Rheumatology Book

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Parathyroid Hormone Analog

Aka: Parathyroid Hormone Analog, Teriparatide, Forteo, Abaloparatide, Tymlos
  1. Mechanism
    1. Recombinant Parathyroid Hormone
    2. Significant bone anabolic activity
  2. Indications: Severe Osteoporosis
    1. Women, postmenopausal, with severe bone loss
    2. Men with Osteoporosis and high risk of Fracture
    3. Osteoporosis refractory to Bisphosphonates
  3. Preparations
    1. Abaloparatide (Tymlos)
      1. Dose: 80 mcg SQ daily for up to 2 years
    2. Teriparatide (Forteo)
      1. Dose 20 mcg SQ daily for up to 2 years
    3. Consider restarting bisphosphonate after Teriparatide course is completed
      1. Black (2005) N Engl J Med 353(6):555-65 [PubMed]
  4. Efficacy: Teriparatide (Forteo)
    1. BMD increases 5.9% at spine and 1.5% at femoral neck
    2. Reduced risk for osteoporotic Fractures
      1. Neer (2001) N Engl J Med 344:1434-41 [PubMed]
  5. Contraindications
    1. Hyperparathyroidism
    2. Osteomalacia
    3. End Stage Renal Disease
    4. Bone cancer
    5. Active Nephrolithiasis
    6. Hypercalcemia
    7. Osteosarcoma risk
      1. Paget's Disease
      2. Prior skeletal radiation
      3. Elevated Alkaline Phosphatase level
  6. Adverse Effects
    1. Common
      1. Orthostatic Hypotension
      2. Transient Hypercalcemia
      3. Nausea
      4. Headache
      5. Palpitations
      6. Arthralgias
      7. Leg Cramps
    2. Uncommon (identified in rat studies)
      1. Osteosarcoma
  7. Precautions
    1. Do not use with bisphosphonate
    2. Use limited to 2 year maximum (due to risk of Osteosarcoma)
    3. Very expensive agents ($20,000 per year or more)
  8. Resources
    1. National Osteoporosis Foundation Clinicians Guide To Osteoporosis
      1. http://www.nof.org/professionals/Clinicians_Guide.htm
  9. References
    1. (2017) Presc Lett 24(7)
    2. Campion (2003) Am Fam Physician 67(7):1521-6 [PubMed]
    3. Orwoll (2003) J Bone Miner Res 18:9-17 [PubMed]
Medication Costs
forteo (on 5/2/2017 at Medicaid.Gov Pharmacy Drug pricing)
FORTEO 600 MCG/2.4 ML PEN INJ $1,208.87 per ml
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

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
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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