Why is this medication prescribed?

Teriparatide injection is prescribed for the treatment of osteoporosis in men and postmenopausal women who are at high risk of having fractures. It is also used to increase bone mass in men with primary or hypogonadal osteoporosis who are at high risk for fractures.

Teriparatide is a form of parathyroid hormone that works by stimulating new bone formation, increasing bone mineral density, and reducing the risk of fractures.

How should this medicine be used?

Here’s how Teriparatide injection is typically used:

• Dosage: The usual dose of teriparatide is 20 micrograms injected subcutaneously once a day.
• Injection site: Teriparatide is administered as a subcutaneous injection into the thigh or abdominal wall. Injection sites should be rotated to minimize the risk of injection site reactions.
• Administration: Teriparatide injection should be administered exactly as prescribed by the healthcare provider. Patients should be trained on proper injection techniques. It is essential to follow the instructions provided with the medication carefully.
• Storage: Teriparatide injection should be stored in the refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze it. Once opened, the cartridge or pen should be used within 28 days.
• Monitoring: Regular monitoring by healthcare professionals is necessary to assess the patient’s response to treatment and to adjust the dosage if needed.
• Supplements: Patients taking teriparatide should ensure an adequate intake of calcium and vitamin D. Your healthcare provider may recommend calcium and vitamin D supplements if your dietary intake is insufficient.

It’s crucial to follow your healthcare provider’s instructions carefully regarding the use of teriparatide injection to maximize its benefits and minimize any potential risks. Always consult your healthcare provider if you have any questions or concerns about your medication regimen.

Other uses for this medicine

Some of these potential off-label uses include:

• Treatment of glucocorticoid-induced osteoporosis: Teriparatide has shown efficacy in increasing bone mineral density and reducing fracture risk in patients receiving long-term glucocorticoid therapy.
• Management of osteoporosis in premenopausal women: While teriparatide is not typically indicated for premenopausal osteoporosis, it may be considered in select cases where other treatments have failed or are contraindicated.
• Treatment of osteoporosis in patients with chronic kidney disease: Some studies have suggested that teriparatide may be beneficial in improving bone density and reducing fracture risk in patients with chronic kidney disease, though further research is needed in this area.

What special precautions should I follow?

Regarding special precautions for teriparatide injection, it’s essential to consider the following:

• Bone cancer risk: Teriparatide should not be used in patients with a history of skeletal malignancies or in patients with Paget’s disease of bone.
• Hypercalcemia: Teriparatide may increase serum calcium levels. Patients should be monitored for signs and symptoms of hypercalcemia, and treatment should be discontinued if hypercalcemia develops.
• Orthostatic hypotension: Some patients may experience orthostatic hypotension (a sudden drop in blood pressure when standing up), especially during the initial weeks of treatment. Patients should be advised to sit or lie down if they experience dizziness or lightheadedness.
• Bone metastases: Teriparatide should not be used in patients with bone metastases or skeletal malignancies.
• Pregnancy and breastfeeding: The safety of teriparatide during pregnancy or breastfeeding has not been established. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus, and breastfeeding should be avoided during treatment.
• Renal impairment: Teriparatide should be used with caution in patients with renal impairment, as it is primarily excreted by the kidneys. Dose adjustment may be necessary in patients with severe renal impairment.
• Interactions: Patients should inform their healthcare provider about all medications they are taking, including prescription, over-the-counter, and herbal supplements, as some medications may interact with teriparatide.

As with any medication, it’s crucial to discuss the potential risks and benefits of teriparatide with your healthcare provider before starting treatment, and to follow their instructions closely throughout the course of therapy.

What special dietary instructions should I follow?

Regarding special dietary instructions for Teriparatide Injection:

• It is essential to ensure an adequate intake of calcium and vitamin D while using teriparatide. Your healthcare provider may recommend calcium and vitamin D supplements if your dietary intake is insufficient.
• Patients should maintain a balanced diet rich in calcium-containing foods such as dairy products, leafy greens, fortified foods, and calcium supplements as prescribed.

What should I do if I forget a dose?

If you forget a dose of Teriparatide Injection:

• If you miss a dose of teriparatide, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule.
• Do not take a double dose to make up for a missed one.
• If you are unsure about what to do, or if you have missed multiple doses, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Teriparatide injection, like any medication, can cause side effects in some people. Not everyone will experience these side effects, and they can vary in severity. Common side effects of teriparatide injection may include:

• Injection site reactions: Pain, redness, bruising, itching, or swelling at the injection site.
• Nausea: Feeling sick to your stomach.
• Headache: Mild to moderate headache.
• Dizziness: Feeling lightheaded or dizzy, especially when standing up quickly.
• Leg cramps: Painful contractions of muscles in the legs.
• Flu-like symptoms: Such as fever, chills, or body aches.
• Weakness: Feeling weak or fatigued.
• Hypercalcemia: High levels of calcium in the blood, which can cause symptoms such as nausea, vomiting, constipation, increased thirst, frequent urination, confusion, or muscle weakness.
• Orthostatic hypotension: A sudden drop in blood pressure when standing up, leading to dizziness or fainting.
• Allergic reactions: Rarely, teriparatide injection can cause allergic reactions such as rash, itching, swelling of the face, tongue, or throat, severe dizziness, or trouble breathing.

It’s essential to report any side effects you experience to your healthcare provider, especially if they are severe or persistent. They can help determine whether the side effects are related to teriparatide injection and provide guidance on managing them. In some cases, your healthcare provider may adjust your dosage or recommend alternative treatments to minimize side effects. If you experience a severe allergic reaction or signs of anaphylaxis (such as difficulty breathing or swelling of the face), seek emergency medical attention immediately.

What should I know about storage and disposal of this medication?

Storage and disposal of Teriparatide Injection:

• Storage:
  • Store Teriparatide Injection in the refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze it.
  • Keep the medication in its original packaging to protect it from light.
  • Once opened, the cartridge or pen should be used within 28 days. Discard any unused portion after this time.
• Disposal:
  • Dispose of Teriparatide Injection according to local regulations for hazardous waste disposal or as instructed by your healthcare provider or pharmacist.
  • Do not dispose of medications in household trash or wastewater unless specifically instructed to do so.

In case of emergency/overdose

• In case of an overdose or emergency, such as accidentally taking too much Teriparatide Injection, seek immediate medical attention or contact a poison control center.
• Symptoms of overdose may include nausea, vomiting, increased thirst, frequent urination, constipation, confusion, muscle weakness, or difficulty breathing.

What other information should I know?

• Keep all appointments with your healthcare provider for monitoring while taking Teriparatide Injection.
• Inform all healthcare providers involved in your care that you are using Teriparatide Injection, including dentists and surgeons.
• It is important to follow your healthcare provider’s instructions closely regarding dosage and administration of Teriparatide Injection.
• Avoid activities that may increase your risk of falling, as Teriparatide Injection may increase bone density but does not eliminate the risk of fractures.
• Inform your healthcare provider of any other medical conditions you have, especially if you have kidney problems or a history of cancer.
• Tell your healthcare provider about all other medications you are taking, including prescription, over-the-counter, and herbal supplements, as they may interact with Teriparatide Injection.

Following these guidelines will help ensure the safe and effective use of Teriparatide Injection and minimize the risk of complications or adverse effects. If you have any questions or concerns about storage, disposal, or what to do in case of emergency, consult your healthcare provider or pharmacist for further guidance.