Teriparatide
Teriparatide (Forteo) is recombinant human parathyroid hormone (1-34), FDA-approved for osteoporosis treatment. It's unique among osteoporosis drugs in that it stimulates new bone formation.
Mechanism of Action
Intermittent PTH exposure paradoxically stimulates osteoblasts more than osteoclasts, resulting in net bone formation. Continuous exposure would cause bone loss, but pulsatile dosing builds bone.
Dosage Overview
Dose Range
20 mcg
Route
subcutaneous
Frequency
1x daily
Cycle Length
52–104 weeks
Reconstitution
Typical Dosage (Research)
20mcg subcutaneously once daily. Maximum treatment duration of 2 years due to theoretical osteosarcoma risk from rat studies.
Subcutaneous injection in thigh or abdomen once daily. Delivered via multi-dose pen. Should sit or lie down after injection due to orthostatic hypotension risk.
Considerations for Men & Women
Women: FDA-approved for postmenopausal osteoporosis (Forteo). Primary indication is in women at high fracture risk. Two-year maximum treatment duration due to osteosarcoma risk in animal studies. Contraindicated during pregnancy.
Men: Also FDA-approved for male osteoporosis and glucocorticoid-induced osteoporosis. Same 20 mcg daily dose and two-year limit. Less commonly prescribed in men due to lower osteoporosis prevalence.
Individual responses vary. These notes reflect general trends from research literature and are not medical advice.
Quick Calculator
Quick Calculator
Concentration: 333.333 mcg/ml
Volume to inject: 0.06 ml
Syringe units (U-100): 6.0 units
Pre-filled with Teriparatide defaults. Adjust values as needed.
Side Effects & Risks
Orthostatic hypotension, leg cramps, nausea, dizziness, headache, and injection site reactions. Transient hypercalcemia possible.
Boxed warning for osteosarcoma risk (seen in rat studies at high doses). Contraindicated in Paget's disease, unexplained elevated ALP, prior bone radiation, or bone metastases.
Who Uses Teriparatide
Post-menopausal women with severe osteoporosis, men with osteoporosis, those with fractures despite other treatments.
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