Teriparatide (Forteo)
Prevention and treatment of osteoporosis should always
include a nutrient-rich diet, the recommended intake of calcium and vitamin D,
regular physical activity, safety precautions for fall prevention, avoidance of
smoking and limited consumption of alcohol. If osteoporosis is
diagnosed, you still must continue to make bone healthy lifestyle
choices. However, lifestyle modifications alone are often not enough.
Your healthcare provider may prescribe an osteoporosis
medication to help stop further bone loss and reduce your risk for
broken bones.
What are the medication options for osteoporosis?
The
U.S. Food and Drug Administration (FDA) has approved several
medications for osteoporosis which fall into two classes: antiresorptive medications and anabolic medications. Antiresorptive medications are used to strengthen bone, prevent bone loss and reduce the risk of fracture (broken bone).
The antiresorptive medications include a class of drugs called bisphosphonates.The four bisphosphonate medications are:
- alendronate - available as a generic medication (Brand name: Fosamax, Fosamax D)
- risedronate (Brand name: Actonel, Actonel with Calcium )
- ibandronate ( Brand name: Boniva)
- zoledronic acid (Brand name: Reclast)
Other approved antiresorptive medications include:
Anabolic medication builds new bone, increases bone density and helps reduce fracture risk. At this time the only approved anabolic medication is:
It is important to speak to your healthcare provider about the medication option that is right for you.
What is teriparatide (Forteo)?
Teriparatide
is the generic name for Forteo (brand name). Forteo is a form of human
parathyroid hormone (PTH). Parathyroid hormone is a naturally occurring
hormone produced by the parathyroid glands. The parathyroid glands are
the four small glands that are located next to the thyroid gland at the
base of the neck. PTH is the major hormone in the body that regulates
the calcium levels in the blood.
What is the use for teriparatide?
Teriparatide is
FDA-approved for the treatment of osteoporosis in postmenopausal women and men and for adults with osteoporosis caused by taking long term glucocorticoids (steroid medications such as prednisone or cortisone taken for more than 3 months)
Who should not use teriparatide?
Most healthcare providers do not consider the use of teriparatide
to prevent osteoporosis or to treat patients who are
not at high risk for fracture. People with Paget's Disease,
hyperparathyroidism, elevated blood calcium, metastatic disease from
any cancer, those who have had radiation therapy to the skeleton, and
young people with growing bones should not use teriparatide.
The package insert on teriparatide includes a black box warning. This warning is stated based on the results from routine animal testing of teriparatide. Teriparatide was given daily to rats from a young age and continued throughout their adult life span. During this study some of the rats developed a bone cancer called osteosarcoma. This bone cancer in humans is a serious but very rare cancer. Osteosarcoma occurs each year in about 4 out of every million adults over age 60. Although osteosarcoma has not been reported in clinical trials there have been a small number of reports of osteosarcoma in teriparatide prescribed patients. This small number of reports is about the same as the number of cases that would be expected to occur in the general population of men and women 60 years or older who are not treated with teriparatide. As of September 2008, over 500,000 patients worldwide have been treated with prescribed teriparatide and there is no evidence of an increased risk of osteosarcoma in human patients.
How is teriparatide usually prescribed?
At this time, teriparatide
is only available as an injection. The injection is given into the
fatty tissue just under the skin, not deeply into the muscle. Teriparatide is
easy to administer. In fact, most individuals are instructed to give
the injection to themselves. When taking teriparatide, it is necessary
to get adequate calcium and vitamin D each day. It also important to follow the universal strategies to promote strong bones.
What are the benefits of teriparatide?
Teriparatide
is the only bone-building medication approved by the FDA to treat
osteoporosis. Clinical studies have shown that teriparatide dramatically
increases bone mass, more so than any other FDA-approved osteoporosis
medication. In addition to improving bone density, teriparatide is the only
FDA-approved osteoporosis medication that restores the internal
architecture of osteoporotic bone. Teriparatide reduces the risk for spine
and other non-spine fractures. The effect of teriparatide on the risk of hip fracture is currently under investigation.
What are the side effects of taking teriparatide?
The
most common side effects of taking teriparatide are dizziness and leg cramps. Elevations in
blood calcium and urine calcium can also occur. Side effects such as
nausea, joint and muscle pains and general weakness may occur but are
rare. The safety and benefits of teriparatide have not been evaluated beyond
two years, so treatment for longer than two years is not recommended.
Like
all medications, it is important to discuss all of the potential
benefits and risks of taking teriparatide with your doctor or healthcare provider. For more information about teriparatide (Forteo) visit the Eli Lilly, Inc. website.
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