All About Xgeva

What is Xgeva?

If you have a cancer or tumor, your doctor may prescribe Xgeva to help prevent bone problems.

Xgeva is a prescription drug used in adults.

• prevent bone fractures in people with multiple myeloma or cancer that has spread to the bones from a solid tumor
• treat hypercalcemia (high calcium levels in the blood) caused by cancer
• “Giant cell tumors can’t be safely removed by surgery, so they’re treated.”

Doctors may also prescribe Xgeva for certain children with giant cell tumors. To learn more about Xgeva’s uses, see the “What indications is Xgeva used for?” section below.

Xgeva basics

The drug denosumab is active. It is part of a group of drugs called RANKL inhibitors. Drugs made from living cells are called bio drugs.

Xgeva is not available in biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.) Instead, denosumab comes only as the brand-name drug Xgeva.

You’ll receive Xgeva as an injection under your skin at a clinic or doctor’s office.

“Learn about Xgeva’s side effects and uses.”

What are Xgeva’s side effects?

Mild or serious side effects may occur with Xgeva. Some of the more common side effects of Xgeva are described in the lists below. All possible side effects are not included in these lists.

The side effects of a drug can depend on other factors.

• The condition you are treating.
• Your age.
• You have other health conditions.
• You take other drugs.

The doctor or the pharmacy can tell you more about the side effects of Xgeva. They can suggest ways to reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Xgeva can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Xgeva’s prescribing information.

Mild side effects of Xgeva have been reported.

• fatigue (low energy) or weakness
• Stomach problems, such as nausea, vomiting, or colon problems.
• There is pain in your body.
• There is swelling in your legs or arms.
• upper respiratory infection such as the common cold
• There is a There is a skin rash..
• There is a throbbing head.
• The breath was very thin.
• decreased appetite
• There is a problem
• low levels of phosphate
• low levels of red blood cells or platelets (cells that help with blood clotting)

The side effects of many drugs can be gone in a few days. If they become intolerable, talk to your doctor or pharmacist.

Serious side effects

There are serious side effects from Xgeva, but they are not common. If you have serious side effects from Xgeva, you should call your doctor. If you think you have a medical emergency, you should call the emergency number.

There have been serious side effects of Xgeva.

• Pneumonia.
• thigh bone break
• hypocalcemia (low calcium levels)*
• The jaw has osteonecrosis.
• allergic reaction*

The side effect focus section gives more information about this side effect.

Side effect focus

There are some side effects of Xgeva.

Osteonecrosis of the jaw

In rare cases, taking Xgeva can cause a jaw problem. The breakdown of bone tissue in the jaw is called ONJ.

Symptoms of ONJ may include:

• “Jaw or mouth pain that doesn’t go away.”
• The teeth, gums, or bones are at risk of being infections.
• There are sores on your gums.
• There is a problem
• Slow healing or persistent pain after a dental procedure.

In Xgeva’s studies, most people who developed ONJ also had other factors that contributed to the condition (such as a tooth removal).

Other factors that may increase the risk of ONJ include:

• For a long time, Xgeva treatment is continuing.
• smoking
• having anemia or diabetes
• Having gum infections.
• Steroids are used to weaken your immune system.
• taking cancer medications that stop the growth of blood vessels, such as bevacizumab (Avastin)

What can help?

It’s important to practice good oral hygiene during your Xgeva treatment. This includes regular brushing, flossing, and seeing your dentist for cleanings and checkups. You’ll also have a dental checkup before starting Xgeva.

If you need to have an invasive dental procedure while receiving Xgeva, your doctor may have to pause your treatment. Examples of these procedures include tooth extractions and dental implant procedures.

Tell your doctor right away if you have a There is a problem or other possible symptoms of ONJ during your treatment with Xgeva. If you develop ONJ, your doctor or dentist will discuss the treatment options for ONJ with you. They may prescribe medications to ease your symptoms or recommend surgical treatments. They may also have you stop your Xgeva treatment.

If you have concerns about your dental health, talk to your doctor or dentist.

Hypocalcemia

Xgeva may cause hypocalcemia (low calcium levels). This was a common side effect in studies of the drug. In some cases, hypocalcemia can be severe.

Hypocalcemia may have symptoms.

