[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Sclerostin inhibitors](https://durgical.com/en/pharmacology/classes/sclerostin-inhibitors/) › Romosozumab

# Romosozumab

## Sclerostin inhibitors?

Sclerostin inhibitors

A monthly antibody injection that blocks sclerostin. It builds bone fast in postmenopausal women at very high fracture risk.

Updated Nov 1, 2026

Also called: Romosozumab-aqqg

## Quick facts

**Group**
[Sclerostin inhibitors](https://durgical.com/en/pharmacology/classes/sclerostin-inhibitors/)

**Target**
Sclerostin (SOST)

**Used for**
Osteoporosis

**Key effects**
Joint pain · Pain and redness at the injection site

**Monitor**
Serum calcium before starting · Dental health before

**ATC**
M05BX06

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

Romosozumab is a humanised monoclonal antibody that binds sclerostin, a protein released by osteocytes that inhibits Wnt signalling in osteoblasts. With sclerostin neutralised, osteoblasts form more bone and bone resorption decreases. Bone mineral density rises quickly; after the course an antiresorptive drug is started so that the gain is kept.

- Romosozumab binds and neutralises sclerostin
- Wnt signalling in osteoblasts is released
- Bone formation rises and resorption falls
- Bone density increases and fractures decrease

## Indications

- Osteoporosis in postmenopausal women at high fracture risk, or when other treatments failed or were not tolerated [Osteoporosis →](https://durgical.com/en/conditions/osteoporosis/)

## Adverse effects

### Common

- Joint pain
- Pain and redness at the injection site

### Serious (rare, important)

- Heart attack, stroke and cardiovascular death (boxed warning)
- Osteonecrosis of the jaw
- Unusual thigh, hip or groin pain (possible atypical femoral fracture)
- Hypocalcaemia (cramps, twitching, tingling)
- Allergic reactions, including angioedema

## Contraindications

- Hypocalcaemia not yet corrected
- Recent heart attack or stroke (especially within the past year): generally avoided
- Hypersensitivity to romosozumab

## Key interactions

**Denosumab or bisphosphonates**
Started after the romosozumab course to keep the bone gained

**Calcium and vitamin D**
Adequate intake is needed during treatment to avoid hypocalcaemia

## What is monitored

- Serum calcium before starting
- Symptoms of heart attack or stroke
- Dental health before and during treatment
- Bone mineral density

## Administration and safety

- Subcutaneous injection into the abdomen, upper arm or thigh by a health professional, monthly for a total of 12 doses
- Calcium is checked and low calcium corrected before the first dose
- A dental examination, and any needed dental treatment, comes before starting

## Pregnancy and breastfeeding

It is approved only for postmenopausal women and is not used in pregnancy or breastfeeding.

## Nursing care

- Ask about heart attack or stroke in the past year before each dose
- Teach the signs of heart attack and stroke and the need for emergency care
- Check calcium and encourage adequate calcium and vitamin D
- Advise a dental check before starting and good oral hygiene

## Pharmacokinetics

**Absorption**
Given by subcutaneous injection once a month by a health professional

## Memory aid

ROMOsozumab ROMps bone up for a year, but watch the heart.

## Test yourself

Think of the answer, then tap the question to see it.

## What does romosozumab bind, and with what effect on bone?

Sclerostin; this releases Wnt signalling, so bone formation rises and bone resorption falls.

## Which patients should not receive romosozumab because of its boxed warning?

People who had a heart attack or stroke within the past year, because it may raise the risk of cardiovascular events.

## How long is the course and what comes after?

Twelve monthly doses, followed by an antiresorptive drug to maintain the gain in bone density.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/romosozumab/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 4

- [Denosumab](https://durgical.com/en/pharmacology/denosumab/)
- [Teriparatide](https://durgical.com/en/pharmacology/teriparatide/)
- [Abaloparatide](https://durgical.com/en/pharmacology/abaloparatide/)
- [Zoledronic acid](https://durgical.com/en/pharmacology/zoledronic-acid/)

## Related conditions 1

- [Osteoporosis](https://durgical.com/en/conditions/osteoporosis/)

[← Back to the class: Sclerostin inhibitors](https://durgical.com/en/pharmacology/classes/sclerostin-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Romosozumab-aqqg Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a619026.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=M05BX06) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/romosozumab/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/romosozumab/