Teriparatide

Teriparatide is a prescription medication used to treat symptoms of osteoporosis.

• Teriparatide is available under the following different brand names: Forteo, Bonsity

Adult dosage

Prefilled injectable pen

• 250mcg/mL (2.4 mL [Forteo, Bonsity])

Osteoporosis

Adult dosage

• 20 mcg SC once daily

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Teriparatide include:

• nausea;
• joint pain; or
• pain anywhere in the body.

Serious side effects of Teriparatide include:

• bone pain;
• new or unusual swelling or lumps under the skin;
• a light-headed feeling (may occur within 4 hours after injection);
• pounding heartbeats or fluttering in the chest after using an injection; or
• high calcium levels--confusion, muscle weakness, nausea, vomiting, lack of energy, constipation, increased thirst or urination, weight loss.

Rare side effects of Teriparatide include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Teriparatide has severe interactions with no other drugs.
• Teriparatide has serious interactions with no other drugs.
• Teriparatide has moderate interactions with the following drug:
  • digoxin
• Teriparatide has minor interactions with at least 12 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Teriparatide?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Teriparatide?”

Cautions

• Transient orthostatic hypotension may occur with initial doses
• May exacerbate urolithiasis; consider risk/benefit in patients with active or recent urolithiasis
• Osteosarcoma risk
  • Avoid use in patients with increased risk of osteosarcoma including those with
  • Open epiphyses (children, young adults)
  • Metabolic bone diseases including Paget disease, bone metastases, or history of skeletal malignancies
  • Prior external beam or implant radiation therapy involving the skeleton
  • Hereditary disorders predisposing to osteosarcoma
• Hypercalcemia and cutaneous calcification
  • Avoid in patients known to have an underlying hypercalcemic disorder
  • Discontinue in patients developing worsening of previously stable cutaneous calcification
  • Hypercalcemia may predispose the patient to digoxin toxicity
• Drug interaction overview
• Digoxin
  • A single teriparatide dose did not alter the effect of digoxin on the systolic time interval
  • Owing to teriparatide may transiently increase serum calcium, use with caution in patients taking digoxin
  • Consider potential onset of signs and symptoms of digitalis toxicity when used in patients receiving digoxin

Pregnancy and Lactation

• There are no available data on use in pregnant women to evaluate for drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes; consider discontinuing drug when pregnancy is recognized.
• Lactation
  • Not known whether teriparatide is excreted in human milk, affects human milk production, or has effects on the breastfed infants; because of potential for osteosarcoma shown in animal studies, advise patients that breastfeeding is not recommended during therapy