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 |
Ontology: Teriparatide (C0070093)
Definition (MSH) | A polypeptide that consists of the 1-34 amino-acid fragment of human PARATHYROID HORMONE, the biologically active N-terminal region. The acetate form is given by intravenous infusion in the differential diagnosis of HYPOPARATHYROIDISM and PSEUDOHYPOPARATHYROIDISM. (Reynolds JEF(Ed): Martindale: The Extra Pharmacopoeia (electronic version). Micromedex, Inc, Englewood, CO, 1995) |
Concepts | Hormone (T125) , Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
MSH | D019379 |
SnomedCT | 425438001, 398823001 |
English | hPTH (1-34), Human Parathyroid Hormone (1-34), TERIPARATIDE @ @ UNIDENTIFIED, TERIPARATIDE UNIDENTIFIED, HPTH 001 034, Teriparatide (substance), Teriparatide, Human PTH (1-34), (1-34)-Human Parathyroid Hormone, Teriparatide [Chemical/Ingredient], parathyroid teriparatide, teriparatide (medication), teriparatide, Teriparatide (product), TERIPARATIDE |
Swedish | Teriparatid |
Czech | teriparatid |
Spanish | teriparatida (sustancia), teriparatida (producto), teriparatida, teriparatide, Hormona Paratiroidea Humana (1-34), hPTH (1-34), Teriparatido |
Finnish | Teriparatidi |
French | hPTH (1-34), Hormone parathyroïdienne humaine (1-34), Tériparatide |
Russian | TERIPARATID, PARATIREOIDNYI GORMON (1-34) CHELOVEKA, ПАРАТИРЕОИДНЫЙ ГОРМОН (1-34) ЧЕЛОВЕКА, ТЕРИПАРАТИД |
Japanese | ヒト副甲状腺ホルモン(1-34), テリパラチド, 酢酸テリパラチド, フォルテオ, テリパラチド酢酸塩 |
Italian | Ormone paratiroideo umano (1-34), hPTH (1-34), Teriparatide |
German | HPTH 001 034, Humanes Parathormon (1-34), Teriparatid, hPTH (1-34) |
Polish | Teryparatyd, hPTH 1-34, Hormon przytarczyc ludzki 1-34 |
Norwegian | hPTH (1-34), Teriparatide, Humant paratyroideahormon (1-34) |
Portuguese | Hormônio (1-34) da Paratireoide Humana, Hormônio Paratireóideo Humano (1-34), Hormônio (1-34) Paratireóideo Humano, hPTH (1-34), Teriparatida |
Ontology: Forteo (C1170286)
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
MSH | D019379 |
English | Lilly Brand of Teriparatide, Teriparatide Lilly Brand, forteo, Forteo |
French | Forteo |
German | Forteo |
Norwegian | Forteo |