Short answer: The Prolia label says that if a dose is missed, give the injection as soon as the patient is available, then schedule the next ones every 6 months from the date of that last injection. The label also warns that stopping, skipping or delaying Prolia raises the risk of broken bones in the spine.
| Situation | What the label says |
|---|---|
| Schedule | 60 mg every 6 months, given by a healthcare provider (2.3) |
| Missed a dose | Give it as soon as possible (2.3) |
| Next dose after a late one | Every 6 months from the date of the late injection (2.3) |
| Risk of a delay | More spine fractures after stopping or delaying (5.6, Medication Guide) |
| Half-life | About 25.4 days (12.3) |
Section 2.3 says that if a dose of Prolia is missed, give the injection as soon as the patient is available, then schedule injections every 6 months from the date of the last injection.
Example: your Prolia was due March 1 and you get it on April 15. Under the label your next injection would be due around October 15, 6 months after April 15, not September 1.
Section 5.6 warns about multiple spine fractures after Prolia is stopped. The Medication Guide says the risk of broken bones, including in the spine, goes up after stopping, skipping or delaying a dose. That is why the label says to get a missed injection as soon as possible rather than waiting.
Denosumab levels fall over 4 to 5 months, with a mean half-life of about 25.4 days (section 12.3).
Six months is long enough to forget. Note the exact date of each injection, because after a late dose the next due date moves with it.
This page summarizes FDA labeling. It is not personalized medical advice; confirm what to do with your prescriber or pharmacist.