Evenity Dosing Interval After Missed Dose
If an Evenity dose is missed, it should be administered as soon as it can be rescheduled, and thereafter scheduled every month from the date of that last dose—there is no specific prohibition against administering at 28 days after the previous injection. 1
FDA-Approved Dosing Schedule
The recommended dosing interval for Evenity is once every month (210 mg subcutaneously), administered as two separate 105 mg injections, for a total treatment duration of 12 monthly doses. 1
If a dose is missed, the FDA label explicitly states to "administer as soon as it can be rescheduled" and then "EVENITY can be scheduled every month from the date of the last dose." 1
This guidance indicates flexibility in the dosing schedule when doses are delayed, allowing resumption of monthly dosing from whenever the missed dose is actually given. 1
Clinical Context and Practical Application
A 28-day interval (4 weeks) falls within the typical definition of "monthly" dosing used in clinical practice, and the FDA label does not specify a minimum interval that must elapse before the next dose. 1
The critical instruction is that subsequent doses should be scheduled monthly from the date of the last administered dose, not from the originally planned schedule. 1
Patients must receive adequate calcium and vitamin D supplementation throughout the 12-month treatment course with Evenity. 1
Important Safety Considerations
Evenity is contraindicated in patients with a history of myocardial infarction or stroke, as cardiovascular events were observed in clinical trials. 2, 3
Hypocalcemia must be corrected prior to initiating each dose of Evenity. 3, 4
After completing the 12-month Evenity treatment course, patients should transition to an antiresorptive agent (such as denosumab or a bisphosphonate) to maintain or further increase bone mineral density gains. 3, 5
Evenity should be reserved for postmenopausal women at very high fracture risk, ideally as first-line treatment after a recent major fracture (within 2 years). 2