II. Mechanism

  1. Recombinant Parathyroid Hormone
  2. Significant bone anabolic activity

III. Indications: Severe Osteoporosis

  1. Women, postmenopausal, with severe bone loss
  2. Men with Osteoporosis and high risk of Fracture
  3. Osteoporosis refractory to Bisphosphonates

IV. 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]

V. 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]

VI. Contraindications

VII. Adverse Effects

VIII. 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)

IX. Resources

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Cost: Medications

forteo (on 5/2/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
FORTEO 600 MCG/2.4 ML PEN INJ $1,208.87 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