Key takeaways:
Prolia (denosumab) is an injectable medication used to treat osteoporosis as well as bone loss in people taking certain cancer medications.
The typical Prolia dosage is 60 mg injected under the skin every 6 months. You’ll need to visit a healthcare professional’s office to receive it.
Prolia can lower blood calcium levels. So it’s recommended to take daily calcium and vitamin D supplements to help prevent this side effect. You’ll also likely need to go for routine blood work to monitor your calcium levels while receiving Prolia.
There are ways to save on Prolia. If you’re eligible, a manufacturer savings card can help you get Prolia for as little as $25 per treatment. A patient assistance program is also available.
Save on related medications
Osteoporosis is a common health condition that weakens the bones. This can raise the risk of bone fractures (breaks). Many people with osteoporosis take medications to help prevent these fractures. Prolia is one example.
Prolia (denosumab) is an injectable osteoporosis medication. It can also treat bone loss caused by certain cancer medications. Prolia is a RANK ligand (RANKL) inhibitor. It works by blocking RANKL, a protein in your body that contributes to the breakdown of bone cells. This helps prevent bone loss and strengthen your bones.
But unlike many medications, you don’t give yourself a dose of Prolia at home. A healthcare professional will give your injection. Even though they will administer it to you, it’s still helpful to know the usual Prolia dosage schedule.
Good to know: Prolia is only FDA approved for adults. So in this article, we’ll only cover Prolia dosages for adults.
What’s the typical Prolia dosage for adults?
The recommended Prolia dosage is 60 mg injected under the skin every 6 months. The injection can be administered in your upper arm, upper thigh, or stomach. This dosage is the same for each of Prolia’s FDA-approved uses.
Typically, a healthcare professional will administer your Prolia injection at their office or clinic. If you’re unable to travel for this appointment, let your healthcare team know. They may prescribe a different osteoporosis medication you can take at home. Or they may consider other options, such as home healthcare, to administer your injection.
Calcium and vitamin D supplementation
Prolia can cause blood calcium levels to drop dangerously low (called hypocalcemia). This side effect is more likely to happen if you have severe kidney disease or are receiving dialysis. But it’s recommended that all people receiving Prolia take daily calcium and vitamin D supplements. This can help prevent this serious side effect.
Prolia’s manufacturer recommends taking at least 1,000 mg of calcium and 400 units of vitamin D every day. But some people may need to take a different amount. Discuss how much you should take with your healthcare professional.
Good to know: You’ll likely go for routine blood work to monitor your calcium levels while receiving Prolia. This helps your healthcare professional watch for signs of hypocalcemia.
Are there any Prolia dosage adjustments for health conditions?
There are no recommended Prolia dosage adjustments based on health conditions. But certain people may need more frequent blood work to monitor their calcium levels, including those:
With advanced kidney disease
Who receive dialysis
With mineral and bone disorder in chronic kidney disease
With a history of hypoparathyroidism
Who have had thyroid or parathyroid surgery
Who take other medications that lower calcium levels, such as cinacalcet (Sensipar)
These situations raise your risk of developing severe hypocalcemia while receiving Prolia. It’s recommended that healthcare professionals monitor blood calcium levels more frequently than usual for these groups of people. Your healthcare professional can let you know if this applies to you and how often you may need to go for blood work.
Do you have to avoid dental work with Prolia?
You don’t necessarily have to avoid dental work while receiving Prolia. But the answer to this question will depend on your health history, unique risks, and what dental work you need. Your healthcare professional will likely ask you to go for a dental exam before you receive your first Prolia dose.
Very rarely, Prolia can cause osteonecrosis of the jaw (ONJ). This is when the jaw bone breaks down or wears away. Tooth extractions (pulling a tooth) and dental infections can raise the risk of developing ONJ. Maintaining good oral hygiene and keeping up with regular dental cleanings can help lower your risk.
All about Prolia: Pharmacists answer common questions about Prolia (denosumab) injections.
What to expect: Read about common and rare Prolia side effects — from back pain to low calcium — and how you can manage them.
Can you manage osteoporosis without medications? In most cases, medications are the best choice for treating osteoporosis. But if you want to explore other options, read about some other ways to strengthen your bones.
You can still have many types of dental work while receiving Prolia. Make sure your dentist knows if you receive Prolia. If you do need to have dental work done, they can weigh the risks and benefits to help develop a plan of action for you.
How do Prolia dosages compare to Xgeva dosages?
Prolia and Xgeva both contain the mediation denosumab. But Xgeva can treat certain cancers and help with some cancer-related complications. Prolia doses are lower and administered less frequently than Xgeva doses.
The typical Xgeva dosage is 120 mg injected under the skin every 4 weeks (about once a month). In some cases, people may need additional doses during the first month of Xgeva treatment. As previously mentioned, the usual Prolia dosage is 60 mg every 6 months.
