Approved Use for EVENITY® (romosozumab-aqqg):
EVENITY® is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk of fracture, or cannot use another osteoporosis medicine ... Read More or other osteoporosis medicines did not work well. Close
Approved Use for Prolia® (denosumab):
Prolia® is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk for fracture or cannot use another osteoporosis medicine... Read More
or other osteoporosis medicines did not work well. Close
Approved Use for EVENITY® (romosozumab-aqqg):
EVENITY® is a prescription medicine used to treat osteoporosis ... Read More in women after menopause who are at high risk of fracture, or cannot use another osteoporosis medicine or other osteoporosis medicines did not work well. Close
Approved Use for Prolia® (denosumab):
Prolia® is a prescription medicine used to treat osteoporosis... Read More
in women after menopause who are at high risk for fracture or cannot use another osteoporosis medicine or other osteoporosis medicines did not work well. Close
For women with osteoporosis after menopause at high risk for fracture. NUTRITION

Calcium and vitamin D:
the basics

When it comes to strengthening bones, it takes a combination of
treatment, activity, and nutrition. You’ve likely encountered the
significance of calcium and vitamin D. However, with all the
numbers and information out there, it can get confusing. Let this
be your quick refresher on the basics.

NUTRITION

Calcium and vitamin D: the basics

When it comes to strengthening bones, it takes a combination of
treatment, activity, and nutrition. You’ve likely encountered the
significance of calcium and vitamin D. However, with all the
numbers and information out there, it can get confusing. Let this
be your quick refresher on the basics.

Count your calcium

Calcium is a mineral that provides structural integrity necessary for bone strength. If you don't get enough calcium, the body will pull it from your bones, making them weaker and easier to break over time. So, it's critical to ensure you're getting enough. The recommended daily amount of calcium for postmenopausal women is 1200mg, including from both dietary and supplemental sources.

How do I get enough calcium?

Dairy products like milk, yogurt, and cheese are rich in calcium, alongside nondairy alternatives like almond and soy milks. Green vegetables like kale and collard greens also contain calcium. Look for foods fortified with calcium like juices, cereals, and breads.

Supplements can help bridge the gap if your dietary intake doesn't reach 1200mg. Remember to pay attention to the elemental calcium content and serving size. Keep in mind that there's no benefit to taking more calcium than you need (it may even carry some risks), so it's recommended that you know your current calcium intake before starting a supplement.

How about vitamin D?

Ever wondered why calcium and vitamin D tend to come up together? It's because the body needs vitamin D to absorb calcium, so making sure that you get enough of both is important. The recommended daily amount of vitamin D for postmenopausal women is at least 1000 IU (international units) of vitamin D3 per day for adults aged 50 years and older, including from both dietary and supplemental sources. Some individuals need more than 1000 IU D3 per day to maintain a normal vitamin D level. This may be determined by a blood test and doctor recommendation.

How do I get enough vitamin D?

Vitamin D is known as the "sunshine" vitamin because it is made in your skin in reaction to sun exposure. However, your ability to produce vitamin D decreases as you age and varies based on how much time you spend outdoors. Keep in mind that it's very challenging to get enough vitamin D through sunlight alone if wearing sunscreen.

Luckily, vitamin D is also found naturally in a few foods, like fatty fish (wild-caught mackerel, salmon, and tuna). Other foods are fortified to include it, like milk and other dairy products, orange juice, soy milks, and fortified cereals.

As with calcium, vitamin D supplements can help you reach your daily target. Vitamin D supplements may be taken with or without food. Remember to check to see if any of the other supplements, multivitamins, or medications you take already contain vitamin D. Many calcium supplements also contain vitamin D, so check to make sure you need an additional vitamin D supplement.

So there you have it—one vitamin and one mineral, two sides of the same valuable coin for bone health nutrition!

*Bone Health & Osteoporosis Foundation (BHOF) is an education partner of Amgen.

More resources

Important Safety Information for EVENITY® (romosozumab-aqqg):

What is the most important information I should know about EVENITY?

EVENITY can cause serious side effects, including increased risk of having a heart attack, stroke, or death from a cardiovascular (heart or blood vessel) problem. Call your healthcare provider or get emergency help right away if you have any of these symptoms: symptoms of heart attack, which may include: chest pain or pressure; shortness of breath; feeling light-headed or dizzy; or symptoms of stroke, which may include: headache; numbness or weakness in face, arm, or legs; difficulty talking; changes in vision or loss of balance. Before you receive EVENITY, tell your healthcare provider if you have had a heart attack or stroke, especially if it has happened in the past year.

Do not receive EVENITY if you: have low blood calcium; or are allergic to romosozumab or any of the ingredients in EVENITY.

Before receiving EVENITY, tell your healthcare provider about all your medical conditions, including if you:

  • have a history of other heart or blood vessel problems
  • have low blood calcium
  • cannot take daily calcium and vitamin D
  • have kidney problems or are on kidney dialysis
  • plan to have dental surgery or teeth removed

What are the possible side effects of EVENITY?

EVENITY may cause serious side effects, including:

Serious allergic reactions have happened in people who receive EVENITY. Call your healthcare provider or go to the nearest emergency room right away if you have any symptoms of a serious allergic reaction including: rash; hives; swelling of the face, lips, mouth, tongue, or throat which may cause difficulty in swallowing or breathing.

Low calcium levels in your blood (hypocalcemia). EVENITY may lower the calcium levels in your blood. Your low blood calcium should be treated before you receive EVENITY. Call your healthcare provider if you have symptoms of low blood calcium such as: spasms, twitches, or cramps in your muscles; numbness or tingling in your fingers, toes or around your mouth.

