Key takeaways

  • Evenity (romosozumab-aqqg) is a prescription drug that’s used to treat osteoporosis.
  • More common side effects of Evenity include headache, joint pain, insomnia, muscle spasms, and neck pain.
  • Evenity may cause long-term side effects, such as osteonecrosis of the jaw.

Evenity is used to treat osteoporosis in females who have gone through menopause. It’s used when other treatments haven’t worked or aren’t well tolerated. Evenity is also used in postmenopausal females who are at high risk of bone fractures.

The active ingredient in Evenity is romosozumab-aqqg. (The reason “-aqqg” appears at the end of the drug’s name is to show that this drug is distinct from similar medications that may be created in the future.) It comes as a liquid solution in a prefilled syringe for injection under the skin.

Keep reading to learn about the common, mild, and serious side effects Evenity can cause. You can also learn more about this drug by reading this overview of Evenity injections.

Evenity has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Boxed warning for Evenity” section.

Note: The use of binary terms such as “male” and “female” or “men” and “women” in this article reflects the language of the sources we’ve used. Unless otherwise noted, it’s unclear whether the research we reference included participants with expansive gender identities.

Some people may experience mild to serious side effects during their Evenity treatment. Examples of this drug’s commonly reported side effects include:

For more information about some of these side effects, see “Tips for managing side effects.”

Mild side effects have been reported with Evenity. These include:

  • peripheral edema (swelling in the lower legs, feet, or hands)
  • muscle spasms
  • neck pain
  • headache
  • joint pain
  • insomnia

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop Evenity treatment unless your doctor recommends it.

Evenity may cause mild side effects other than those listed previously. See the drug’s prescribing information for details.

For more information about some of these side effects, see “Tips for managing side effects.”

Serious side effects have been reported with Evenity. These include:

If you develop serious side effects with Evenity, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while using Evenity and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Allergic reaction

For some people, Evenity can cause an allergic reaction.

In general, symptoms of an allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue Evenity treatment.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Evenity, they may have you switch to a different treatment.

Long-term side effects of Evenity

Long-term side effects include those that may start at any time you’re taking a drug, even if you’ve taken it for a long time. They also include side effects that persist and may not go away, even after you stop taking the drug.

Examples of long-term side effects reported in studies of Evenity include:

  • osteonecrosis of the jaw
  • risk of cardiovascular problems, including stroke or heart attack (see “Boxed warning for Evenity”)
  • low blood calcium levels

Talk with your doctor to learn more about possible side effects of Evenity injections and how long they may last.

Get answers to some frequently asked questions about Evenity’s side effects.

Does Evenity cause hair loss?

No. Hair loss wasn’t reported in studies of Evenity. But hair loss can have many other causes, such as stress, illness, or genetics. It can also be caused by other medications you take. If you’re concerned about hair loss, talk with your doctor. They can discuss possible causes and offer suggestions to help manage it.

How long does Evenity stay in your system?

The active ingredient in Evenity is a biologic drug called romosozumab-aqqg. (An active ingredient is what makes a drug work.) Research has shown that romosozumab has a half-life of 12.8 days after 3 consecutive monthly doses. This suggests it takes your body about 2 months to clear it from your system. (It usually takes 4 to 5 half-lives for a drug to be fully eliminated.)

Drugs like romosozumab are typically broken down by the liver and excreted by the kidneys. If you have liver or kidney problems, Evenity may stay in your system longer.

What happens when you stop Evenity?

Stopping treatment with Evenity can cause the benefits of the drug to wear off. Evenity works to increase the formation of new bone and slow the breakdown of old bone.

Do not stop treatment with Evenity without talking with your doctor. If you have questions about side effects of Evenity, talk with your doctor or pharmacist.

Evenity has a boxed warning about the increased risk of heart attack, stroke, or death from cardiovascular (heart and blood vessel) problems. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

You may have a higher risk of these serious side effects if you already have certain risk factors, such as type 2 diabetes or heart disease.

What might help

Tell your doctor about any health conditions you may have, including type 2 diabetes, high blood pressure, obesity, and whether you smoke. They’ll determine whether Evenity is safe for you.

If you’ve had a stroke or heart attack in the past year, your doctor won’t prescribe Evenity for you. And if you have a stroke or heart attack during your treatment with this drug, your doctor will have you stop your treatment.

Symptoms of a heart attack include:

Symptoms of a stroke can include:

  • headache
  • loss of balance or vision
  • numbness or weakness in your face or limbs

To learn more about boxed warnings of Evenity, talk with your doctor or pharmacist.

There may be things you can do to help make certain Evenity side effects more manageable. If you have ongoing, worsening, or bothersome side effects, talk with your doctor or pharmacist. They can suggest tips for managing them or recommend other available treatment options for your condition.

Headache

Evenity may cause headaches. This was a common but mild side effect reported in studies of the drug.

But a headache can also be a sign of a serious side effect of Evenity such as stroke.

What might help

If you have mild headaches with Evenity, your doctor may suggest ways to manage them. This may include taking an over-the-counter pain reliever such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol), or lying down in a quiet place.

If you have a headache that’s bothersome or severe, call your doctor. And if you have other symptoms along with it, such as loss of balance, or numbness or weakness of your limbs or face, get medical help immediately by calling 911 or your local emergency medical number. These may be signs of a more serious side effect of Evenity.

Joint pain

Evenity injections may increase your risk of joint pain. This was a common but mild side effect of the drug reported in studies. Joint pain may also be caused by certain health conditions such as arthritis.

Tell your doctor right away if you have severe joint pain. This may be a sign of a more serious side effect of Evenity such as bone problems.

What might help

If you have joint pain with Evenity, talk with your doctor. They can help determine the cause. In some cases, if you have severe pain, they may suggest switching you to a different medication that’s better suited for you. They may also check whether you have other kinds of bone problems or a fracture.

Insomnia

In studies of Evenity, insomnia was a commonly reported but mild side effect of the drug. Keep in mind, there may be other causes for insomnia including other medications you take or other health conditions you may have.

What might help

For mild insomnia, your doctor may suggest lifestyle changes to manage sleep problems. These may include:

  • drinking less caffeine
  • reducing stress
  • getting more exercise
  • maintaining a regular sleep schedule

If you experience ongoing insomnia that’s interfering with your quality of life, talk with your doctor. They can help determine the cause and offer solutions. If your insomnia is bothersome or severe, they may have you stop Evenity and will suggest a different treatment for your condition.

Keeping track of side effects

During your Evenity treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were using when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Taking notes and sharing them with your doctor will help them learn more about how Evenity affects you. They can then use this information to adjust your treatment plan if needed.

Consider the following important information before starting Evenity.

Evenity has a boxed warning. A boxed warning is the most serious warning from the FDA. For details, see “Boxed warning for Evenity“.

Other warnings

Before using Evenity, discuss your health history with your doctor. Evenity may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

  • kidney problems
  • low blood calcium levels
  • osteonecrosis of the jaw
  • previous allergic reaction to this or a similar drug

Pregnancy and breastfeeding with Evenity

Evenity is only approved for use in females who have gone through menopause. It’s not known if it’s safe to use while pregnant or breastfeeding. Evenity can pass into breast milk. If you have questions about Evenity’s uses, talk with your doctor.

Note: The use of binary terms such as “male” and “female” or “men” and “women” in this article reflects the language of the sources we’ve used. Unless otherwise noted, it’s unclear whether the research we reference included participants with expansive gender identities.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.