• There are muscle spasms or cramps.
• There is numbness and tingling in the hands and feet.
• There are confusion or memory problems.
• Depression.
• “Hearing things that aren’t really there is called hallucinations.”
• brittle nails

There have been fatal cases of hypocalcemia in people who took Xgeva. It is not known if the drug was the cause or if other factors were involved. If you are concerned about the risk of hypocalcemia with Xgeva, you should talk to your doctor.

If you have a serious problem with your kidneys or take medication that lowers your calcium levels, you may be at higher risk of this side effect.

What can help?

Your doctor will check your calcium levels before you get Xgeva. They will treat hypocalcemia before they prescribe Xgeva.

You will have blood tests to check for low calcium levels. If you have other risk factors for developing this side effect, you may have these tests more frequently in the first few weeks of treatment.

Your doctor may recommend you take supplements to help prevent low calcium levels during your Xgeva treatment. These supplements may include calcium, magnesium, and vitamins D and D3. These products are available without a prescription, but your doctor will tell you the type and amount of the supplements to take.

Allergic reaction

Some people may have an allergic reaction to Xgeva. Allergic reactions have been reported in people taking Xgeva but weren’t seen in the drug’s studies.

A mild allergic reaction can include some symptoms.

• There is a There is a skin rash..
• It is itchy.
• flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is not uncommon. A severe allergic reaction can cause swelling under your skin, usually in your lips, hands, or feet. They can also include swelling of your mouth, throat, and tongue, which can cause breathing problems.

If you have an allergic reaction to Xgeva, call your doctor. If you think you have a medical emergency, call the emergency number.

What should I know about Xgeva vs. alternative drug Prolia?

Xgeva and Prolia contain the same active drug, denosumab. But these drugs are used to treat or prevent different conditions related to the bones.

For an in-depth comparison of Xgeva and Prolia, see this article.

What does Xgeva cost?

There are many factors that affect the cost of prescription drugs. What your insurance plan covers is one of the factors.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. The Xgeva website also has information about financial assistance options.

You can also check out this article to learn more about saving money on prescriptions.

What is Xgeva’s dosage?

Your doctor will tell you the right amount of Xgeva. Your doctor will determine the dosage you receive.

Form and strength

Xgeva is a liquid solution. The 120 imimes of the drug in each vial is 1.7 imimes of solution.

You’ll receive Xgeva as an injection under your skin at a clinic or doctor’s office.

Recommended dosages

You will receive Xgeva doses every 4 weeks.

If you’re taking Xgeva to treat giant cell tumors or hypercalcemia caused by cancer, you’ll likely receive two extra doses during your first month of treatment.

Your doctor will check your schedule for Xgeva.

Questions about Xgeva’s dosage

There are many questions about Xgeva.

• What if I miss a dose of Xgeva? If you miss an appointment to receive a dose of Xgeva, call your doctor’s office right away. They’ll work with you to reschedule your appointment as soon as possible.
• Will I need to use Xgeva long term? If Xgeva is working to improve your condition, your treatment may be long term. Talk with your doctor about the benefits of long-term use and the risks of stopping your treatment.
• How long does Xgeva take to work? Xgeva should slow down your body’s breakdown of bone within a few weeks of starting treatment. During your treatment, your doctor will monitor you to make sure the drug is still working for your condition.

What indications is Xgeva used for?

There are several indications listed below. The specific uses and conditions for which a medication is taken are identified indications.

Some adults use Xgeva.

• prevent bone fractures in people with multiple myeloma or cancer that has spread to the bones from a solid tumor
• treat hypercalcemia (high calcium levels in the blood) due to cancer
• “Giant cell tumors can’t be safely removed by surgery, so they’re treated.” (Xgeva may also be used in certain children with this condition)

Below are the uses described in more detail.

Xgeva for preventing fractures in people with cancer

Xgeva is used to prevent bone breaks in adults who have cancer.

• multiple myeloma, a cancer that affects the bone marrow
• cancer that has spread to the bones (also called bone metastases) from a solid tumor. A few examples of solid tumors are prostate cancer, breast cancer, and lung cancer.

Your body naturally maintains your bones by continually breaking down bone tissue, then rebuilding it. With multiple myeloma or bone metastases, the cancer can interfere with the body’s natural bone maintenance. This may cause bones to break down more quickly than usual. This, along with the effects of certain cancer treatments such as radiation, can lead to weak bones. Weak bones are more likely to fracture (break).

