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 BRAND NAMES
 MECHANISM OF ACTION
Osteoporosis happens when not enough new bone grows to replace the bone that is naturally broken down. Gradually, the bones become thin and fragile, and more likely to break. In women, osteoporosis is more common after the menopause, when the levels of the female hormone estrogen fall. Osteoporosis can also occur in both sexes as a side effect of glucocorticoid treatment.
Parathyroid hormone (PTH) is the primary regulator of calcium and phosphate metabolism in bone and kidney
Teriparatide, is identical to the active fragment of endogenous human parathyroid hormone. It acts like the hormone to stimulate bone formation by acting on osteoblasts (bone-forming cells) and indirectly by increasing intestinal absorption of calcium from food and tubular re-absorption of calcium and excretion of phosphate by the kidney
Teriparatide is indicated for:
- Treatment of postmenopausal women with osteoporosis at high risk for fracture
- Increase of bone mass in men with primary or hypogonadal osteoporosis at high risk for fracture
- Treatment of men and women with osteoporosis associated with sustained systemic glucocorticoid therapy at high risk for fracture
The recommended dose is 20 micrograms, once a day as a subcutaneous injection into the thigh or abdominal wall
Patients should receive calcium and vitamin D supplements if they do not get enough from their diet. Teriparatide can be used for up to two years. Only one two-year course of Teriparatide should be given to a patient in their lifetime.
- Hypersensitivity to Teriparatide.
- Teriparatide should not be used in young adults whose bones are not yet fully mature.
- Pregnancy and breast-feeding
- Pre-existing hypercalcemia
- Hyperparathyroidism and Paget’s disease
- Prior external beam or implant radiation therapy to the skeleton
- Patients with skeletal malignancies or bone metastases
 WARNINGS AND PRECAUTIONS
- Treatment duration for more than 2 years during a patient’s lifetime is not recommended (Studies in rats indicate an increased incidence of osteosarcoma with long-term administration of teriparatide)
- Urolithiasis: Use with caution in patients with active or recent urolithiasis because of risk of exacerbation.
- Transient orthostatic hypotension may occur with initial doses
 PREGNANCY AND LACTATION
 SIDE EFFECTS
The most common side effect is pain in the arms or legs and nausea.
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