Description and Brand Names

Drug information provided by: IBM Micromedex

US Brand Name

  1. Forteo

Descriptions


Teriparatide injection is used to treat osteoporosis in postmenopausal women who are at high risk for bone fracture. It reduces the risk of having bone and spine fracture in postmenopausal women with osteoporosis.

Teriparatide injection is also used to increase bone mass in men with primary or hypogonadal osteoporosis who are at high risk for bone fracture or cannot use other osteoporosis treatments.

Teriparatide injection is also used to treat osteoporosis caused by steroid (glucocorticoid) medicine in men and women who are at high risk for bone fracture or cannot use other osteoporosis treatments.

Teriparatide is a synthetic form of the natural human parathyroid hormone. This medicine helps your body to form new bone, increase bone mineral density and bone strength. As a result, it reduces the chance of getting a fracture (broken bone).

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Solution

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of teriparatide injection in the pediatric population. Safety and efficacy have not been established. However, use is not recommended because it may increase the risk for bone cancer in children with open epiphyses (bones are still growing).

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of teriparatide injection in the elderly.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Digoxin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bone cancer, or history of or
  • High levels of alkaline phosphatase (enzyme found in the bones) or
  • Metabolic bone disease (eg, Paget's disease of the bone)—Use is not recommended. This medicine may increase the risk for bone cancer (osteosarcoma) in patients with these conditions.
  • Hypercalcemia (high calcium in the blood) or
  • Hypercalciuria (high calcium levels in the urine) or
  • Hyperparathyroidism (overactive parathyroid) or
  • Kidney stones, active or recent—Use with caution. May make these conditions worse.
  • Kidney disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use

A nurse or other trained health professional will give you this medicine. It is given as a shot under your skin, usually in the stomach or thigh.

This medicine comes with a Medication Guide and the User Manual. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Teriparatide may sometimes be given at home to patients who do not need to be in a hospital or clinic. If you are using this medicine at home, your doctor or nurse will teach you how to prepare and inject the medicine. Be sure that you understand how to use the medicine.

You should receive the first several injections of this medicine while sitting or lying down if needed, until you know how this medicine affects you.

If you use teriparatide at home, you will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. This will help prevent skin problems.

Use a new needle each time you inject your medicine. Do not store the prefilled pen with the needle attached.

If the medicine in the prefilled syringe has changed color, or if you see particles in it, do not use it.

You may take calcium and vitamin D supplements while you are using this medicine if needed. Follow your doctor's instructions about how to take these supplements.

Use of this medicine and parathyroid hormone analogs for more than 2 years during your lifetime is not recommended. Talk with your doctor if you have any concerns about this.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage form (prefilled pen):
    • For osteoporosis:
      • Adults—20 micrograms (mcg) injected under the skin once a day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store in the refrigerator. Do not freeze.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

You might not use all of the medicine in each prefilled pen. Throw away any unused medicine after 28 days, even if there is still medicine in it.

Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

This medicine may increase your risk of having osteosarcoma (bone cancer). This is more likely to occur if you have a history of radiation treatment involving your bones. Check with your doctor right away if you have bone pain that does not go away or a new soft tissue mass that is tender to palpation.

This medicine may increase levels of calcium in the blood and urine. High calcium in the urine may cause kidney stones. Call your doctor right away if you have blood in the urine, confusion, constipation, dry mouth, metallic taste, muscle weakness, nausea or vomiting, pain in the side, back, or stomach, or weight loss.

This medicine may cause some people to become dizzy or drowsy. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Confusion
  2. constipation
  3. depression
  4. dry mouth
  5. headache
  6. incoherent speech
  7. increased urination
  8. loss of appetite
  9. metallic taste
  10. muscle weakness
  11. nausea
  12. stomach pain
  13. thirst
  14. unusual tiredness
  15. vomiting
  16. weight loss

Less common

  1. Arm, back, or jaw pain
  2. chest pain, discomfort, tightness, or heaviness
  3. cough
  4. fainting
  5. fast or irregular heartbeat
  6. fever or chills
  7. nausea
  8. sneezing
  9. sore throat
  10. sweating
  11. trouble breathing

Incidence not known

  1. Hives or welts, itching, skin rash
  2. redness of the skin
  3. swelling or puffiness of the mouth and face

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Acid or sour stomach
  2. belching
  3. blurred vision
  4. body aches or pain
  5. diarrhea
  6. difficulty having a bowel movement (stool)
  7. difficulty with moving
  8. dizziness
  9. heartburn
  10. hoarseness
  11. indigestion
  12. lack or loss of strength
  13. muscle pain, stiffness, or spasm
  14. nervousness
  15. pain in the joints
  16. pounding in the ears
  17. runny or stuffy nose
  18. tender, swollen glands in the neck
  19. trouble with swallowing
  20. voice changes

Less common

  1. Back pain
  2. discomfort
  3. discouragement
  4. dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  5. feeling of constant movement of self or surroundings
  6. feeling sad or empty
  7. indigestion
  8. irritability
  9. lack of appetite
  10. leg cramps
  11. loss of interest or pleasure
  12. neck pain
  13. sensation of spinning
  14. sleeplessness
  15. stomach cramps
  16. swollen mouth and tongue
  17. tiredness
  18. tooth disorder
  19. trouble concentrating
  20. trouble sleeping
  21. unpleasant taste
  22. urge to have bowel movement

Incidence not known

  1. Bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
  2. flushing
  3. unusually warm skin

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.