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Denosumab missed dose — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsDenosumab missed doseGPhC CRA

A patient receiving denosumab for osteoporosis says her 6-month injection is now 3 months overdue because she missed the clinic appointment. What is the most appropriate action?

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Correct answer: AAdvise prompt prescriber review because delayed doses can increase fracture risk

Denosumab discontinuation or substantial delay can be associated with rebound bone turnover and increased vertebral fracture risk. The patient needs prompt review to arrange the injection or an alternative strategy. Calcium and vitamin D may be important but do not replace antiresorptive treatment. The pharmacist should escalate rather than reassure falsely.

Reference: BNF; MHRA Drug Safety Update