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Updated September 2022
Teriparatide (brand names: Forteo®, Terrosa®) is a medicine used to treat severe osteoporosis. Osteoporosis is a common disease that causes bones to become fragile and brittle so that they break (fracture) more easily even as a result of normal activity (as distinct from a fall).
Fractures are painful and restrict a person’s ability to carry out their normal daily tasks. Teriparatide reduces the risk of a broken bone or fracture.
Bone is constantly changing with older bone being broken down and new bone being formed to take its place. This usually happens in a balanced way. If the cycle becomes unbalanced bone breaks down faster than it is replaced. This leads to osteoporosis.
Teriparatide is a man-made form of a substance called parathyroid hormone, which is found naturally in the body and has an important role in maintaining healthy bones. Teriparatide increases bone formation thereby increasing bone strength and reducing the risk of fracture.
Since osteoporosis is usually not painful (until a fracture occurs) you will not ‘feel’ any immediate benefit from your treatment with teriparatide.
The treatment controls osteoporosis but does not cure it. It is therefore important to continue to use teriparatide even if you feel well.
Do not stop using teriparatide until advised by your doctor.
You may be asked to have tests to check the effect of treatment on your bones. For example a bone mineral density test is usually done one or two years after first starting teriparatide. This is a type of X-ray that involves a very small amount of radiation.
Tests of urine or blood are also sometimes used to measure the effects of treatment on bone formation and breakdown.
To make sure it is effective it is very important that you follow the instructions for using teriparatide carefully, including the instructions for storage and disposal. Ask your doctor or pharmacist to explain anything you do not understand.
Teriparatide is given as an injection under the skin (subcutaneously). It is injected in the thigh or abdomen once a day. It comes in a pen- shaped device to make the daily injection easier. The teriparatide pen contains enough medicine for 28 doses.
It is important to use a new needle for each injection.
The teriparatide daily dose is 20 micrograms.
Use it at around the same time every day to help you remember. The best time to take it is at night before going to bed.
If a dose is missed use it as soon as possible that day. However, if the day has already passed, skip the missed dose and continue your regular dosing schedule. Never inject more than one dose per day. Do not use more or less teriparatide or use it more often than prescribed by your doctor.
It is safe to take most other medicines when you are taking teriparatide. However, teriparatide should not be taken with some other osteoporosis medicines (see Precautions).
Your doctor will usually recommend that you take calcium and vitamin D as additional treatment for osteoporosis. Do not stop taking these medicines unless advised by your doctor.
For osteoporosis, treatment with teriparatide is usually given continuously for up to 18 months and no longer. After that further treatment with an alternative medicine for osteoporosis is recommended.
Most people who take teriparatide do not experience side effects. Tell your doctor if you are concerned about possible side effects.
The most common side effects include:
Less common side effects include:
There are a number of other uncommon side effects and precautions. These are described in the leaflet that comes with the medicine. Read this information and discuss any concerns with your doctor.