Teriparatide

Indications

Teriparatide is used for: Postmenopausal osteoporosis, Primary or hypogonadal osteoporosis in males

Adult Dose

Subcutaneous Postmenopausal osteoporosis, Primary or hypogonadal osteoporosis in males Adult: 20 mcg daily into the thigh or abdominal wall. Max treatment duration: 18 mth.

Child Dose

Renal Dose

Administration

Contra Indications

Patients at increased risk of osteosarcoma (e.g. Paget's disease of bone, unexplained increases in serum alkaline phosphatase, paediatric patients or young adults with open epiphyses and patients who have received prior external beam or implant radiation therapy involving the skeleton), pre-existing hypercalcaemia, bone metastases or a history of skeletal malignancies, severe renal impairment. Pregnancy and lactation.

Precautions

Moderate renal impairment, active or recent urolithiasis. Following SC inj, serum calcium concentrations may increase transiently, reaching a max at 4-6 hr and returning to baseline within 16-24 hr; routine calcium monitoring not needed. Patients to contact their doctor if they develop persistent symptoms of hypercalcaemia (e.g, nausea, vomiting, constipation, lethargy, muscle weakness).

Pregnancy-Lactation

Interactions

Reduced anabolic effects with bisphosphonates, avoid concurrent use. May affect digoxin effects due to teriparatide effects on calcum.

Adverse Effects

Side effects of Teriparatide : Nausea, pain in the limb, headache, dizziness, muscle cramps, inj site reactions, depression, increased uric acid concentrations. Orthostatic hypotension especially at beginning of treatment, if affected, do not drive or operate machinery.

Mechanism of Action

Teriparatide, a biosynthetic peptide fragment of the biologically active region of the human parathyroid hormone, is a regulator of bone metabolism. By preferentially stimulating the osteoblastic activity over osteoclastic activity, it stimulates new bone formation on trabecular and cortical bone surfaces. Anabolic effects of teriparatide are seen in an increase in skeletal mass, bone strength and bone formation and resorption markers.