Description

Xgeva (Denosumab) Injection 120mg in Pakistan – Price, Uses, Dosage, Side Effects

Xgeva (Denosumab) 120mg injection is an imported biologic medicine used for the prevention of skeletal-related events (SREs) in cancer patients with bone metastases, as well as for the treatment of giant cell tumors of bone in adults and skeletally mature adolescents. It is a human monoclonal antibody (IgG2) that works by inhibiting RANKL (Receptor Activator of Nuclear Factor Kappa-B Ligand), a key protein involved in bone destruction.

✅ Formulation: Xgeva Injection 120mg (1.7 mL vial)
✅ Active Ingredient: Denosumab (human monoclonal antibody)
✅ Import Status: Imported medicine
✅ Price in Pakistan: Rs. 35,000 – Rs. 45,000 per vial (price varies by pharmacy)
✅ Manufacturer: Amgen (global biotech company)

Denosumab

Human monoclonal antibody used for the treatment of various bone conditions

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Uses

Treatment of osteoporosis, treatment-induced bone loss, bone metastases, and giant cell tumor of bone

Contraindications

Not to be used by individuals with low blood calcium levels

Common Side Effects

Joint and muscle pain, increased risk of infections, hypocalcemia

Xgeva (denosumab) is a fully human IgG2 monoclonal antibody with high affinity and specificity for human RANK Ligand (RANKL). Denosumab has an approximate molecular weight of 147 kDa and is produced in genetically engineered mammalian (Chinese hamster ovary) cells.Denosumab is not a small molecule drug, so it does not have a typical chemical structure like a synthetic drug. As a monoclonal antibody, its structure consists of four polypeptide chains – two identical heavy chains and two identical light chains – linked together by disulfide bonds.

Medical Uses of Xgeva Injection

Xgeva (Denosumab) is prescribed for:

• Prevention of Skeletal-Related Events (SREs): Helps reduce bone fractures, spinal cord compression, and the need for surgery or radiation in patients with advanced cancer involving the bones.

• Treatment of Giant Cell Tumors of Bone: For unresectable tumors in adults and skeletally mature adolescents.

• Hypercalcemia of Malignancy (HCM): Reduces dangerously high calcium levels in the blood caused by cancers, especially when other treatments fail.

• Improvement of Bone Density & Strength: By reducing osteoclast activity, it helps strengthen bones and lowers fracture risk.

Mechanism of Action – How Xgeva Works

• Active Molecule: Denosumab – a human IgG2 monoclonal antibody.

• Target: RANKL (Receptor Activator of Nuclear Factor Kappa-B Ligand).

• Action: Prevents RANKL from binding to RANK receptors on osteoclasts and their precursors.

• Effect:

  • Decreases formation and survival of osteoclasts.

  • Reduces bone breakdown (resorption).

  • Protects bone structure and prevents cancer-related bone complications.

Dosage & Administration

• Standard Dose: 120 mg subcutaneous injection (under the skin).

• Frequency: Once every 4 weeks.

• Giant Cell Tumors: Extra doses on day 8 and day 15 during the first month.

• Administration Site: Upper arm, thigh, or abdomen.

• Supervision: Must be given by a trained healthcare professional.

Storage Instructions

• Refrigeration: Store between 2°C – 8°C (in the original carton).

• Room Temperature: Stable for up to 30 days if kept below 25°C.

• Do Not Freeze: Freezing damages the medicine.

• Avoid Shaking: Vigorous shaking can inactivate the monoclonal antibody.

Supplementation During Xgeva Therapy

To prevent low calcium (hypocalcemia), patients should take:

• Calcium: At least 500 mg daily.

• Vitamin D: At least 400 IU daily (unless contraindicated).

Ingredients in Xgeva Injection

• Active Ingredient: Denosumab 120 mg (per 1.7 mL solution)

• Excipients: Sorbitol, Acetate buffer, Polysorbate 20, Sodium Hydroxide, Water for Injection

Safety, Warnings & Contraindications

🚫 Do NOT use Xgeva if you have:

• Pre-existing hypocalcemia (low calcium levels)

• Known allergy to denosumab or formulation ingredients

⚠️ Use with caution if:

• You have kidney disease (risk of hypocalcemia increases).

• You are undergoing chemotherapy, radiation, or steroid therapy (higher ONJ risk).

• You are planning dental procedures (increased chance of osteonecrosis of the jaw).

• You are pregnant or breastfeeding (can harm unborn or nursing infants).

Possible Side Effects of Xgeva

Common side effects may include:

• Bone, joint, or muscle pain

• Fatigue and weakness

• Nausea or constipation

• Low calcium levels (hypocalcemia)

• Increased risk of infections

• Skin rash or itching

Serious but rare side effects:

• Osteonecrosis of the Jaw (ONJ): Pain, swelling, poor healing in jawbone.

• Severe Hypocalcemia: Tingling, spasms, irregular heartbeat.

• Serious Allergic Reactions: Swelling, rash, difficulty breathing.

Drug Interactions

Xgeva may interact with:

• Bisphosphonates (should not be combined).

• Immunosuppressants (prednisone, methotrexate, biologics).

• Blood thinners (warfarin, Eliquis).

• Calcimimetics (increase risk of low calcium).

• Certain chemotherapy agents (cyclophosphamide, methotrexate, bleomycin).

👉 Always inform your doctor about all prescription, OTC, and herbal medicines you are taking.

Pregnancy & Breastfeeding Considerations

• Pregnancy: Xgeva can harm an unborn baby (risk of miscarriage, abnormal bone growth, stillbirth). Women must use effective contraception during treatment and for at least 5 months after the last dose.

• Breastfeeding: Not recommended. Denosumab may pass into breast milk and affect infant bone growth.

• Fertility: Animal studies suggest potential effects on reproduction.

Patient Monitoring

• Calcium levels: Must be checked regularly.

• Dental health: Routine dental check-ups recommended.

• Kidney function: Monitored in patients with renal impairment.

• Bone health scans: To assess treatment efficacy.

Xgeva Injection Price in Pakistan

💉 Xgeva (Denosumab) 120mg Injection Price:

• Approx. Rs. 35,000 – Rs. 45,000 per vial

• Price may vary depending on pharmacy, city, and availability.

Final Verdict

Xgeva (Denosumab) Injection 120mg is a highly effective biologic therapy for patients with bone metastases, giant cell tumors, and cancer-related hypercalcemia. By inhibiting RANKL and osteoclast activity, it prevents bone fractures, spinal cord compression, and other skeletal-related events in cancer patients.

While it is effective, Xgeva requires strict medical supervision, calcium & vitamin D supplementation, and regular monitoring to ensure safety and efficacy.