What Is Evenity? Uses, Dosage, and What You Need to Know in 2026

Evenity (romosozumab-aqqg) is one of the most advanced osteoporosis medications ever developed. Approved by the FDA in April 2019, it works differently from any other osteoporosis treatment — building new bone while also slowing bone loss at the same time. This comprehensive guide explains what Evenity is, what it's approved for, how it's given, and what patients can expect.

What Is Evenity?

Evenity is the brand name for romosozumab-aqqg, a humanized monoclonal antibody classified as a sclerostin inhibitor. It was developed by Amgen in collaboration with UCB Pharma and was the first drug of its kind to receive FDA approval. Evenity targets a protein called sclerostin, which is produced by bone cells (osteocytes) and normally acts as a brake on bone formation.

By blocking sclerostin, Evenity simultaneously:

Increases bone formation (building new bone)

Decreases bone resorption (slowing bone breakdown)

This dual action is what makes Evenity unique — no other approved osteoporosis drug achieves both effects simultaneously to this degree.

What Is Evenity FDA-Approved For?

Evenity is FDA-approved for the treatment of osteoporosis in postmenopausal women at high risk for fracture. "High risk" is defined as:

A history of osteoporotic fracture (broken a bone due to weakened bones), OR

Multiple risk factors for fracture (such as low bone mineral density, age, family history, smoking, steroid use), OR

Failed or intolerant to other available osteoporosis therapies

Evenity is not currently FDA-approved for men or premenopausal women, though research in these populations is ongoing.

How Is Evenity Given?

Evenity is given as a subcutaneous (under the skin) injection by a healthcare provider. Each monthly dose consists of two 105 mg prefilled syringes administered consecutively (total dose: 210 mg). The injections can be given in the abdomen (at least 2 inches from the navel), outer thigh, or upper arm. You visit your doctor's office once monthly for 12 months — Evenity treatment is limited to this 12-month course.

What Happens After the 12-Month Course?

The bone-building effect of Evenity wanes after the 12-month treatment period. After completing Evenity, it is essential to start an antiresorptive medication — such as alendronate (Fosamax), zoledronic acid (Reclast), or denosumab (Prolia) — to preserve the bone density gains achieved during Evenity therapy. Without follow-up therapy, bone density declines relatively quickly after Evenity is stopped.

How Effective Is Evenity?

Evenity's efficacy was established in two major Phase 3 clinical trials:

FRAME trial: Evenity significantly reduced new vertebral fractures at 12 months vs. placebo. The 24-month vertebral fracture incidence was 75% lower in the Evenity group (vs. placebo, followed by denosumab).

ARCH trial: In women with severe osteoporosis and prior fragility fractures, Evenity (followed by alendronate) reduced vertebral fracture risk by 48%, nonvertebral fracture risk by 19%, and hip fracture risk by 38% compared to alendronate alone.

How Does Evenity Compare to Other Osteoporosis Treatments?

Most osteoporosis drugs (bisphosphonates like alendronate, and denosumab/Prolia) are antiresorptive — they slow bone loss but don't actively build new bone. Teriparatide (Forteo) and abaloparatide (Tymlos) are also anabolic agents (bone builders), but they work by activating the PTH receptor and don't have the simultaneous antiresorptive component that Evenity does. Evenity's unique dual mechanism makes it particularly valuable for patients at very high fracture risk who need rapid bone density gains.

What Are the Most Important Safety Considerations?

Evenity carries an FDA boxed warning for increased risk of heart attack, stroke, and cardiovascular death. It should not be used in patients who have had an MI or stroke in the past 12 months. Other important risks include low calcium (hypocalcemia), osteonecrosis of the jaw, and atypical femoral fractures. See our complete guide to Evenity side effects for a full breakdown.

How Do I Get Evenity?

Evenity requires a prescription and prior authorization from insurance. It's dispensed through specialty pharmacies and administered in a healthcare provider's office. If you're having trouble locating a pharmacy that can source it, medfinder can help you identify pharmacies near you that carry it.