What happens if you miss a dose of Prolia?
Missing a dose of Prolia can lead to bone loss. And this can raise your risk for bone fractures, particularly the bones in your spine. In some cases, people experienced fractures as soon as 1 month after a missed dose of Prolia.
You should do your best to get your Prolia injections on time. If you know you won’t be able to make your appointment, let your healthcare team know right away.
How to save on Prolia
There are ways to save on Prolia, which is available as a reference (brand-name) medication. GoodRx can help you navigate between copay savings cards and patient assistance programs to save money on your prescription.
Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $25 for Prolia using a savings card from the manufacturer.
Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Prolia’s patient assistance program, which offers the medication free of charge.
Save with a biosimilar. Depending on your location and situation, you may be eligible for a biosimilar version of Prolia. Your healthcare team can tell you more about Jubbonti (denosumab-bbdz), Conexxence (denosumab-bnht), or Stoboclo (denosumab-bmwo).
Frequently asked questions
You can receive Prolia as long as it’s working well and doesn’t cause serious side effects. There are long-term studies that suggest Prolia is safe to use for at least 10 years. Talk to your healthcare team if you’re concerned or want to stop Prolia. They can suggest alternative treatments to help reduce your risk of fractures.
It’s not typically recommended to receive Prolia before the standard 6 months between doses. But if you know you won’t be able to receive your injection on time, tell your healthcare team. In some cases, they may suggest getting your dose a few weeks early. Some studies have found that receiving Prolia 1 month early didn’t significantly change the risk of fractures.
Just keep in mind that if you receive Prolia earlier than usual, this will also change your dosage schedule going forward.
Prolia has no known drug interactions. But there are some medications that could worsen certain Prolia side effects. Examples include other medications that lower calcium levels, such as diuretics (water pills) and medications that raise your risk of infection, such as prednisone. You also may want to wait a few days between your Prolia dose and receiving injectable vaccines. This can help limit pain, redness, or irritation at the injection site.
You can receive Prolia as long as it’s working well and doesn’t cause serious side effects. There are long-term studies that suggest Prolia is safe to use for at least 10 years. Talk to your healthcare team if you’re concerned or want to stop Prolia. They can suggest alternative treatments to help reduce your risk of fractures.
It’s not typically recommended to receive Prolia before the standard 6 months between doses. But if you know you won’t be able to receive your injection on time, tell your healthcare team. In some cases, they may suggest getting your dose a few weeks early. Some studies have found that receiving Prolia 1 month early didn’t significantly change the risk of fractures.
Just keep in mind that if you receive Prolia earlier than usual, this will also change your dosage schedule going forward.
Prolia has no known drug interactions. But there are some medications that could worsen certain Prolia side effects. Examples include other medications that lower calcium levels, such as diuretics (water pills) and medications that raise your risk of infection, such as prednisone. You also may want to wait a few days between your Prolia dose and receiving injectable vaccines. This can help limit pain, redness, or irritation at the injection site.
The bottom line
The typical Prolia (denosumab) dosage is 60 mg injected under the skin every 6 months. You can’t give yourself your dose. A healthcare professional will administer Prolia to you, most likely in their office or clinic. You’ll likely need to take daily calcium and vitamin D supplements to help prevent low calcium, a serious Prolia side effect. Your healthcare professional should also routinely monitor your blood calcium levels while you’re receiving Prolia.
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References
Amgen. (2025). Prolia- denosumab injection [package insert]. DailyMed.
Endocrine Society. (2022). Hypoparathyroidism.
Hanley, D. A., et al. (2012). Denosumab: Mechanism of action and clinical outcomes. International Journal of Clinical Practice.
Kendler, D. L., et al. (2021). Denosumab in the treatment of osteoporosis: 10 years later: A narrative review. Advances in Therapy.
Medicare.gov. (n.d.). Home health services.
National Institute of Dental and Craniofacial Research. (2024). Oral Hygiene. National Institutes of Health.
National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Mineral & bone disorder in chronic kidney disease. National Institutes of Health.
Song, M. (2019). Dental care for patients taking antiresorptive drugs: A literature review. Restorative Dentistry & Endodontics.
Tay, W. L., et al. (2022). Discontinuing denosumab: Can it be done safely? A review of the literature. Endocrinology and Metabolism.
U.S. Food and Drug Administration. (2024). Prolia (denosumab): Drug safety communication - FDA adds boxed warning for increased risk of severe hypocalcemia in patients with advanced chronic kidney disease.
Wong-Pack, M., et al. (2016). The effects of noncompliance to prolia (denosumab) on the changes in bone mineral density: A retrospective review. Journal of Osteoporosis.
