What Is Evenity?

David Fuller

Last Updated On: June 30, 2025

An estimated 1 in 3 women over age 50 will experience osteoporotic fractures, making bone disease a primary global health concern. Osteoporosis and other skeletal conditions reduce bone density and increase fracture risk, often leading to long-term disability and reduced quality of life.

In response to this growing burden, newer treatment options have emerged. One such therapy is Evenity, a prescription medication designed to strengthen bones and reduce the likelihood of fractures. Its unique dual mechanism of action makes it a notable choice for specific patient groups.

In this article, we will explore what Evenity is, how it works, who it’s for, and what to expect in terms of benefits, side effects, and treatment protocols.

Key Takeaways

• Evenity is a prescription medication designed to treat osteoporosis in postmenopausal women at high risk for fractures.
• It works through a dual-action mechanism, stimulating bone formation and inhibiting bone resorption to enhance bone strength and reduce the risk of fractures.
• The treatment is administered as two injections per month, for a 12-month regimen.
• Evenity is most beneficial for patients who have experienced a recent fracture or have a low T-score indicating osteoporosis.
• Common side effects include joint pain, headaches, and fatigue. However, serious side effects are rare when the medication is administered correctly.
• The treatment is discontinued after 12 months, and patients typically transition to maintenance therapy with antiresorptive agents such as bisphosphonates or Prolia.
• Evenity has demonstrated significant benefits in increasing bone density, particularly in high-risk areas such as the spine and hips.

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What Makes Evenity Unique Among Osteoporosis Treatments

Evenity stands out as a unique treatment for osteoporosis due to its dual-action mechanism. It works by inhibiting sclerostin, a naturally occurring protein that inhibits bone formation, and stimulating osteoblasts, the cells responsible for building bone. At the same time, Evenity reduces the activity of osteoclasts, which break down bone. This dual approach helps stimulate bone formation while limiting bone loss, setting it apart from traditional osteoporosis medications.

While most treatments for osteoporosis either focus on building bone (anabolic agents) or preventing bone loss (antiresorptive agents), Evenity offers both functions. This combination leads to faster and more effective bone strengthening and density improvements, especially in the spine and hips, which are high-risk areas for fractures. 

Evenity’s ability to rapidly build bone makes it a great option for patients at high fracture risk or those with a history of previous fractures, providing them with immediate intervention. However, Evenity’s 12-month treatment window is crucial to consider. After this period, treatment must be switched to an antiresorptive agent to help maintain the gains achieved during Evenity therapy.

Approved Indications and Ideal Patient Profile for Evenity

Evenity is FDA-approved for the treatment of osteoporosis in postmenopausal women who are at high risk for fractures. The ideal candidates include women who have already experienced fractures or those who have not responded adequately to other osteoporosis treatments. This makes Evenity a great choice for patients who need rapid skeletal restoration.

Evenity is particularly suitable for the following groups:

• Women who have suffered a recent vertebral or hip fracture—patients in this group are at higher risk for subsequent fractures, making Evenity an ideal choice for rebuilding bone.
  
• Those with a T-score of -2.5 or lower, indicating the presence of osteoporosis. Evenity can help increase bone mineral density (BMD), particularly in critical areas such as the spine and hips.
  
• Individuals with risk factors such as advanced age, prolonged corticosteroid use, or a family history of osteoporosis, who can benefit from timely intervention and support from Evenity.

For patients in need of rapid bone restoration, Evenity is an excellent choice. After completing the 12-month course, transitioning to antiresorptive agents like bisphosphonates or Prolia helps preserve the gains made during the anabolic phase and reduces fracture risks.

Evenity Dosing, Duration, and Administration Guidelines

Evenity’s effectiveness relies on a structured dosing regimen. Unlike daily or weekly osteoporosis medications, Evenity follows a monthly dosing schedule, ensuring maximum benefit from its dual-action mechanism. Correct administration and adherence to this schedule have a significant influence on treatment outcomes.

