| Osteoporosis, Postmenopausal
Prolia vs Miacalcin
Side-by-side clinical, coverage, and cost comparison for osteoporosis, postmenopausal.Deep comparison between: Prolia vs Miacalcin with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsMiacalcin has a higher rate of injection site reactions vs Prolia based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Miacalcin but not Prolia, including UnitedHealthcare
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Category
Prolia
Miacalcin
At A Glance
SC injection
Every 6 months
RANKL inhibitor
SC or IM injection
Daily to every 6 hours
Calcitonin receptor agonist
Indications
- Osteoporosis, Postmenopausal
- Osteoporosis
- Osteoporosis steroid-induced
- Osteitis Deformans
- Hypercalcemia
- Osteoporosis, Postmenopausal
Dosing
Osteoporosis, Postmenopausal, Osteoporosis, Osteoporosis steroid-induced 60 mg as a single subcutaneous injection once every 6 months in the upper arm, upper thigh, or abdomen; all patients should receive calcium 1000 mg daily and at least 400 IU vitamin D daily.
Osteitis Deformans 100 USP Units (0.5 mL) once daily by subcutaneous or intramuscular injection; ensure adequate calcium and vitamin D intake.
Hypercalcemia Start at 4 USP Units/kg every 12 hours SC or IM; increase to 8 USP Units/kg every 12 hours if no response in 1-2 days; may further increase to 8 USP Units/kg every 6 hours if no response after 2 more days.
Osteoporosis, Postmenopausal 100 USP Units (0.5 mL) once daily by subcutaneous or intramuscular injection; ensure adequate calcium (at least 1000 mg/day) and vitamin D (at least 400 IU/day) supplementation.
Contraindications
- Pre-existing hypocalcemia
- Pregnancy
- Hypersensitivity to any component of Prolia (including anaphylaxis, facial swelling, and urticaria)
- Hypersensitivity to calcitonin salmon or any of the excipients (reactions have included anaphylaxis with death, bronchospasm, and swelling of the tongue or throat)
Adverse Reactions
Most common (>=2%) Back pain, pain in extremity, musculoskeletal pain, hypercholesterolemia, cystitis
Serious Severe hypocalcemia, hypersensitivity reactions, osteonecrosis of the jaw, atypical subtrochanteric and diaphyseal femoral fractures, multiple vertebral fractures following discontinuation, serious infections, dermatologic adverse reactions
Postmarketing Anaphylaxis, rash, urticaria, facial swelling, erythema, severe symptomatic hypocalcemia, severe musculoskeletal pain, marked PTH elevation in severe renal impairment, multiple vertebral fractures following discontinuation, cutaneous lichenoid drug eruptions, alopecia, vasculitis, DRESS syndrome
Most common (>=10%) Nausea with or without vomiting, local inflammatory reactions at injection site
Most common (2-5%) Flushing of face or hands, skin rashes, pruritus of the ear lobes
Serious Hypersensitivity reactions including anaphylaxis, hypocalcemia with tetany and seizures, malignancy (increased incidence observed in meta-analysis)
Postmarketing Bronchospasm, urticaria, influenza-like symptoms, fatigue, edema, arthralgia, musculoskeletal pain, hypertension, abdominal pain, diarrhea, polyuria, dizziness, headache, paresthesia, tremor, visual disturbance
Pharmacology
RANKL inhibitor; human IgG2 monoclonal antibody that binds RANKL, preventing RANKL/RANK interaction on osteoclasts and their precursors, thereby inhibiting osteoclast formation, function, and survival to decrease bone resorption and increase bone mass and strength in both cortical and trabecular bone.
Calcitonin receptor agonist; calcitonin salmon acts primarily on bone to produce a marked transient inhibition of osteoclast-mediated bone resorption, with additional direct effects on the kidneys increasing excretion of phosphate, calcium, and sodium, and actions on the gastrointestinal tract.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Prolia
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (11/12) · Qty limit (11/12)
Miacalcin
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Prolia
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Miacalcin
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Prolia
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Miacalcin
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Prolia.
Cost estimate not availableAssistance Fund: Hypophosphatasia (HPP)
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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ProliaView full Prolia profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.