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Parathyroid Hormone Analogue (Anabolic Bone Agent)

Teriparatide

Brand names: Forsteo

Teriparatide is a recombinant parathyroid hormone analogue used for severe osteoporosis. Unlike bisphosphonates it is anabolic (bone-building) and is given by daily subcutaneous injection for a limited lifetime treatment duration.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Recommended dosage is 20 mcg subcutaneously once a day ( 2.1 ) Consider supplemental calcium and Vitamin D based on individual patient needs ( 2.1 ) Administer as a subcutaneous injection into the thigh or abdominal region ( 2.2 ) Administer initially under circumstances in which the patient can sit or lie down if symptoms of orthostatic hypotension occur ( 2.2 ) Use of teriparatide for more than 2 years during a patient's lifetime should only be considered if a patient remains at or has returned to having a high risk for fracture ( 2.3 ) 2.1 Recommended Dosage The recommended dosage is 20 mcg given subcutaneously once a day. Instruct patients to take supplemental calcium and vitamin D if …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-05-27. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It is a recombinant fragment of parathyroid hormone; intermittent administration preferentially stimulates osteoblast activity, increasing bone formation.

Prescribing in practice

  • It is contraindicated where there is increased osteosarcoma risk, including Paget's disease of bone, prior skeletal radiotherapy and unexplained raised alkaline phosphatase.
  • Transient hypercalcaemia can occur after dosing.
  • Lifetime treatment duration is limited and it is given as a once-daily subcutaneous injection.

Monitoring

Monitor calcium status and clinical response; review against the maximum lifetime treatment duration.

Counselling the patient

  • Inject under the skin once daily as shown, and rotate injection sites.
  • Dizziness can occur after the first few doses; give the injection where you can sit or lie down.
  • This is a time-limited course; follow-on treatment is usually needed to maintain the benefit.

Evidence & guidelines

Specialist-initiated anabolic option for severe osteoporosis (NICE).

Reference: NICE TA161; FRAX Fracture Risk Assessment; Lilly Forsteo SPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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