Compare Actonel vs. Prolia

Head-to-head comparisons of medication uses, side effects, ratings, and more.



Prevents bone loss. Actonel (Risedronate) is a first-choice treatment for osteoporosis and is available as a generic, but how you have to take it can be a hassle.Prevents bone loss. Prolia (Denosumab) is an effective and convenient treatment for osteoporosis if other options haven’t worked or aren’t appropriate for you. There’re risks of some rare side effects, so make sure you're following up with your doctor regularly.
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Reviews & ratings
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Reviews for Actonel (Risedronate)
of people say Actonel (Risedronate) is worth it
say it works well
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Side effects

We haven’t found good data for Actonel side effects.

FDA side effect reports for Actonel »
  • Hypercholesterolemia 1%
  • Ankle and leg swelling 1%
  • Ear, nose, or throat infection 1%
  • Sciatica 1%
  • Bone pain 1%
  • Passing gas 1%
  • Muscle pain 1%
  • Heart-related chest pain 1%
  • Rash 1%
  • Pain in extremity 1%
More Prolia side effects »
How it works
Actonel (Risedronate) is a bisphosphonate. It slows down osteoclasts, the cells that break down bone. This results in greater bone mass and lowers the possibility of fractures.Prolia (Denosumab) is a monoclonal antibody. It blocks a protein that sends signals to break down your bones, and therefore prevents bone loss.
Type of medication
BisphosphonatePrescription only
Monoclonal antibodyPrescription only
Available as
  • Pill
  • Extended release
  • Injection
Used for (click to learn more)
Risk factors for serious side effects
      • Oral or dental surgery
      • Cancer
      • Poor oral hygiene
          Detailed Actonel (Risedronate) risks & warnings »
          • Taking steroids
            • Kidney problems
            • Not taking calcium supplements
            • Taking other medicines that can lower calcium blood levels
            • History of hypoparathyroidism (low levels of parathyroid hormone)
            • Weak immune system
            • Taking medicines that block your immune system (such as transplant medications or steroids)
            • Oral or dental surgery
            • Cancer diagnosis
            • Taking steroids or chemotherapy
            • Poor oral hygiene
              Detailed Prolia (Denosumab) risks & warnings »
              Pregnancy category
              CFDA pregnancy category (Weigh risks vs. benefits)

              Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

              See the FDA package insert
              XFDA pregnancy category (Unsafe)

              Research studies with real people or animals found harmful effects on unborn babies. If you’re pregnant, the risks to your unborn baby outweigh the benefits.

              See the FDA package insert
              No specific alcohol-related info.No specific alcohol-related info.
              • If you're taking the extended release medication, take it after your first meal of the day with at least a half cup of water.
              No specific food-related info.
              Kidneys and liver
              No specific kidneys and liver-related info.No specific kidneys and liver-related info.
              No specific sex-related info.No specific sex-related info.
              No specific sleep-related info.No specific sleep-related info.
              • Consider adding weight-bearing exercises as part of your exercise routine.
              No specific weight-related info.
              Upsides and benefits
              • Available in generic.
              • Available in oral tablets that can be taken once or twice a month, once a week, or once a day.
              • Prolia (Denosumab) is effective at preventing bone loss, making your bones stronger and lowering your chance of getting a fracture.
              • Only need to get an injection every 6 months, so you don’t have to remember to take something every day.
              Downsides and risks
              • You have to take it first thing in the morning with a full glass of water.
              • You have to remain upright for at least 30 minutes after you take the medication, which can be a problem if you have mobility issues.
              • Approved for women only after they’ve reached menopause. Don’t use this if you’re pregnant or planning to become pregnant.
              • Can lower blood calcium levels. You might need to take calcium supplements to prevent this.
              • Not available as a generic.
              Tips from our pharmacists for people taking the medication
              • If you're taking the fast release medication, take it first thing when you wake up by swallowing the whole pill with a full glass of water.
              • Don't eat or drink anything for 30 minutes after you've taken the fast release medication.
              • If you're taking the extended release medication, take it after your first meal of the day with at least a half cup of water.
              • Stay sitting or standing and Don't take any other medications, vitamins or supplements for at least 30 minutes after you take the medication.
              • If you have pain with swallowing, around your chest or stomach, or new or worsening heartburn, talk to your doctor.
              • Call your doctor if you develop pain in your jaw, hips or thighs.
              • Keep taking your calcium and vitamin D.
              • If you forget to take your dose, skip it and take it the following morning.
              • Some of these medications are only taken once or twice a month, others are taken once a week and others once a day. Talk to your pharmacist if you're not sure.
              • Consider adding weight-bearing exercises as part of your exercise routine.
              • Remember to get your shot every 6 months. Write it down on your calendar.
              • If your doctor also told you to take calcium and vitamin D, remember to take them as well. They'll work with Prolia (Denosumab) to help protect your bones.
              • Can cause skin irritation, joint pain, limb pain, and back pain.
              • Let your doctor know if you start getting more infections.
              • Let your dentist know that you’re taking Prolia (Denosumab) since it can cause problems in the jaw bone after dental procedures.
              Learn more
              More about ActonelSide effectsReviews & ratingsAlternativesFDA package insert
              More about ProliaSide effectsReviews & ratingsAlternativesFDA package insert