Teriparatide and parathyroid hormone

Parathyroid hormone is naturally produced by four small glands in the neck and helps regulate calcium levels in your blood. Teriparatide is very similar to the naturally occurring hormone. It helps new bone formation and so reduces the risk of fractures. A synthetic form of the hormone itself is also available.

Teriparatide is usually used only in severe cases of osteoporosis, particularly:

• in people with several fractures
• in people with very low bone density
• when other treatments haven't been effective.

It's important to continue treatment as your doctor advises – even though you won't be able to feel whether it's working.

Is there any reason I shouldn't have teriparatide or parathyroid hormone?

Teriparatide and parathyroid hormone must not be given if you have:

• high calcium levels
• overactive parathyroid glands
• cancers that involve the bone
• Paget's disease.

These treatments should not be given if you've had radiotherapy to your bones, for example as part of breast cancer treatment.

Teriparatide and parathyroid hormone come in a pen-like syringe. You can inject yourself under the skin (subcutaneously) – usually in the abdomen or thigh. Your healthcare team will show you how to do this.

Teriparatide is usually given every day for 18 months and for a maximum of two years.

It's important to continue treatment as your doctor advises – even though you won't be able to feel whether it's working.

Teriparatide is usually very well tolerated.

Possible side-effects include:

• gastro-intestinal problems such as nausea, reflux symptoms
• palpitations
• dizziness
• headaches
• fatigue
• depression
• slight irritation at the injection site
• occasional troublesome bone pain.

It's usually fine to take other medicines alongside teriparatide or parathyroid hormone, but check with your doctor or pharmacist before starting any new medications.

Vaccinations

There's no reason why you shouldn't have vaccinations while you're on teriparatide or parathyroid hormone.

Alcohol is unlikely to interact with teriparatide or parathyroid hormone. However, heavy drinking is a risk factor for osteoporosis and for having falls so it's recommended that you drink alcohol only in moderation.

Teriparatide and parathyroid hormone are usually used only for the most severe forms of progressive osteoporosis, so it's very unlikely that they would be used in women of child-bearing age.

It's important to get enough calcium and vitamin D. You may be prescribed a daily supplement of calcium and/or vitamin D if your doctor thinks you may have a deficiency.