Xgeva slows bone breakdown to prevent bone breaks. The drug stops certain bone cells from breaking down bone tissue when it is attached to a specificprotein in your body. This strengthens your bones.

Xgeva for hypercalcemia

Xgeva is also used in certain adults to treat hypercalcemia due to cancer. For this use, doctors prescribe Xgeva for adults who have already tried a bisphosphonate drug, but it didn’t work effectively. Examples of bisphosphonates are alendronate (Fosamax), pamidronate (Aredia), and zoledronic acid (Zometa).

Some people with cancer have high levels of calcium. Cancer can cause your bones to break down more quickly than usual. Calcium is released into the blood when bones break. Xgeva slows bone breakdown by treating high calcium levels.

Xgeva for giant cell tumors

“Xgeva is used to treat giant cell tumors that can’t be safely removed by surgery. A giant cell tumor is a rare type of bone tumor. Older children with stopped bones are the ones who are usually prescribed Xgeva. This happens around 12 years old.”

Xgeva works to treat giant cell tumors by attaching to certain proteins. This can help prevent the tumors from growing. This may help shrink the tumors.

What should I know about Xgeva vs. alternative drug Zometa?

Xgeva and Zometa are used to treat bones.

The active drug denosumab is in Xgeva.

For more information about how these drugs compare, see this article.

What are some frequently asked questions about Xgeva?

Find out what the answers are to some questions.

Does Xgeva cause dental side effects?

It’s possible. Teeth problems have been reported in people taking Xgeva. In studies of people receiving Xgeva for giant cell tumors (a rare type of bone tumor), There is a problem was a common side effect.

In rare cases, Xgeva may cause osteonecrosis of the jaw (ONJ). This refers to the breakdown or death of bone tissue in the jaw. For more information, see “Side effect focus” in the “What are Xgeva’s side effects?” section above.

It’s important to practice good oral hygiene during your Xgeva treatment. This includes regular brushing, flossing, and seeing your dentist for cleanings and checkups. You’ll also have a dental checkup before starting Xgeva. Tell your doctor or dentist right away if you have a There is a problem during treatment, as this could be a sign of ONJ.

Is Xgeva a chemotherapy drug?

No, Xgeva isn’t a chemotherapy drug. Chemotherapy drugs treat cancer by killing fast-growing cells in your body, including healthy cells.

Xgeva is a kind of targeted therapy. Although the drug is used in people with certain types of cancer, the drug doesn’t kill cancer cells (or any fast-growing cells). Instead, Xgeva helps prevent and treat serious bone problems, such as bone fractures. It’s used in people with multiple myeloma, cancer that has spread to the bones, hypercalcemia (high calcium levels in the blood) due to cancer, and bone tumors. Xgeva works to slow bone breakdown. It also works to keep bone tumors from growing.

If you have questions about how Xgeva works, you should talk to your doctor.

Can Xgeva cause long-term side effects?

It is possible. People who take Xgeva for a long time may have side effects.

• The jaw is broken down or dies of bone tissue.
• thigh bone break

Additionally, long-term side effects have been reported in people after their Xgeva treatment ended. Examples of these side effects included hypercalcemia (high calcium levels in the blood). For more information about the possible side effects of stopping Xgeva, see “Side effect focus” in the “What are Xgeva’s side effects?” section above.

Your doctor will keep an eye on you after your Xgeva treatment.

Will I experience side effects after stopping Xgeva treatment?

Possibly.

Side effects may be caused by stopping Xgeva treatment. These side effects may include:

• hypercalcemia has high calcium levels in your blood.
• The spine has a broken bone.

Some people have high calcium levels after stopping Xgeva treatment. The side effect was in people with giant cell tumors. Doctors only prescribe Xgeva for this condition in adults and children who have stopped growing bones.

Additionally, The spine has a broken bone. have occurred in some people after stopping Xgeva. This risk may be higher in people with osteoporosis (bone loss) or who have had bone fractures.

It is important to talk with your doctor about the risks and benefits of Xgeva treatment, as well as the risks and benefits of stopping it.

Your doctor and you will decide how long your treatment will last. You should not stop going to your Xgeva appointments on your own. If you want to stop the drug, you should talk to your doctor. They can help you decide if you should stop treatment.

If you and your doctor decide to stop Xgeva, they will keep a close watch on you. This may include getting a blood test.

How is Xgeva given?

