What is the recommended total dose of Evenity (romosozumab), 11 or 12 doses?

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Last updated: April 11, 2025 • View editorial policy

From the Guidelines

The recommended dose of Evenity is a total of 12 monthly doses. This is based on the most recent and highest quality study from 2023, which states that the use of romosozumab should be limited to 12 monthly doses because the anabolic effect wanes after 12 monthly doses 1.

Key Points

  • Evenity is administered as two consecutive subcutaneous injections (for a total of 210 mg) once monthly for 12 months.
  • This medication is typically used for postmenopausal women with osteoporosis at high risk for fracture.
  • After completing the 12-month Evenity treatment course, patients should transition to an antiresorptive osteoporosis therapy to maintain bone density gains.
  • The bone-forming effects of Evenity diminish after 12 months, and without follow-up treatment, the bone density improvements may be lost, as noted in the study by Qaseem et al. 1.

Important Considerations

  • Evenity works by both increasing bone formation and decreasing bone resorption, which helps improve bone mineral density and reduce fracture risk.
  • The 12-month duration is specifically designed to optimize these effects while minimizing potential risks associated with longer-term use, such as the increased risk for major adverse cardiovascular events associated with romosozumab 1.

From the FDA Drug Label

The treatment duration for EVENITY is 12 monthly doses. The recommended dose of Evenity is 12 doses total, administered once every month. 2

From the Research

Dosage of Evenity

  • The recommended dose of Evenity (romosozumab) is 210 mg administered as two subcutaneous injections of 105 mg each, once a month for 12 months 3.
  • This dosage is indicated for the treatment of severe osteoporosis in postmenopausal women at high risk of fracture.
  • It is recommended that patients begin antiresorptive therapy after completing treatment with romosozumab 3.

Total Number of Doses

  • The total number of doses is 12, given once a month for 12 months 3.
  • There is no evidence to suggest that the recommended dose is 11 doses total.
  • Re-administration of romosozumab for an additional 12 months may be considered for patients at high fracture risk despite sequential therapy 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

▼Romosozumab for osteoporosis.

Drug and therapeutics bulletin, 2021

Research

Verifying the effectiveness of romosozumab re-administration on bone mineral density.

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.