cholesterol levels (7%)
- Bladder inflammation (6%)
- Vertigo (5%)
- Swelling in the hands or feet (5%)
- Upper respiratory tract infection (5%)
- Nerve pain (5%)
Men with osteoporosis:
- Back pain (8%)
- Joint pain (7%)
- Common cold symptoms (7%)
Osteoporosis caused by corticosteroids:
- Back pain (5%)
- High blood pressure (4%)
- Bronchitis (4%)
- Headache (4%)
Bone loss from cancer treatments:
- Joint pain (14%)
- Back pain (12%)
Less Common Side Effects
Postmenopausal women with osteoporosis:
- Bone pain
- Stomach pain
- Passing gas
- Heartburn
- Trouble sleeping
- Rash
- Sore throat
- Itching
- Heartburn
Men with osteoporosis:
- Rash
- Eczema
- Infection
Osteoporosis caused by corticosteroids:
- Indigestion
- Urinary tract infection
- Upper stomach pain
- Upper respiratory tract infection
- Constipation
- Vomiting
Bone loss from cancer treatments:
- Pain in the arms and legs
- Muscle pain
Jubbonti (denosumab) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reactions: itching, rash, hives, throat tightness, swelling in your face and throat, trouble breathing
- Dangerously low calcium levels: muscle cramps or spasms, tingling around the mouth or in fingers, seizures, confusion, abnormal heart rhythm
- Fracture in the thigh bone: new or unusual hip, thigh, or groin pain; dull, aching pain
- Jawbone damage: jaw pain or swelling, loose teeth, gum infections, slow‑healing mouth sores after dental work
- Serious infections: fever or chills, skin that’s red or tender to touch, shortness of breath, cough, severe stomach pain, burning or urgency when urinating
- Skin problems: redness, itching, rash, dry skin, blisters, skin peeling
- Bone, joint, or muscle pain
The following Jubbonti (denosumab) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Low calcium level—muscle pain or cramps, confusion, tingling, or numbness in the hands or feet
- Osteonecrosis of the jaw—pain, swelling, or redness in the mouth, numbness of the jaw, poor healing after dental work, unusual discharge from the mouth, visible bones in the mouth
- Severe bone, joint, or muscle pain
- Skin infection—skin redness, swelling, warmth, or pain
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Back pain
- Headache
- Joint pain
- Muscle pain
- Pain in the hands, arms, legs, or feet
- Runny or stuffy nose
- Sore throat
Get your GoodRx coupon
$2008.80
GoodRx discount
$1546.22
Pros and cons of Jubbonti (denosumab)
Pros
- Injected twice a year by a healthcare professional
- Builds bone and lowers fracture risk in several high‑risk groups
- Interchangeable with Prolia, so pharmacies can substitute when allowed
Cons
- Requires regular calcium and vitamin D and blood calcium checks
- Can cause severe low calcium, especially with serious kidney problems
- Risk of jaw problems and rare thigh fractures
Pharmacist tips for Jubbonti (denosumab)
- You'll need to go to the medical office every 6 months to get your Jubbonti (denosumab) injection. Write the date and time of your appointments on your calendar to help you remember.
- If you miss a Jubbonti (denosumab) injection, make a new appointment as soon as you can. Your next injection will be 6 months after that.
- Take calcium and vitamin D every day while receiving Jubbonti (denosumab). This helps keep your calcium levels normal and supports strong bones. Ask your care team how much you should take.
- If you have kidney problems, you might need extra lab tests and closer monitoring during treatment. That's because Jubbonti (denosumab) can raise your risk for low calcium.
- Keep your dental health in good shape while getting Jubbonti (denosumab) to help lower the risk of jaw problems and infections. Brush, floss, and tell your dentist you’re receiving the medication.
- Tell your care team right away if you have new thigh or groin pain while receiving Jubbonti (denosumab). This could be a sign of a rare bone problem. Early care can help prevent a fracture.
- Watch for signs of low calcium while getting Jubbonti (denosumab). Call your care team if you notice tingling, muscle cramps, or confusion. These can be signs your calcium is too low.
- Tell your prescriber and pharmacist about all medications and supplements before and during treatment with Jubbonti (denosumab). Some can affect your calcium levels or increase side effects. Don’t take other medications with denosumab at the same time.
- Pregnancy: Jubbonti (denosumab) can harm an unborn baby. If you can become pregnant, use birth control during treatment and for at least 5 months after your last dose.
- Breastfeeding: Don’t breastfeed while getting Jubbonti (denosumab). It’s not known if the medication passes into breast milk. Talk to your prescriber about safe feeding options for your baby.
Risks and warnings for Jubbonti (denosumab)
Jubbonti (denosumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Dangerously low calcium levels
- Risk factors: Serious kidney problems | Receiving dialysis | History of hypoparathyroidism (low levels of parathyroid hormone) | Thyroid surgery | Parathyroid surgery | Problems absorbing nutrients | Taking other medications that lower calcium levels
Jubbonti (denosumab) can cause very low calcium levels in your blood. Your risk is higher if you have serious kidney problems, have had certain surgeries, have trouble absorbing nutrients, or take other medications that lower calcium. In some cases, low calcium can last for weeks or months and might need ongoing treatment.
