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Drug side effects

denosumab Side Effects

The reactions most often reported to the FDA for denosumab (also sold as Prolia, Xgeva), with demographics, serious outcomes, and reporting trends.

Data updated 2026-05-15

196,342
FAERS reports

Data from the FDA Adverse Event Reporting System (FAERS), 2008 to 2025. A FAERS report records a temporal association, not proof of cause. See our methodology for how figures are compiled and de-duplicated.

The most commonly reported side effects of denosumab come from 196,342 reports to the FDA, broken down here by frequency, patient demographics, and serious outcomes.

This page analyzes 196,342 reports to the FDA Adverse Event Reporting System (FAERS) for denosumab (Prolia): the reactions reported most often, who reported them, serious outcomes such as hospitalization, and year-over-year trends. A FAERS report does not prove the drug caused the effect, and report volume tracks how widely a drug is used, not how likely an effect is for any one person. Educational information, not medical advice.

Total Reports

196,342

Reports Mentioning Death

25,105

12.8% of reports — not proof the medicine caused the death

Hospitalizations

30,164

15.4% of reports

Top Indication

Product Used For Unknown Indication

Most Reported Adverse Reactions

DEATH
19,930
ARTHRALGIA
8,682
OSTEONECROSIS OF JAW
8,425
FATIGUE
7,481
PAIN IN EXTREMITY
6,893
PAIN
6,774
BACK PAIN
6,757
NAUSEA
5,301
DIARRHOEA
5,093
FALL
4,973
RASH
4,215
MYALGIA
4,163
BONE PAIN
3,978
ASTHENIA
3,959
PRODUCT STORAGE ERROR
3,667
MALAISE
3,601
DYSPNOEA
3,592
HEADACHE
3,548
HYPOCALCAEMIA
3,223

Who Reports Side Effects

Gender Distribution

Female 146,088 (84%)
Male 28,091 (16%)
Unknown 668

Age Distribution

0-17 563 (0%)
18-44 3,094 (3%)
45-64 29,230 (24%)
65-74 38,063 (32%)
75+ 49,014 (41%)

Reporting Trend by Year

2008 2025

Reactions in Death Reports

Top reactions reported in 25,105 reports where death was an outcome. These are voluntarily reported and do not establish causation.

Reaction Reports
DEATH 19,825
FATIGUE 544
PNEUMONIA 541
MALIGNANT NEOPLASM PROGRESSION 520
DISEASE PROGRESSION 467
NAUSEA 444
DIARRHOEA 400
ASTHENIA 372
GENERAL PHYSICAL HEALTH DETERIORATION 364
DYSPNOEA 355
DECREASED APPETITE 307
ANAEMIA 303
VOMITING 294
HOSPITALISATION 291
FALL 289
HYPOCALCAEMIA 284
SEPSIS 258
RESPIRATORY FAILURE 245
OSTEONECROSIS OF JAW 239

Reactions in Hospitalization Reports

Top reactions in 30,164 reports where hospitalization was an outcome.

Reaction Reports
HOSPITALISATION 2,427
FALL 2,023
FATIGUE 1,905
DIARRHOEA 1,878
NAUSEA 1,809
HYPOCALCAEMIA 1,806
PNEUMONIA 1,727
DYSPNOEA 1,531
ASTHENIA 1,396
OSTEONECROSIS OF JAW 1,392
PAIN 1,261
PYREXIA 1,211
VOMITING 1,210
ARTHRALGIA 1,118
MALAISE 1,116
DEATH 1,062
BACK PAIN 1,047
PAIN IN EXTREMITY 1,030
ANAEMIA 1,011

Compare denosumab vs abaloparatide →

What the FAERS Data Reveals About denosumab Side Effects

The FDA Adverse Event Reporting System (FAERS) contains 196,342 voluntary reports linked to denosumab and its brand equivalents (Prolia, Xgeva), spanning 2008 through 2025. Of those, 25,105 (12.8%) listed death as an outcome and 30,164 (15.4%) involved hospitalization. The most common indication reported alongside adverse events was Product Used For Unknown Indication.

Demographic breakdowns help contextualize who is being exposed to the drug. Of reports with known sex, 84% were female and 16% male; age distribution skews toward 75+, with 49,014 reports in that bracket. The single most reported reaction is death with 19,930 submissions, followed by arthralgia and osteonecrosis of jaw.

How to read these numbers

FAERS is a signal-detection tool, not a scorecard. Reports are voluntary, and a single case may list multiple suspect drugs, so numbers above should not be read as incidence rates or per-patient risk. Widely prescribed drugs naturally accumulate more reports than niche therapies even when individual risk is low. These aggregates are useful for spotting patterns that merit further pharmacovigilance, not for choosing between medications. This page is for educational reference only and is not medical advice, speak with a licensed clinician about any side-effect concerns.