Forteo ® (teriparatide injection)

20-mcg daily dose in a 2.4-mL prefilled delivery device

This information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.

FORTEO® (teriparatide injection): Monitoring of Labs

The Forteo label does not specify labs to monitor; however, available literature offers suggestions on clinical work up prior to, and during therapy.



The teriparatide label does not specify certain lab tests to monitor. However, available literature offers suggestions on clinical work-up prior to, and during, therapy.

Clinical Work-Up Prior to Initiating Teriparatide Therapy

Prior to initiating therapy with teriparatide, suggested clinical tests that may be conducted are

  • LS and TH BMD by DXA
  • total serum calcium
  • ALP
  • BSAP or serum OC
  • NTX or CTX
  • serum uric acid
  • 25-hydroxyvitamin D
  • parathyroid hormone, and
  • CrCl.1

Monitoring While on Teriparatide Therapy

While on teriparatide therapy, Miller et al suggested to test

  • LS and TH BMD by DXA 12 months following initiation, and 
  • biochemical markers of bone formation (ALP or OC) at baseline and 3-6 months.1

Follow-Up Tests to Teriparatide Therapy

Following the initiation of teriparatide therapy, Miller et al suggested to test

  • total serum calcium, and
  • LS and TH BMD by DXA after 24 months of therapy.1

If symptoms such as nausea, vomiting, constipation, lower energy, or muscle weakness arise, it may be signs of high serum calcium.

Enclosed Prescribing Information


The published reference below is available by contacting 1-800-LillyRx (1-800-545-5979).

1Miller PD, Bilezikian JP, Deal C, et al. Clinical use of teriparatide in the real world: initial insights. Endocr Pract. 2004;10(2):139-148.


ALP = bone alkaline phosphatase

BMD = bone mineral density

BSAP = bone-specific alkaline phosphatase

CrCl = creatinine clearance

CTX = Type I collagen cross-linked C-telopeptide

DXA = dual-energy x-ray absorptiometry

LS = lumbar spine

NTX = N-telopeptide of collagen cross-links

OC = osteocalcin

TH = total hip

Date of Last Review: January 21, 2020

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