A daily injection that builds new bone
Teriparatide
A daily self-injection that builds new bone to treat severe osteoporosis and reduce the risk of fractures.
What is Teriparatide?
Teriparatide is a specialist medicine used to treat osteoporosis in people at high risk of breaking bones, including some people who keep having fractures despite other treatments. Unlike most osteoporosis medicines, which slow bone loss, teriparatide actively builds new bone. It is given as a daily injection under the skin, usually self-administered with a pen device. It is used for a limited total period (typically up to two years over a lifetime), partly because of a theoretical bone-cancer (osteosarcoma) concern seen in animal studies. After the course, another osteoporosis medicine is usually started to keep the benefit.
Education and reference only. This is a plain-language guide to Teriparatide — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Teriparatide is a bone-building medicine used to treat osteoporosis, a condition where bones become thin and fragile and break easily. It is a form of parathyroid hormone and is used for people at high risk of fractures, such as those who have already had fractures or who have not done well on other treatments. Most osteoporosis medicines work by slowing the breakdown of bone, but teriparatide is different: it stimulates the formation of new bone. It is given as a daily injection under the skin, usually using a prefilled pen, for a limited period under specialist supervision.
How it works
Bone is constantly being broken down and rebuilt. Parathyroid hormone has a striking effect: when it is given in a small daily pulse, as with teriparatide, it tips the balance towards building new bone rather than removing it, increasing bone density and strength and reducing the risk of fractures. This bone-building action is why it is reserved for people at high risk and why it is given as a once-daily injection rather than continuously. The course is limited in length, after which the gains are usually preserved by following on with another osteoporosis medicine.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist injection used in the UK to treat osteoporosis in people at high risk of fractures, by building new bone.
What it treats
Conditions Teriparatide is used for
Practical use
How to take Teriparatide
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Give it once a day as an injection under the skin, using the pen device as you have been shown.
- For the first doses, be ready to sit or lie down, as some people feel briefly dizzy afterwards.
- Keep to the limited course length your specialist sets, as it is not a lifelong treatment.
- Store the pen as instructed, usually in the fridge, and follow the disposal advice for needles.
- Expect to start another osteoporosis medicine after the course, to keep the bone you have gained.
Weighing it up
Advantages & disadvantages of Teriparatide
Advantages
- Actively builds new bone rather than just slowing bone loss.
- Strongly reduces the risk of fractures in people at high risk.
- A good option for people who keep fracturing despite other osteoporosis treatments.
Disadvantages
- Given as a daily self-injection rather than a tablet.
- Used only for a limited total time over a lifetime.
- Can cause brief dizziness after early doses, and follow-on treatment is usually needed afterwards.
Practical use
Good to know
A key point is that teriparatide is used for a limited total time over a person's life, usually up to around two years, and is not meant to be taken indefinitely. This limit comes partly from animal studies that raised a concern about a rare bone cancer called osteosarcoma; this has not been shown to be a problem in people at the doses used, but the duration limit and some cautions remain as a precaution. It is a daily injection you give yourself with a pen, and feeling briefly dizzy or light-headed after the first few doses is common, so the first dose is often given where you can sit or lie down. After the course finishes, another osteoporosis medicine is usually started, because stopping without follow-on treatment lets the new bone be lost again.
Who should not take it / use with caution
- People with certain bone conditions, such as Paget's disease, unexplained raised bone blood tests, or previous radiotherapy to the bones, should not use it because of a higher bone-cancer concern.
- People with high blood calcium, certain bone cancers or cancer that has spread to bone should not use it.
- It is not used in pregnancy or breastfeeding, in children and growing teenagers, or in severe kidney problems.
Monitoring
- Reviewing the response over the course, often with a bone-density scan.
- Checking blood calcium where needed, especially if symptoms suggest it is raised.
- Planning follow-on osteoporosis treatment as the course comes to an end.
Side effects
- Brief dizziness or light-headedness, especially after the first few doses.
- Leg cramps, nausea or aching joints and limbs.
- A temporary rise in blood calcium, which is usually mild but is checked if needed.
Key interactions
- It can raise blood calcium, so it is used with care alongside digoxin, where calcium changes matter.
- Tell your team about calcium and vitamin D supplements, which are often continued but reviewed.
- Give a full list of your medicines so anything affecting calcium can be considered.
Available as: A solution for injection under the skin, given by a prefilled pen.
Answers
Teriparatide: frequently asked questions
What is teriparatide used for?
It is used to treat osteoporosis in people at high risk of fractures, building new bone rather than just slowing bone loss.
Why can I only use it for a limited time?
It is used for a limited total period, usually up to around two years, partly because of a bone-cancer concern raised in animal studies, kept as a precaution.
Will I feel dizzy?
Some people feel briefly dizzy or light-headed after the first few doses, so it is wise to sit or lie down when taking those early injections.
Do I inject it myself?
Yes, it is usually given once a day as a self-injection under the skin using a pen device, after your team has shown you how.
What happens when the course finishes?
Another osteoporosis medicine is usually started afterwards, because stopping without follow-on treatment lets the new bone be lost again.
The wider class
About Parathyroid hormone analogue (bone-building osteoporosis treatment)
Teriparatide belongs to the parathyroid hormone analogue (bone-building osteoporosis treatment) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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