Parathyroid hormone for osteoporosis

Examples

Generic Name	Brand Name
teriparatide	Forteo

Teriparatide (Forteo) has been approved by Health Canada 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.¹

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 is a relatively new osteoporosis medication, and its long-term effects are unknown. 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 post-menopausal women.² The risk of fractures was not studied in men.³

Teriparatide should not be taken at the same time with bisphosphonates. Taking these medicines together does not build more bone density.^{4, 5} 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.⁶

Side Effects

The most common side effects are:

• Nausea and vomiting.
• Leg cramps.
• Headache.
• Dizziness.

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; however, 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.

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Author:	Douglas Dana Robin Parks, MS	Last Updated: February 21, 2007
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Carla J. Herman, MD, MPH - Internal Medicine Andrew Swan, MD, CCFP, FCFP - Family Medicine
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