Before starting Jubbonti (denosumab), your prescriber might check your calcium levels and treat them if they’re too low. After each injection, your prescriber will check your calcium and other mineral levels within 2 weeks, then monitor your levels regularly.
It's important to take calcium and vitamin D while receiving Jubbonti (denosumab). These help keep your calcium levels in a safe range. Tell your care team right away if you notice symptoms like confusion, muscle cramps, or tingling in your mouth, hands, or feet.
Allergic reactions
Jubbonti (denosumab) can cause serious allergic reactions, including anaphylaxis. Symptoms include trouble breathing, tightness in your throat, swelling of your face or airway, itching, or hives. If this happens, get medical help right away and let your prescriber know.
Jawbone damage
- Risk factors: Oral or dental procedures | Cancer | Taking steroids or chemotherapy | Poor oral hygiene | History of gum problems | Anemia | Clotting problems | Infection | Wearing dentures that don't fit well | Taking Jubbonti (denosumab) for a long time
Although it's rare, some people taking Jubbonti (denosumab) have had jawbone damage, called osteonecrosis of the jaw (ONJ). Your risk is higher if you’ve had recent dental work, poor oral hygiene, gum problems, or wear dentures that don’t fit well. It might also be higher if you have cancer, anemia, blood-clotting problems, or if you take steroids or get chemotherapy. Your prescriber might recommend a dental exam before starting the medication.
To lower your risk, practice good oral hygiene. Brush and floss every day and get regular dental checkups. Tell your care team if you plan to have dental work, and let your dentist know you’re taking Jubbonti (denosumab).
Call your prescriber or dentist right away if you have jaw pain, swelling, or drainage. These can be signs of ONJ.
Thigh bone fractures
- Risk factors: Taking steroids
People getting Jubbonti (denosumab) might have unusual fractures in the thigh bone. These can happen with little or no injury and may occur in both legs. It’s not clear if the medication directly causes these fractures.
Before a fracture happens, you might feel a dull, aching pain in your thigh, hip, or groin for weeks or months. This can be an early warning sign. Tell your care team right away if you notice any new or unusual pain in these areas.
Multiple spine fractures after stopping treatment
- Risk factors: Previous spine fracture
Fractures in the spine have happened after stopping Jubbonti (denosumab) treatment, sometimes as early as 7 months after the last dose. Your risk might be higher if you’ve had a spine fracture before. Your prescriber will weigh the risks and benefits before starting treatment.
If you need to stop Jubbonti (denosumab), your prescriber will usually start another medication to help lower your risk. Stay on your 6-month injection schedule and call your care team right away if you miss an appointment.
Serious infections
- Risk factors: Weak immune system | Taking medications that weaken your immune system
Some people taking Jubbonti (denosumab) have had serious infections. In studies, some infections were severe enough to require hospital care, including infections of the skin, stomach, urinary tract, ear, and heart.
Your risk is higher if you have a weak immune system or take other medications that affect your immune system, like steroids and transplant medications.
Tell your prescriber if you notice any signs of infection while taking Jubbonti (denosumab). Call your care team right away if you have symptoms of a serious infection, such as fever, chills, severe pain, or redness and swelling of the skin.
Severe skin reactions
Jubbonti (denosumab) can cause skin problems like dermatitis, eczema, or rashes. They can occur on different parts of your body, not just where the injection is given.
Tell your care team if you notice any new or worsening skin symptoms. If the reaction is severe, your prescriber might decide to stop treatment.
Severe bone, muscle, or joint pain
It’s not common, but some people taking Jubbonti (denosumab) have had severe bone, muscle, or joint pain. This can start as early as 1 day after beginning treatment or might take several months to appear. In some cases, the pain can make it hard to move or do daily activities.
Tell your care team right away if you have new or worsening pain. If the pain is severe, your prescriber might decide to stop treatment.
Jubbonti (denosumab) dosage
The average cost for 1 syringe of 1ml of 60mg/ml of Jubbonti (denosumab) is $1,546.22 with a free GoodRx coupon. This is 23.03% off the average retail price of $2,008.80. 
Syringe
Syringe| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1ml of 60mg/ml | 1 syringe | $1,546.22 | $1,546.22 |
Typical dosage for Jubbonti (denosumab)
Jubbonti (denosumab) is an injection that's given to you by a trained healthcare professional at a medical office.
The typical dose is 60 mg injected under the skin once every 6 months.
How much does Jubbonti (denosumab) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Prolia (brand)
$1,546.22
Jubbonti (denosumab) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Jubbonti (denosumab) will not be safe for you to take.
- Low calcium levels
- Currently pregnant
What are alternatives to Jubbonti (denosumab)?
There are a number of medications that your doctor can prescribe in place of Jubbonti (denosumab). Compare a few possible alternatives below.
News about Jubbonti (denosumab)
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