If you have problems caused by some kinds of cancer, your doctor might suggest Xgeva (denosumab) as a treatment option for you.

Xgeva is a prescription medication that’s used to:

  • prevent serious bone problems in adults with multiple myeloma or cancerous solid tumors that have spread to bone
  • treat giant cell tumor of bone that can’t be operated on in adults and in adolescents whose bones have finished growing
  • treat hypercalcemia (high calcium levels) in adults that’s caused by cancer and doesn’t respond to bisphosphonate treatment

Xgeva belongs to a group of drugs called RANK ligand inhibitors. It’s sometimes called a bone-modifying agent. The drug comes as a liquid that’s given as an injection under your skin. This is done by your doctor or a healthcare professional.

This article describes the dosages of Xgeva, including its form, strength, and how the drug’s given. To learn more about Xgeva, see this in-depth article.

Note: This article covers Xgeva’s typical dosages, which are provided by the drug’s manufacturer. But when using Xgeva, always take the dosage that your doctor prescribes.

Below is information about dosages for each condition Xgeva is approved to treat.

Note: Your doctor may prescribe calcium and vitamin D supplements for you to take with Xgeva. These supplements treat or prevent hypocalcemia (low calcium levels). Make sure to take them as prescribed.

What is Xgeva’s form?

Xgeva comes as a clear to pale yellow solution (liquid mixture) in a single-dose vial. Your doctor or healthcare professional will inject Xgeva under your skin using a syringe and needle.

What strength does Xgeva come in?

Xgeva comes in a strength of 120 milligrams (mg) per 1.7 milliliters (mL).

What are the typical dosages of Xgeva?

The dosage and administration frequency for Xgeva injections depends on the condition being treated. The information below describes common dosages that are typically recommended. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for multiple myeloma and bone metastasis from solid tumors

Xgeva’s dosage for multiple myeloma and cancerous solid tumors that have metastasized (spread) to bone is 120 mg every 4 weeks.

Your doctor may prescribe calcium and vitamin D supplements for you to take with Xgeva. These supplements treat or prevent hypocalcemia (low calcium levels). Make sure to take them as prescribed.

Dosage for giant cell tumor of bone

Xgeva’s dosage for giant cell tumor of bone is 120 mg every 4 weeks. On days 8 and 15 of the first month of treatment, you’ll receive another injection of 120 mg.

Your doctor may prescribe calcium and vitamin D supplements for you to take with Xgeva. This helps treat or prevent hypocalcemia. Make sure to take them as prescribed.

Dosage for hypercalcemia caused by cancer

Xgeva’s dosage for hypercalcemia (high calcium levels) that’s caused by cancer and doesn’t respond to bisphosphonate treatment is 120 mg every 4 weeks. On days 8 and 15 of the first month of treatment, you’ll receive another 120-mg injection.

What’s the dosage of Xgeva for children?

Xgeva is approved to treat giant cell tumor of bone in adolescents whose bones have finished growing. The dosage for these adolescents is the same as the dosage for adults, which is described in “Dosage for giant cell tumor of bone” just above.

Is Xgeva used long term?

Yes, Xgeva is typically used as a long-term treatment. If you and your doctor determine that Xgeva is safe and effective for you, it’s likely that you’ll use it long term.

Below are answers to some commonly asked questions about Xgeva.

Can Xgeva injections be given once every 3 months?

No, Xgeva is not given every 3 months. Xgeva injections are given every 4 weeks to help prevent serious bone problems.

Xgeva can be used to treat cancerous solid tumors that have spread to bone. Zoledronic acid is a drug that’s used to treat breast cancer that has spread to bone. This drug may be given every 3 months instead of every 4 weeks, if approved by your doctor.

But zoledronic acid is a different kind of drug than Xgeva. These drugs have different doses and amounts of time needed between injections. Make sure to not change your treatment or Xgeva dosage without first talking with your doctor.

Is Xgeva used to treat osteoporosis? If so, what’s the dosage?

No, Xgeva is not approved to treat osteoporosis (weakened bones).

Xgeva contains the active ingredient denosumab, which is also the active ingredient in a different drug called Prolia. Prolia is approved to treat osteoporosis. Although Xgeva and Prolia have the same active ingredient, they have different uses and dosages. These drugs should not be taken together.

Xgeva is given by a doctor or healthcare professional as an injection under your skin. It may be injected into your abdomen (belly), upper arm, or upper thigh. It’s not approved for injection into a vein, muscle, or just below the skin’s surface.

For information on Xgeva expiration, storage, and disposal, see this article.

If you miss an appointment to receive an Xgeva injection, call your doctor to reschedule as soon as possible. It’s important to get an injection of Xgeva every 4 weeks. It might be helpful to schedule your next dose before you leave each appointment.

To help remember appointments, you could set a reminder on your phone or mark your injection schedule on a calendar.

The sections above describe the typical dosages provided by Xgeva’s manufacturer. If your doctor recommends Xgeva for you, they’ll prescribe the dosage that’s right for you.

Remember, you shouldn’t change your dosage of Xgeva without your doctor’s recommendation. Only take Xgeva exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • Should my dosage change if I start having side effects from Xgeva?
  • Does my dosage of Xgeva change if I’m taking other medications at the same time?
  • If I have liver problems or kidney problems, will I need an adjusted Xgeva dosage?

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.