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Burosumab Treatment: Dosage, Side Effects, and Injection Guidelines
Summary or Key Points
Burosumab is a prescription medication used to treat rare bone disorders, such as X-linked hypophosphatemia (XLH) and other conditions that result in low phosphate levels. It works by helping the body maintain normal phosphate levels, which are essential for healthy bones. Burosumab is administered through an injection, with the dosage tailored to the specific condition being treated. Always consult your healthcare provider before starting or adjusting your treatment.
Names of Medication
US Brand Name: Crysvita (Burosumab)
The generic name refers to the active ingredient, which remains consistent across all brands. In this case, Burosumab is the generic name, while Crysvita is the brand name.
Pharmacologic Category
Monoclonal Antibody
Phosphate-Regulating Hormone Blocker
Burosumab Dosing Guidelines
Burosumab is prescribed for various conditions that affect bone health and phosphate levels. The dosage may vary depending on the condition being treated. Always follow your healthcare provider’s instructions, and consult them before making any changes to your dose. If you need assistance, our telemedicine providers are available to help.
Burosumab for X-linked Hypophosphatemia (XLH)
Adults: The typical dose is 1 mg/kg of body weight, administered every 4 weeks. The dose may be adjusted based on phosphate levels and how well you respond to treatment.
Burosumab for Hypophosphatemic Rickets
Adults: The recommended dose is 1 mg/kg of body weight, given every 4 weeks. The duration of treatment depends on your response and phosphate levels.
Burosumab for Osteomalacia
Adults: The usual dose is 1 mg/kg, administered every 4 weeks. Your doctor will monitor your phosphate levels and adjust the dose as needed.
Burosumab for Osteitis Fibrosa Cystica
Adults: The typical dose is 1 mg/kg every 4 weeks. Your doctor will determine the length of treatment based on your condition.
Burosumab for Renal Tubular Acidosis
Adults: The recommended dose is 1 mg/kg every 4 weeks. Your healthcare provider will monitor your condition and adjust the treatment as necessary.
Burosumab for Vitamin D-Resistant Rickets
Adults: The usual dose is 1 mg/kg every 4 weeks. Your doctor will adjust the dose based on your phosphate levels and response to treatment.
Burosumab for Hypophosphatemic Osteomalacia
Adults: The dose is typically 1 mg/kg every 4 weeks. Your healthcare provider will monitor your progress and adjust the dose as needed.
Burosumab for Fibrous Dysplasia
Adults: The recommended dose is 1 mg/kg every 4 weeks. Your doctor will determine the length of treatment based on your condition.
Burosumab for Paget’s Disease
Adults: The typical dose is 1 mg/kg every 4 weeks. Your healthcare provider will monitor your response and adjust the dose as needed.
Burosumab for Osteogenesis Imperfecta
Adults: The usual dose is 1 mg/kg every 4 weeks. Your doctor will adjust the dose based on your phosphate levels and response to treatment.
Burosumab Dosage Forms and Strengths
Burosumab is available in the following dosage forms:
- Injection: 10 mg/mL solution in a single-dose vial
- Injection: 20 mg/mL solution in a single-dose vial
- Injection: 30 mg/mL solution in a single-dose vial
Burosumab Administration Instructions
Burosumab is administered as a subcutaneous injection (under the skin). It is typically given by a healthcare provider in a clinic or hospital setting, though some patients may be trained to administer the injection at home. Always follow your doctor’s instructions carefully. If you miss a dose, contact your healthcare provider for guidance.
Burosumab Side Effects and Adverse Reactions
Like all medications, Burosumab may cause side effects. Not everyone will experience these, but it’s important to be aware of potential reactions. If you experience severe side effects, contact your healthcare provider immediately. Our telemedicine team is available to address any concerns.
Common Side Effects: These may include injection site reactions (such as redness, swelling, or pain), headache, and fever. These effects are usually mild and tend to resolve on their own.
Less Common Side Effects: Some patients may experience muscle pain, dizziness, or nausea. If these symptoms persist, consult your doctor.
Serious Side Effects: Rare but serious side effects include allergic reactions (such as hives, difficulty breathing, or swelling of the face or throat), high phosphate levels, or worsening kidney function. Seek medical attention immediately if you experience any of these symptoms.
Burosumab Contraindications
A contraindication is a specific situation or condition where a medication should not be used because it could cause harm. It is important to know if you have any contraindications before starting a new medication. Below are the contraindications for Burosumab:
Hypersensitivity to Burosumab or any of its components: If you have had an allergic reaction to Burosumab or any of its ingredients, you should not take it. Allergic reactions can be serious and may include symptoms such as rash, itching, swelling, or difficulty breathing.