Severe jaw bone problems (osteonecrosis) may occur. Your healthcare provider should examine your mouth before you start EVENITY and may tell you to see your dentist. Ask your healthcare provider or dentist about good mouth care.

Unusual thigh bone fractures. Symptoms of this type of fracture include new or unusual pain in your hip, groin, or thigh.

The most common side effects of EVENITY include joint pain and headaches.

These are not all the possible side effects of EVENITY. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Approved Use:

EVENITY is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk of fracture, or cannot use another osteoporosis medicine or other osteoporosis medicines did not work well.

Please see accompanying EVENITY full Prescribing Information, including Medication Guide.

Important Safety Information for Prolia® (denosumab):

What is the most important information I should know about Prolia?

If you receive Prolia, you should not receive XGEVA® (denosumab). Prolia contains the same medicine as XGEVA.

Prolia can cause serious side effects (including):

Increased risk of severe low calcium levels in your blood (hypocalcemia). Prolia may lower the calcium levels in your blood. If you have low blood calcium before you start receiving Prolia, it may get worse during treatment. Your low blood calcium must be treated before you receive Prolia. Talk to your doctor before starting Prolia. Your doctor may prescribe calcium and vitamin D to help prevent low calcium levels in your blood while you take Prolia. Take calcium and vitamin D as your doctor tells you to.

If you have advanced chronic kidney disease (may or may not be on kidney dialysis), Prolia may increase your risk for severe low calcium levels in your blood, which could result in hospitalization, life-threatening events and death. A mineral and bone disorder associated with kidney disease called chronic kidney disease-mineral bone disorder (CKD-MBD) may increase your risk for severe low calcium levels in blood. Before you start Prolia and during treatment, your doctor may need to do certain blood tests to check for CKD-MBD.

Most people with low blood calcium levels do not have symptoms, but some people may have symptoms. Call your doctor right away if you have symptoms of low blood calcium such as:

  • spasms, twitches, or cramps in your muscles
  • numbness or tingling in your fingers, toes, or around your mouth

Serious allergic reactions have happened in people who take Prolia. Call your doctor or go to your nearest emergency room right away if you have any symptoms of a serious allergic reaction, including low blood pressure (hypotension); trouble breathing; throat tightness; swelling of your face, lips, or tongue; rash; itching; or hives.

Severe jaw bone problems (osteonecrosis) may occur. Your doctor should examine your mouth before you start Prolia and may tell you to see your dentist. It is important for you to practice good mouth care during treatment with Prolia.

Unusual thigh bone fractures. Some people have developed unusual fractures in their thigh bone. Symptoms of a fracture include new or unusual pain in your hip, groin, or thigh.

Increased risk of broken bones, including broken bones in the spine, after stopping, skipping or delaying Prolia. Talk with your doctor before starting Prolia treatment. After your treatment with Prolia is stopped, or if you skip or delay taking a dose, your risk for breaking bones, including bones in your spine, is increased. Your risk for having more than 1 broken bone in your spine is increased if you have already had a broken bone in your spine. Do not stop, skip or delay taking Prolia without first talking with your doctor. If your Prolia treatment is stopped, talk to your doctor about other medicine that you can take.

Serious infections in your skin, lower stomach area (abdomen), bladder, or ear may happen. Inflammation of the inner lining of the heart (endocarditis) due to an infection may also happen more often in people who take Prolia. You may need to go to the hospital for treatment.

Prolia is a medicine that may affect the ability of your body to fight infections. People who have weakened immune systems or take medicines that affect the immune system may have an increased risk for developing serious infections.

Skin problems such as inflammation of your skin (dermatitis), rash, and eczema have been reported.

Bone, joint, or muscle pain. Some people who take Prolia develop severe bone, joint, or muscle pain.

Do not take Prolia if you: have low blood calcium; or are pregnant or plan to become pregnant, as Prolia may harm your unborn baby; or are allergic to denosumab or any ingredients in Prolia.

Before taking Prolia, tell your doctor about all of your medical conditions, including if you:

  • Take the medicine XGEVA (denosumab)
  • Have low blood calcium
  • Cannot take daily calcium and vitamin D
  • Had parathyroid or thyroid surgery (glands located in your neck)
  • Have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome)
  • Have kidney problems or are on kidney dialysis
  • Are taking medicine that can lower your blood calcium levels
  • Plan to have dental surgery or teeth removed
  • Are pregnant or plan to become pregnant
    Females who are able to become pregnant:
    • Your healthcare provider should do a pregnancy test before you start treatment with Prolia.
    • You should use an effective method of birth control (contraception) during treatment with Prolia and for at least 5 months after your last dose of Prolia.
    • Tell your doctor right away if you become pregnant while taking Prolia.
  • Are breast-feeding or plan to breast-feed

What are the possible side effects of Prolia?

It is not known if the use of Prolia over a long period of time may cause slow healing of broken bones. The most common side effects of Prolia are back pain, pain in your arms and legs, high cholesterol, muscle pain, and bladder infection.

These are not all the possible side effects of Prolia. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Approved Use:

Prolia is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk for fracture or cannot use another osteoporosis medicine or other osteoporosis medicines did not work well.

Please see Prolia full Prescribing Information, including Medication Guide.

Important Safety Information for EVENITY® (romosozumab-aqqg):

What is the most important information I should know about EVENITY?

EVENITY can cause serious side effects, including increased risk of having a heart attack, stroke, or death from a cardiovascular (heart or blood vessel) problem.

EVENITY can cause serious side effects...

Important Safety Information for Prolia® (denosumab):

What is the most important information I should know about Prolia?

If you receive Prolia, you should not receive XGEVA® (denosumab). Prolia contains the same medicine as XGEVA...

If you receive Prolia, you should not receive...