II. Mechanism
- Recombinant Parathyroid Hormone
- Significant bone anabolic activity
III. Indications: Severe Osteoporosis
- Women, postmenopausal, with severe bone loss
- Men with Osteoporosis and high risk of Fracture
- Osteoporosis refractory to Bisphosphonates
IV. Preparations
- Abaloparatide (Tymlos)
- Dose: 80 mcg SQ daily for up to 2 years
- Teriparatide (Forteo)
- Dose 20 mcg SQ daily for up to 2 years
- Consider restarting bisphosphonate after Teriparatide course is completed
V. Efficacy: Teriparatide (Forteo)
- BMD increases 5.9% at spine and 1.5% at femoral neck
- Reduced risk for osteoporotic Fractures
VI. Contraindications
- Hyperparathyroidism
- Osteomalacia
- End Stage Renal Disease
- Bone Cancer
- Active Nephrolithiasis
- Hypercalcemia
-
Osteosarcoma risk
- Paget's Disease
- Prior skeletal radiation
- Elevated Alkaline Phosphatase level
VII. Adverse Effects
- Common
- Uncommon (identified in rat studies)
VIII. Precautions
- Do not use with bisphosphonate
- Use limited to 2 year maximum (due to risk of Osteosarcoma)
- Very expensive agents ($20,000 per year or more)
IX. Resources
- National Osteoporosis Foundation Clinicians Guide To Osteoporosis
X. References
- (2017) Presc Lett 24(7)
- Campion (2003) Am Fam Physician 67(7):1521-6 [PubMed]
- Orwoll (2003) J Bone Miner Res 18:9-17 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| teriparatide (on 11/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| TERIPARATIDE 620 MCG/2.48 ML | Generic | $996.60 per ml |
| forteo (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| FORTEO 600 MCG/2.4 ML PEN INJ | $1,596.70 per ml | |
| tymlos (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| TYMLOS 80 MCG DOSE PEN INJECTR | $1,413.23 per ml | |