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Bonsity
teriparatide
Adult Dosing .
Dosage forms: INJ (pen): 20 mcg per injection
osteoporosis, postmenopausal
- [20 mcg SC qd]
- Info: for pts w/ high fracture risk; weigh risk/benefit of use >2y; calcium and vitamin D supplementation recommended if inadequate dietary intake
osteoporosis, male primary or hypogonadal
- [20 mcg SC qd]
- Info: for pts w/ high fracture risk; weigh risk/benefit of use >2y; calcium and vitamin D supplementation recommended if inadequate dietary intake
osteoporosis, steroid-induced
- [20 mcg SC qd]
- Info: for pts w/ anticipated use of >2.5 mg/day prednisone or equivalent >3mo and incr. fracture risk; refer to ACR guidelines; weigh risk/benefit of use >2y; calcium and vitamin D supplementation recommended if inadequate dietary intake
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- breastfeeding
- Paget bone dz
- epiphysis, open
- bone XRT hx
- skeletal malignancy hx
- bone metastases
- metabolic bone dz
- hereditary disorder w/ osteosarcoma risk
- hypercalcemia
- hyperparathyroidism
- caution: calciphylaxis risk
- caution: autoimmune disorder
- caution: renal failure
- caution: urolithiasis
Drug Interactions .
Overview
teriparatide
parathyroid hormone analog
- hypercalcemia
Monitor/Modify Tx
- abaloparatide
- calcipotriene topical
- calcitriol
- calcitriol topical
- calcium acetate
- calcium carbonate
- calcium chloride
- calcium citrate
- calcium gluconate
- chlorothiazide
- chlorthalidone
- cholecalciferol (vitamin D3)
- digoxin
- doxercalciferol
- ergocalciferol (vitamin D2)
- hydrochlorothiazide
- indapamide
- methyltestosterone
- metolazone
- palopegteriparatide
- paricalcitol
- testosterone
- vitamin A (retinol)
Caution Advised
- betamethasone
- budesonide
- cortisone
- deflazacort
- dexamethasone
- fludrocortisone
- hydrocortisone
- methylprednisolone
- prednisolone
- prednisone
- triamcinolone
- vamorolone
- warfarin
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- anaphylaxis
- angioedema
- osteosarcoma
- hypercalcemia
- calciphylaxis
- hypotension, orthostatic
- depression
- pneumonia
Common Reactions
- nausea
- hypercalcemia, transient
- arthralgia
- rhinitis
- asthenia
- dizziness
- gastritis
- cough
- dyspnea
- pneumonia
- pharyngitis
- constipation
- dyspepsia
- diarrhea
- orthostatic hypotension, transient
- insomnia
- rash
- depression
- anxiety
- vertigo
- vomiting
- hyperuricemia
- leg cramps
- syncope
- angina
- hyperhidrosis
- tooth disorder
- injection site rxn
Safety/Monitoring .
Monitoring Parameters
consider urine CA if hypercalciuria or urolithiasis
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; no known risk of teratogenicity, though possible risk of skeletal variations based on animal data at >60x recommended human dose
Lactation
Clinical Summary
avoid use while breastfeeding; no human data available, though theoretical risk of infant hypercalcemia based on drug's mechanism of action; no human data available to assess effects on milk production
Pharmacology .
Metabolism: unknown; CYP450: unknown
Excretion: unknown; Half-life: 0.8-1h
Subclass: Osteoporosis: Parathyroid Hormone (PTH) Analogs
Mechanism of Action
binds to parathyroid hormone receptors and preferentially stimulates osteoblastic activity over osteoclastic activity, stimulating new bone formation and increasing skeletal mass and bone strength
Formulary .
No Formulary Selected
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