The dosing protocol for Evenity is as follows:

• Two subcutaneous injections of 105 mg each, administered on the same day, deliver the full 210 mg monthly dose. This is essential to maintain the anabolic effect throughout the 12 months of treatment.
  
• Prefilled syringes ensure ease of administration, but the injections must be given into the subcutaneous tissue at a 45° to 90° angle, depending on the patient’s body type.
  
• Injection site rotation is crucial to minimize risks such as swelling or lipodystrophy (fat atrophy). Alternating between the right and left sides of the abdomen or thighs helps promote consistent absorption and reduces irritation.

After administration, gentle pressure should be applied to the injection site to minimize minor bleeding or bruising. The 12-month treatment window ensures that the anabolic effects plateau, and patients must transition to antiresorptive therapy afterward.

Evenity Safety Profile: Key Side Effects and Contraindications

While Evenity is generally well-tolerated, it carries some risks that require careful consideration and evaluation. Most side effects are mild and include injection-site reactions such as redness, swelling, or tenderness. Joint pain, headache, and fatigue are also common but typically resolve on their own.

One of the most critical risks associated with Evenity is cardiovascular health. Evenity carries a boxed warning for major adverse cardiovascular events (MACE), such as heart attack and stroke, particularly in patients with a history of cardiac events. This makes careful screening essential before starting treatment.

In addition to cardiovascular screening, patients should also undergo baseline lab tests for serum calcium, vitamin D, and renal function. This helps prevent complications like hypocalcemia (low calcium levels), which can lead to muscle cramps, numbness, or arrhythmias. Supplementing with calcium and vitamin D during treatment is strongly recommended.

Managing Evenity Hair Loss Concerns

Some patients have raised the question, “Does Evenity cause hair loss?” Although there are anecdotal reports of hair thinning during Evenity treatment, clinical studies have not documented this as a direct side effect. The cause of hair shedding is more likely due to factors such as stress, hormonal changes, or nutrient deficiencies.

For patients concerned about hair loss, a thorough evaluation—including tests for ferritin, vitamin D, and thyroid function—can help identify any underlying causes of hair loss. Nutritional support and stress management may also improve symptoms. It’s important to reassure patients that Evenity has not been conclusively linked to hair loss, and most shedding resolves with time.

Conclusion

Evenity’s dual mechanism of action makes it unique among osteoporosis treatments. By stimulating osteoblast activity while inhibiting osteoclast activity, Evenity promotes rapid bone restoration, particularly in high-risk areas like the spine and hips. This makes it a valuable tool for patients in need of rapid intervention.

With careful monitoring, proper dosing, and patient selection, Evenity offers a safe and effective option for improving bone density and reducing fracture risk in postmenopausal women.

FAQs

1. What is the dosing schedule for Evenity?

Two 105 mg injections monthly for 12 doses, followed by maintenance treatment to preserve gains.

2. Are there hair loss concerns with Evenity?

No direct causal link exists, but some patients report shedding. Investigate other causes, such as stress or nutrition.

3. Can cardiovascular patients take Evenity?

No—contraindicated in those with MI or stroke within the past year.

4. What comes after Evenity treatment?

Continue with antiresorptives like bisphosphonates or Prolia to sustain bone density benefits.

References

Epidemiology of osteoporosis and fragility fractures. International Osteoporosis Foundation. Published February 17, 2025. https://www.osteoporosis.foundation/facts-statistics/epidemiology-of-osteoporosis-and-fragility-fractures

Shen Y, Huang X, Wu J, et al. The Global Burden of Osteoporosis, low bone mass, and its related fracture in 204 countries and territories, 1990-2019. Frontiers in Endocrinology. 2022;13. doi:10.3389/fendo.2022.882241

Amgen Inc. EVENITY (romosozumab-aqqg) injection, for subcutaneous use: Prescribing Information. U.S. Food and Drug Administration. 2019. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/761062s000lbl.pdf

Mechanism of Action (MOA) | EVENITY® (romosozumab-aqqg) HCP. https://www.evenityhcp.com/why-evenity/mechanism-of-action