Hyperphosphatemia (high phosphate levels in the blood): Burosumab increases phosphate levels in the blood. If your phosphate levels are already high, taking Burosumab could lead to dangerous complications, such as calcification (hardening) of tissues and organs.
Severe renal impairment or end-stage renal disease: Patients with severe kidney disease may not be able to properly process the medication, leading to harmful side effects. Burosumab is not recommended for people with severe kidney problems.
Drug to Drug Interactions
Burosumab may interact with other medications, potentially altering its effectiveness or increasing the risk of side effects. It’s essential to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some known drug interactions:
- Phosphate supplements: Taking phosphate supplements alongside Burosumab can lead to dangerously high phosphate levels in the blood.
- Vitamin D analogs (e.g., Calcitriol): Vitamin D analogs, such as Calcitriol (Rocaltrol) or Paricalcitol (Zemplar), may also increase phosphate levels, potentially causing hyperphosphatemia when used with Burosumab.
Burosumab in Pregnancy
Is it safe to take Burosumab during pregnancy?
There is limited information on the use of Burosumab during pregnancy. While animal studies have not shown direct harm to the fetus, human studies are still lacking. As a result, Burosumab should only be used during pregnancy if the potential benefits outweigh the risks. If you are pregnant or planning to become pregnant, it’s important to discuss your treatment options with your healthcare provider. You can also schedule a telemedicine consultation with one of our providers to review your specific situation.
Burosumab while Breastfeeding
Is it safe to take Burosumab while breastfeeding?
Currently, there is no data on whether Burosumab passes into breast milk or its potential effects on a breastfeeding infant. Given the unknown risks, it is generally recommended to either discontinue breastfeeding or avoid using Burosumab while nursing. If you are breastfeeding, consult your healthcare provider to determine the best course of action for both you and your baby.
Estimated Cost of Burosumab Treatment
The cost of Burosumab can be significant without insurance. With a GoodRX coupon, the estimated cost for a 30-day supply ranges from approximately $10,000 to $12,000. Prices may vary depending on the pharmacy and location. If cost is a concern, speak with your healthcare provider about financial assistance programs or alternative treatment options.
Possible Alternatives to Burosumab
For certain conditions, alternative treatments or lifestyle changes may help manage symptoms. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore these options.
- X-linked hypophosphatemia (XLH): Alternatives include phosphate supplements and active forms of vitamin D (such as calcitriol). In more severe cases, physical therapy and orthopedic surgery may be considered.
- Hypophosphatemic rickets: Treatment may involve phosphate supplements and vitamin D analogs. Dietary changes to increase phosphate intake may also be recommended.
- Osteomalacia: Common treatments include vitamin D supplementation and adjustments to calcium intake. Weight-bearing exercises may also help improve bone strength.
- Osteitis fibrosa cystica: Often caused by hyperparathyroidism, treatment may involve surgery to remove the overactive parathyroid gland. Medications like bisphosphonates may also be prescribed.
- Renal tubular acidosis: Treatment typically includes alkali therapy (such as sodium bicarbonate or potassium citrate) to correct the acid-base imbalance.
- Vitamin D-resistant rickets: Treatment usually involves high doses of calcitriol and phosphate supplements.
- Hypophosphatemic osteomalacia: Phosphate supplements and vitamin D analogs are the primary treatments. Weight-bearing exercises may also help improve bone health.
- Fibrous dysplasia: Bisphosphonates may be used to reduce bone pain and prevent fractures. Surgery may be required in severe cases.
- Paget’s disease: Bisphosphonates and calcitonin are commonly used to slow bone turnover and reduce pain. Physical therapy may also be beneficial.
- Osteogenesis imperfecta: While there is no cure, bisphosphonates can help strengthen bones. Physical therapy and orthopedic interventions may also be necessary.
Recent Updates on Burosumab Research
Recent studies on Burosumab have shown promising results in improving phosphate levels and bone health in patients with X-linked hypophosphatemia (XLH) and other phosphate-wasting disorders. Ongoing clinical trials are investigating the long-term effects of Burosumab, particularly in pediatric patients and those with other rare bone diseases. Researchers are also exploring whether Burosumab could benefit conditions beyond XLH, such as tumor-induced osteomalacia.
As new research emerges, it’s important to stay informed and consult your healthcare provider about how these findings may impact your treatment plan. If you have questions about Burosumab or would like to discuss the latest research, you can schedule a telemedicine appointment with one of our providers today.
