Parathyroid Hormone for Osteoporosis
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Teriparatide (Forteo) has been approved by the U.S. Food and Drug Administration (FDA) to treat osteoporosis in men and women. It is given by daily injection.
How It Works
Teriparatide is a synthetic version of parathyroid hormone, which is the body's primary regulator of calcium and phosphate in the bones. Teriparatide stimulates bone growth and slows the rate of bone loss.
Why It Is Used
Teriparatide is used to treat severe osteoporosis in people at high risk for bone fractures. It can be used by both men and women. Teriparatide treatment is reserved for people with severe osteoporosis who are unable to take other medications, or for whom other medications are not effective. The reasons why teriparatide is used after other treatments include its high cost, need for daily injections, and unknown long-term effects.
How Well It Works
Studies show that taking teriparatide along with supplemental calcium and vitamin D significantly increased bone density at the spine and hip, compared to taking only calcium and vitamin D. Also, parathyroid hormone reduced the risk of fractures in postmenopausal women. The risk of fractures was not studied in men.1
Teriparatide should not be taken at the same time with bisphosphonates. Taking these medicines together does not build more bone density.2, 3 But taking the two medications at different times and in a specific order may build more bone density. For example, you could take teriparatide for one year and then take a bisphosphonate for the following year to maintain or build bone density.4
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
Call your doctor if you have:
- Fainting or a lightheaded feeling that does not go away.
- Nausea, vomiting, or diarrhea that does not go away.
Common side effects of this medicine include:
- Joint pain.
- Stuffy or runny nose.
- Feeling of loss of strength or energy.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Teriparatide is very expensive and must be given by daily injections.
In animal studies of teriparatide, some rats developed a form of bone cancer called osteosarcoma. So far in human studies of teriparatide, no cases of osteosarcoma have been reported. But these studies have lasted only a few years, so the risk is still unknown. Until long-term effects are known, it is not recommended that teriparatide be taken for longer than 2 years. After you quit taking teriparatide, you will take another medicine such as alendronate, which is a bisphosphonate, to prevent bone loss.
Teriparatide is not recommended for young people whose bones have not stopped growing or who have had radiation therapy that involved the bones.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
- Abramowicz M (2003). Teriparatide (Forteo) for osteoporosis. Medical Letter on Drugs and Therapeutics, 45(1149): 9–10.
- Black DM, et al. (2003). The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis. New England Journal of Medicine, 349(13): 1207–1215.
- Finklestein JS, et al. (2003). The effects of parathyroid hormone, alendronate, or both in men with osteoporosis. New England Journal of Medicine, 349(13): 1216–1226.
- Black DM, et al. (2005). One year of alendronate after one year of parathyroid hormone (1-84) for osteoporosis. New England Journal of Medicine, 353(6): 555–565.
Last Revised: May 14, 2012
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