Generic
Teriparatide
2 brands available in the market
At a glance
Teriparatide is a parathyroid hormone analog (PTH 1-34) used for the treatment of osteoporosis in postmenopausal women and men at high risk for fracture. It stimulates new bone formation.
Description
Teriparatide is the 34 N-terminal amino acids of endogenous parathyroid hormone. It binds to specific high-affinity cell-surface receptors, mediating physiological actions on bone and kidney. Once-daily administration preferentially stimulates osteoblastic over osteoclastic activity, promoting new bone formation on trabecular and cortical surfaces and increasing bone strength.
Indications
- Osteoporosis in postmenopausal women at high risk for fracture
- Bone mass increase in men with primary or hypogonadal osteoporosis at high risk for fracture
- Glucocorticoid-induced osteoporosis in men and women at high risk for fracture
Therapeutic class
Thyroid Drugs & Hormones
Pharmacological class
Parathyroid Hormone Analog (Anabolic Agent)
Pharmacology
Teriparatide activates PTH receptors, increasing osteoblastic activity and stimulating new bone formation. Once-daily administration favors bone formation over resorption, increasing bone mineral density and strength.
Mechanism of action
Stimulates new bone formation to increase bone mass and strength.
Dosage
Adult Dose (SC):
- Recommended: 20 mcg subcutaneously once daily
- Treatment duration: Maximum 2 years in a lifetime
Administration
- Subcutaneous injection (thigh or abdominal wall)
- Administer in a sitting or lying position to avoid orthostatic hypotension with initial doses
- Use under guidance from a trained health professional
Missed dose
If you miss a dose, take the next scheduled dose; do not double the dose.
Side effects
Common Side Effects:
- Arthralgia (joint pain)
- Pain
- Nausea
Other:
- Hypercalcemia (transient)
- Dizziness (orthostatic hypotension)
- Injection site reactions
Precautions & warnings
- Do not use in Paget's disease, pediatric/young adults with open epiphyses, or prior skeletal radiation therapy
- Do not use in bone metastases, history of skeletal malignancies, metabolic bone diseases other than osteoporosis, or hypercalcemic disorders
- Caution in active or recent urolithiasis
- Do not use for more than 2 years in a lifetime
Contraindications
- Hypersensitivity to teriparatide or excipients (angioedema, anaphylaxis)
- Paget's disease of bone
- Pediatric/young adults with open epiphyses
- Prior external beam or implant radiation to the skeleton
- Bone metastases or history of skeletal malignancies
- Hypercalcemia of unknown origin
Drug interactions
- Digoxin: Teriparatide may transiently increase serum calcium; caution required
- Hydrochlorothiazide: Does not affect serum calcium response
- Furosemide: Small increases in serum calcium and 24-hour urine calcium (not clinically important)
Food interactions
Caution is advised when consuming alcohol with Teriparatide; consult your doctor.
Use in pregnancy
Use in Pregnancy: Insufficient data; consider discontinuing teriparatide if pregnancy is recognized; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Unknown if excreted in human milk or effects on milk production/infant; consider benefits of breastfeeding and maternal clinical need; consult your doctor.
Pediatric use
Safety and efficacy not established in pediatric patients
Geriatric use
Indicated for elderly
Renal / hepatic impairment
Renal Impairment: Caution in mild-moderate renal impairment; severe: not studied; consult your doctor.
Hepatic Impairment: Not studied in hepatic impairment; consult your doctor.
Overdose effects
Overdose may cause hypercalcemia, nausea, dizziness; temporarily discontinue, increase hydration; provide symptomatic treatment.
Storage conditions
Store at 2-8°C in a refrigerator; do not freeze; do not use if frozen; keep out of reach of children.
Chemical structure
Teriparatide