Consultation and Medical Evaluation
Before your Evenity treatment begins, a thorough consultation with your healthcare provider is paramount. This initial meeting establishes a baseline for your bone health and assesses any potential risk factors. You must provide a complete medical history to your doctor.
Full Medical History Review
Your healthcare provider needs to know about your entire medical background, not just your osteoporosis. Certain conditions can increase the risks associated with Evenity. Be prepared to discuss:
- Cardiovascular events: A recent history of a heart attack or stroke within the past year is a contraindication for Evenity, as the medication can increase the risk of these events.
- Kidney health: Inform your doctor if you have any kidney problems or are on dialysis, as this can affect calcium levels.
- Low blood calcium (hypocalcemia): This condition must be corrected before starting Evenity. Your doctor will likely check your blood calcium levels and prescribe supplements if needed.
Dental Examination and Planning
Evenity is associated with a rare but serious side effect known as osteonecrosis of the jaw (ONJ), especially in patients undergoing certain dental procedures.
- Pre-treatment dental exam: A dental check-up is recommended before starting Evenity. Your dentist and doctor should be aware of your treatment plan.
- Dental surgery considerations: If you have invasive dental procedures planned, such as a tooth extraction or dental implants, discuss them with your doctor and dentist beforehand. They may recommend delaying the procedure.
- Ongoing oral hygiene: Maintaining excellent dental hygiene throughout the treatment is critical for reducing the risk of ONJ. Brush and floss regularly, and alert your dentist that you are on Evenity before any work is done.
Pre-Injection Day Checklist
Following specific steps on the day of your appointment can greatly improve the comfort and effectiveness of your Evenity injection.
Hydration and Medication
- Hydrate adequately: Drink plenty of water before your appointment to ensure you are well-hydrated. This can help minimize discomfort associated with injections.
- Take supplements: Your doctor will likely prescribe daily calcium and vitamin D supplements. Continue taking these as directed, even on injection days, to maintain proper calcium levels.
- Consider pain management: Some patients experience muscle aches or soreness at the injection site. Taking an acetaminophen about an hour before your appointment can help manage this discomfort. Avoid NSAIDs unless your doctor advises otherwise, as their effect on bone metabolism is sometimes debated.
Evenity Syringe Preparation
Evenity is administered as two separate subcutaneous injections. To make the injections more comfortable, proper handling of the medication is necessary.
- Allow to warm to room temperature: The prefilled syringes must be removed from the refrigerator and allowed to warm for at least 30 minutes before injection. Do not speed this process by heating it in any way, such as with hot water or a microwave.
- Visual inspection: Before administration, a healthcare provider will visually inspect the solution. It should be a clear to opalescent, colorless to light yellow solution. If it appears cloudy, discolored, or has particles, it should not be used.
Clothing and Injection Site Selection
- Wear comfortable clothing: Choose loose-fitting clothing that allows easy access to the potential injection sites: the thigh, abdomen, or upper arm.
- Rotate injection sites: To minimize skin reactions, like redness or pain, the two injections should be given at different sites. The site should also be rotated monthly. Avoid injecting into skin that is tender, bruised, red, or scarred.
Comparison of Evenity vs. Other Osteoporosis Treatments
| Feature | Evenity (Romosozumab) | Bisphosphonates (e.g., Alendronate) | Denosumab (Prolia) |
|---|---|---|---|
| Mechanism | Promotes new bone formation and decreases bone breakdown. | Slows down bone breakdown. | Inhibits bone breakdown. |
| Administration | Two subcutaneous injections monthly for 12 months. | Oral daily or weekly pills, or intravenous infusion. | Subcutaneous injection every 6 months. |
| Cardiovascular Risk | Increased risk of heart attack or stroke, especially within the first year of treatment. | Minimal or no increased risk typically associated with oral forms. | No known direct increased cardiovascular risk. |
| Jawbone Risk (ONJ) | Small risk, requires dental monitoring. | Small risk, requires dental monitoring. | Small risk, requires dental monitoring. |
| Post-Treatment | Requires follow-up treatment with another medication to maintain gains. | Long-term use may have risks. | If stopped, bone density can decline rapidly. |
Conclusion
Preparing for an Evenity injection is a multi-step process that involves careful medical consultation, attention to dental health, and following specific instructions on the day of your appointment. By working closely with your healthcare team, communicating any changes in your health, and adhering to the pre-injection protocol, you can ensure a safe and effective treatment experience. Remember to stay hydrated, take your prescribed supplements, and allow the medication to warm properly to room temperature before administration. These steps are vital for managing your osteoporosis and supporting your journey toward stronger, healthier bones. You can find more detailed safety information and medication guides directly from the official Evenity website at https://www.evenity.com.
