Are any of the following medications the same as Xgeva (denosumab)?

Denosumab (Xgeva) Medication Identification

Denosumab is the only medication on the list that is the same as Xgeva, as Xgeva is the brand name for denosumab at the 120mg dose used for prevention of skeletal-related events in patients with bone metastases.

Understanding Denosumab Products

Denosumab is available in two distinct FDA-approved formulations:

1. Xgeva (denosumab 120mg): Used for prevention of skeletal-related events in patients with bone metastases from solid tumors 1, 2

   • Administered subcutaneously every 4 weeks
   • Higher dose formulation (120mg)
   • Primarily used in oncology settings

2. Prolia (denosumab 60mg): Used for osteoporosis treatment 2

   • Administered subcutaneously every 6 months
   • Lower dose formulation (60mg)
   • Primarily used in non-oncology settings

Important Clinical Considerations

Medication Safety

• The FDA label explicitly states: "Prolia contains the same active ingredient (denosumab) found in Xgeva. Patients receiving Prolia should not receive Xgeva" 2
• This warning exists because receiving both medications would result in excessive denosumab exposure and increased risk of adverse effects

Clinical Applications

• Denosumab (Xgeva) is indicated for:
  • Prevention of skeletal-related events in patients with bone metastases from solid tumors 1
  • Delaying time to first skeletal-related event by approximately 8.2 months compared to zoledronic acid 3
  • Management of bone pain in metastatic disease 1

Mechanism of Action

• Denosumab is a fully human monoclonal antibody that binds to RANKL (receptor activator of nuclear factor kappa-B ligand) 1
• By binding RANKL, it prevents interaction with RANK receptors on osteoclasts, inhibiting osteoclast formation, function, and survival 1
• This mechanism reduces bone resorption and increases bone mass density

Potential Adverse Effects

• Hypocalcemia: Can be severe; requires calcium and vitamin D supplementation 2
• Osteonecrosis of the jaw: Requires dental evaluation before starting treatment 2
• Atypical femoral fractures: Patients should report unusual thigh or hip pain 2
• Hypersensitivity reactions: Including anaphylaxis in rare cases 2

Clinical Practice Recommendations

• Preventive dental measures are necessary before starting denosumab 1
• Calcium and vitamin D supplementation is essential during treatment 2
• For patients with advanced chronic kidney disease, special monitoring is required 2
• Regular monitoring of serum calcium levels is recommended 2

None of the other medications listed in the question (ABILIFY MAINTENA, Aranesp, ASCENIV, etc.) contain denosumab or are equivalent to Xgeva.