For Caregivers

Be ready to care

Great care starts with you

The relationship between a patient and a doctor is a private one. If your loved one has invited you into that relationship, there are a variety of ways you can help them.

You need to take care of yourself first. If you're not taking care of yourself, you can't take care of anyone else - Jane

Take an active role in discussing bone health

  • Being informed means you will be better prepared to take care of your loved one
  • You may find it helpful to write down questions before each doctor's visit and to take notes during appointments
    • This way, you and your loved one can review the information later
  • Don't hesitate to ask the doctor or nurse for more information or to explain something again. It's important to understand your loved one's health status and treatment plan
Learn more about XGEVA® important safety information.

Watch for signs and symptoms of serious bone problems*

  1. Serious bone problems are defined as broken bones (fractures), the need for surgery to prevent or repair broken bones, the need for radiation treatments to the bone, and pressure on the spinal cord (spinal cord compression).1
  • In addition to regular testing and monitoring for bone metastases, or "bone mets," you should be aware of possible signs or symptoms associated with serious bone problems2
  • If your loved one experiences a new symptom, he or she should tell the doctor right away. These symptoms may indicate the need for urgent medical care2:
    • Bone pain
    • Severe back pain
    • Numbness or weakness in parts of the body
    • Any bladder problems, such as trouble urinating or loss of bladder control
    • Any loss of bowel control
Talk to your doctor to find out if XGEVA® is best for your for serious bone problems.

Don't wait for bone pain. Develop a plan.

Serious bone problems can happen within months from the diagnosis of the first bone met.3,4 Be sure to:

  1. Ask your loved one if they feel pain or are experiencing any other changes (e.g., swelling, stiffness, limping). Be sure to bring up any of these changes during your next visit with your healthcare team
  2. Take the pressure off of your loved one by taking notes and asking questions about their bone health during doctor appointments
  3. Listen to their concerns and provide emotional support
  4. Offer suggestions about bone-targeting medicines like XGEVA® that will help protect against serious bone problems if your loved one has a bone met from a solid tumor1
  5. Prepare some questions for the doctor:
    • What are bone metastases?
    • What are serious bone problems?
    • What are the risks of serious bone problems?
    • How can XGEVA® help prevent serious bone problems?
    • How can I help my loved one feel better during treatment?
    • What are the side effects of XGEVA®?
    • After starting treatment with XGEVA®, what side effects should we be aware of?

Important Safety Information

Do not take XGEVA® if you have low blood calcium (hypocalcemia). Your low blood calcium must be treated before you receive XGEVA®. XGEVA® can significantly lower the calcium levels in your blood and some deaths have been reported. Take calcium and vitamin D as your doctor tells you to. Tell your doctor right away if you experience spasms, twitches, cramps, or stiffness in your muscles or numbness or tingling in your fingers, toes, or around your mouth.

Do not take XGEVA® if you are allergic to denosumab or any of the ingredients of XGEVA®. Serious allergic reactions have happened in people who take XGEVA®. Call your doctor or go to your nearest emergency room right away if you have any symptoms of a serious allergic reaction, including low blood pressure (hypotension); trouble breathing; throat tightness; swelling of the face, lips, or tongue, rash; itching; or hives.

What is the most important information you should know about XGEVA®?

Do not take XGEVA® if you take Prolia. XGEVA® contains the same medicine as Prolia® (denosumab).

Severe jaw bone problems (osteonecrosis)

Unusual thigh bone fracture

Risk of high calcium levels in patients who are still growing

Increased risk of broken bones in the spine after discontinuing XGEVA®

Possible harm to your unborn baby

Tell your doctor if you:

While taking XGEVA®, you should:

What are the possible side effects of XGEVA®?

These are not all the possible side effects of XGEVA®. For more information, ask your doctor or pharmacist.

Call your doctor for medical advice about side effects. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit, or call 1-800-FDA-1088.

Please see Full Prescribing Information.


XGEVA® is a prescription medicine used to prevent fracture, spinal cord compression, or the need for radiation or surgery to bone in patients with multiple myeloma and in patients with bone metastases from solid tumors.

  1. XGEVA® (denosumab) prescribing information, Amgen.
  2. American Cancer Society. Bone metastasis. American Cancer Society website. Revised May 2, 2016. Accessed June 5, 2017.
  3. Saad F, Gleason DM, Murray R, et al; for the Zoledronic Acid Prostate Cancer Study Group. A randomized, placebo-controlled trial of zoledronic acid in patients with hormone-refractory metastatic prostate carcinoma. J Natl Cancer Inst. 2002;94(19):1458-1468.
  4. Lipton A, Theriault RL, Hortobagyi GN, et al. Pamidronate prevents skeletal complications and is effective palliative treatment in women with breast carcinoma and osteolytic bone metastases: long term follow-up of two randomized, placebo-controlled trials. Cancer. 2000;88(5):1082-1090.