TERIPARATIDE

Do NOT use teriparatide if:

• you are allergic to any ingredient in teriparatide
• you have high levels of alkaline phosphatase, calcium, or parathyroid hormone in your blood
• you have deformed bones, softening of the bones (osteomalacia), Paget disease, pseudohypoparathyroidism, or rickets
• you have a history of bone tumors, bone cancer, or other cancers that have spread to your bones
• you have had radiation therapy involving the bones
• you have a bone disease other than osteoporosis
• the patient is a child or young adult whose bones may still be growing
• you are pregnant or breast-feeding

The most common side effects are nausea, joint aches, and pain.

Precautions

Before using teriparatide injection:

• tell your doctor and pharmacist if you are allergic to teriparatide, mannitol, or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain anticoagulants (‘blood thinners’) such as heparin; digoxin (Digitek, Lanoxin); hydrochlorothiazide (HCTZ, HydroDIURIL, Microzide); certain medications for seizures such as phenytoin; certain steroids such as prednisone; certain vitamins such as vitamins A and D. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• in addition to the conditions listed in the IMPORTANT WARNING section, tell your doctor if you have or have ever had any condition that causes you to have too much calcium in your blood, such as disease of the parathyroid gland; kidney or urinary tract stones; and liver, kidney, or heart disease.
• you should know that teriparatide injection should only be used by women once they have passed menopause and, therefore, cannot become pregnant or breast-feed. Teriparatide injection should not be used during pregnancy or while breast-feeding.
• you should know that teriparatide injection may cause fast heartbeat, dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start using teriparatide injection. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Be sure a chair is nearby when you inject teriparatide injection so you can sit down if you get dizzy.
• talk to your doctor about other things you can do to prevent osteoporosis from worsening. Your doctor will probably tell you to avoid smoking and drinking large amounts of alcohol and to follow a regular program of weight-bearing exercise.

Interactions

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

• Major: Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
• Moderate: Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
• Minor: Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

If the victim has collapsed or is not breathing, call local emergency hotline.

Symptoms of overdose may include:

• nausea
• vomiting
• dizziness
• headache
• lightheadedness and fainting on standing
• constipation
• lack of energy
• muscle weakness

Available brands:

• Teriparatide
• Forteo