Teriparatide (Forteo, also available in generic form) is a recombinant form of parathyroid hormone, used to treat some forms of osteoporosis. It is manufactured and marketed by Eli Lilly and Company.
administration
Teriparatide is given by injection once a day in the thigh or abdomen. The recommended dose is 20 mg per day.
Side effects
Adverse events most frequently reported are nausea, leg cramps and dizziness. The main risk of teriparatide is an increased risk of osteosarcoma, at least as seen in rat studies. It should be noted that, unlike humans, bones of rats grow throughout their lives. Tumors found in studies in rats have been located at the ends of bones that grew up after the injections began. Cases of bone tumors and osteosarcoma have been rarely reported in the postmarketing period.
Mechanism of Action
Teriparatide is a portion of human parathyroid hormone (PTH), the amino acid sequence 1 to 34, of the complete molecule (containing 84 amino acids). Endogenous PTH is the main regulator of the metabolism of calcium and phosphate in bone and kidney. PTH increases serum calcium, the fulfillment of this part by increased bone resorption. Thus, chronically elevated PTH will deplete bone. However, intermittent exposure to PTH activates osteoclasts over osteoblasts. Thus, once daily injections of teriparatide have a net effect of stimulating the formation of new bone tissue leading to bone mineral density increased.
Teriparatide is the first and to date only FDA approved agent for the treatment of osteoporosis that stimulates new bone formation.
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