Description
Teriparatide is the recombinant human parathyroid hormone sequence 1-34, the biologically active region of complete parathyroid hormone (PTH 1-84). The substance was developed by Eli Lilly as Forteo and has been clinically approved since 2002 for treatment of severe osteoporosis.
Per study reports Teriparatide activates the PTH/PTHrP receptor in osteoblasts. With intermittent dosing (daily) the anabolic effect on bone formation predominates - in contrast to chronic PTH elevation (e.g., with hyperparathyroidism) which has catabolic bone effects. This “PTH paradox” effect is the basis of osteoporotic action.
Clinical studies document significant bone density increases at spine (10-15%) and hip bone (3-6%) over 18-24 months of therapy. Reduction of vertebral fractures is about 65% vs placebo - higher than under bisphosphonates.
Pharmacokinetically subcutaneously administered with short half-life (about 1 hour). A once-daily injection is clinical standard.
Known effects in studies: mild hypercalcemia, dizziness, leg muscle cramps, in rare cases orthostatic hypotension after first injection. The FDA limits use to 24 months due to osteosarcoma signal in rat studies (not confirmed in humans).
You can order Teriparatide as lyophilized peptide in 10-pack at 10mg per vial.
This information is for research and educational purposes only. No medical recommendations.
Risks & Safety
Teriparatide is a clinically approved parathyroid hormone fragment and is well characterized; within the therapeutic dose range it is considered largely well tolerated, but it has a more clearly defined side effect profile than most pure peptides.
Documented in clinical studies:
- Calcium metabolism: mild hypercalcemia is the most commonly documented finding and follows directly from the PTH mechanism.
- Circulation: dizziness and, in rare cases, orthostatic hypotension shortly after the first injection are described in the literature.
- Musculoskeletal and gastrointestinal: leg muscle cramps and nausea occur occasionally in studies.
- Osteosarcoma signal: high-dose rat studies observed an increased occurrence of osteosarcoma. This signal has not been confirmed in humans, but the FDA nonetheless limits approved use to 24 months. This point is the most relevant safety aspect of the compound.
Monitoring via bloodwork is recommended. This classification does not replace medical advice. Risk and responsibility for any actual use lie entirely with the buyer.
Studies
- Effect of Parathyroid Hormone (1-34) on Fractures and Bone Mineral Density in Postmenopausal Women with Osteoporosis - NEJM 2001, Neer et al: pivotal approval trial showing ~65% reduction in vertebral fractures vs placebo.
- Parathyroid Hormone and Teriparatide for the Treatment of Osteoporosis: A Review of the Evidence and Suggested Guidelines for Its Use - Endocrine Reviews 2005, Hodsman et al: mechanism and evidence review of anabolic PTH action.
- The Effects of Parathyroid Hormone and Alendronate Alone or in Combination in Postmenopausal Osteoporosis - NEJM 2003, Black et al: PaTH trial, BMD effect of PTH monotherapy vs combination with alendronate.
- Teriparatide or Alendronate in Glucocorticoid-Induced Osteoporosis - NEJM 2007, Saag et al: head-to-head trial in glucocorticoid-induced osteoporosis.
- Bone Neoplasms in F344 Rats Given Teriparatide [rhPTH(1-34)] Are Dependent on Duration of Treatment and Dose - Toxicologic Pathology 2004, Vahle et al: preclinical osteosarcoma signal, basis for the FDA 24-month limit.