MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Drugs affecting bone structure and mineralisation

Drug Safety Update 

May 2022: Denosumab 60mg (Prolia): should not be used in patients under 18 years due to the risk of serious hypercalcaemia

August 2020: Denosumab 60mg (Prolia): increased risk of multiple vertebral fractures after stopping or delaying ongoing treatment

 June 2018: Denosumab (Xgeva) for giant cell tumour of the bone: risk of clinically significant hypocalcaemia following discontinuation

 June 2018: Denosumab (Xgeva) for advanced malignancies involving bone: study data show new primary malignancies reported more frequently than zoledronic acid

 June 2017: Denosumab: reports of osteonecrosis of the external auditory canal

 July 2015: Denosumab; intravenous bisphosphonates osteonecrosis of the jaw further measures to minimise risk 

 September 2014: Denosumab updated recommendations minimising the risk of osteonecrosis of the jaw and monitoring for hypocalcaemia

 February 2013: Denosumab 60 mg (Prolia▼): Rare cases of atypical femoral fracture with long-term use.

NICE Guidance (see drug-specific links below)


Please click here for the shared care protocol for prescribing denosumab for the treatment of osteoporosis