Your doctor will explain how Xgeva will be given to you. They will tell you how much you will be given.

Taking Xgeva

You’ll receive Xgeva as an injection under your skin at a clinic or doctor’s office. Xgeva injections are given in the upper arm, upper thigh, or abdomen (belly).

Taking Xgeva with other drugs

You can take certain supplements while taking Xgeva. They include calcium and vitamins D and E.

There are supplements for calcium and vitamins D and E. Talk to your doctor about the correct amount of calcium and the correct amount of vitamins D and E.

Taking these supplements can help prevent or manage hypocalcemia (low calcium levels), which is a serious side effect of Xgeva. (For more information, see “Side effect focus” in the “What are Xgeva’s side effects?” section above.)

Questions for your doctor

You may have questions about Xgeva. Discuss your concerns with your doctor.

Here are a few tips that might help you.

• Before your appointment, write down questions such as:
  • How will Xgeva affect my body?
• Bring someone with you to your appointment to make you feel more comfortable.
• “If you don’t understand something, ask your doctor to explain it.”

“Your doctor and other healthcare professionals are available to help you. They want you to get the best care possible. Don’t be afraid to ask questions or give feedback on your treatment”

What should be considered before taking Xgeva?

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before you start taking Xgeva, you should tell your doctor about all your drugs. You should describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about the risks associated with Xgeva.

Interactions with drugs or supplements

Xgeva should not be given to people who’re receiving Prolia. This is because Prolia and Xgeva contain the same active drug, denosumab.

Taking certain drugs with Xgeva may increase the risk of side effects. These drugs can be examples.

• Cinacalcet is a drug used in people with chronic kidney disease.
• tacrolimus and etanercept are immunosuppressive drugs.
• Anti-angiogenic drugs are drugs that prevent new blood vessels from forming.
• Steroids, such as Medrol and prednisone.

Warnings

If you have a medical condition that affects your health, Xgeva may not be right for you. Before you take Xgeva, talk to your doctor about your health history. Factors to consider are:

• Allergic reaction. If you’ve had an allergic reaction to Xgeva, Prolia, or any of their ingredients, your doctor will likely not prescribe Xgeva. Ask them what other medications are better options for you.
• Low calcium level. Xgeva may cause hypocalcemia (low calcium levels). If you’ve been told you have low calcium levels, or if you take a medication that lowers calcium levels, talk with your doctor. They’ll treat your hypocalcemia before considering Xgeva for you. If they prescribe Xgeva, they’ll also have you take calcium and vitamin D supplements to help maintain healthy calcium levels. And they’ll monitor your calcium levels closely during treatment.
• Kidney problems. Xgeva may cause low calcium levels. If you have kidney problems, this side effect is more likely to occur. Because of this risk, doctors typically recommend calcium and vitamin D supplements for people who take Xgeva and have kidney problems. Your doctor will also monitor your calcium levels closely during treatment.
• Osteoporosis. Before starting Xgeva treatment, tell your doctor if you have osteoporosis. (This condition causes weak and brittle bones.) Xgeva can cause certain fractures during treatment and after stopping it. You may have a greater risk for this side effect if you have osteoporosis. Your doctor can recommend whether it’s safe for you to use Xgeva.

Xgeva and alcohol

It is safe to drink alcohol during your treatment.

If you drink alcohol, you should talk to your doctor about the amount that is safe for you to drink.

Pregnancy and breastfeeding

Xgeva is not a good choice for pregnant women. The drug may cause harm to a fetus.

“If you are able to become pregnant, your doctor will have you take a pregnancy test. They need to know you aren’t pregnant before you start treatment. Birth control will be prescribed by your doctor for at least 5 months after your last dose of Xgeva.”

It is not known if Xgeva is safe to use while breastfeeding. Before you start treatment with Xgeva, talk with your doctor.

What to ask your doctor

Certain people can be helped by Xgeva to prevent or treat bone problems.

Your doctor can provide more information about the pros and cons of using Xgeva for your condition. They can also tell you about other treatment options for multiple myeloma, cancer that’s spread to the bones, hypercalcemia (high calcium levels in the blood), and bone tumors.

You may have questions about using Xgeva. Discuss these with your doctor. Some questions you may want to ask are:

• How long will my treatment last?
• Should I take any supplements with Xgeva?
• Is it safe to keep taking my other drugs?
• Can I drive myself to my appointments?