Teriparatide
/ Recombinant human parathyroid hormone amino acids 1-34ALIAS · Forteo · rhPTH(1-34)
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FDA-approved (Forteo, 2002) for osteoporosis in postmenopausal women and men at high fracture risk. Only PTH analog approved for bone-building (anabolic) therapy.
Teriparatide is recombinant human parathyroid hormone comprising the N-terminal 34 amino acids (rhPTH 1-34). Unlike chronic elevation of PTH (which causes bone resorption), intermittent daily PTH administration produces a net anabolic effect on bone, stimulating osteoblast activity and increasing trabecular and cortical bone formation.
Pivotal fracture trials in postmenopausal women (Neer 2001, NEJM) demonstrated reduction in vertebral and nonvertebral fractures. Approved indications include osteoporosis in postmenopausal women, osteoporosis in men, and glucocorticoid-induced osteoporosis.
Boxed warning: rodent studies showed dose- and duration-dependent osteosarcoma. Original labeling limited treatment duration to 2 years; the restriction was removed in 2020 after long-term human data did not replicate the rodent malignancy signal. Other AEs include hypercalcemia, nausea, orthostatic hypotension.
Regulatory status
- FDA status:
- FDA-approved
- Compounding:
- Not eligible for compounding (approved, not in shortage)