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
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.
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.
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
Side effects
Common Side Effects:
- Arthralgia (joint pain)
- Pain
- Nausea
Other:
- Hypercalcemia (transient)
- Dizziness (orthostatic hypotension)
- Injection site reactions
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.
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
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.
Therapeutic class
Thyroid Drugs & Hormones
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