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Forteo ® (teriparatide injection)
20-mcg daily dose in a 2.4-mL prefilled delivery deviceThis 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.
Teriparatide should not be prescribed for patients who are at an increased baseline risk for osteosarcoma, including those who have had prior external beam or implant radiation therapy.1
Radiation-induced osteosarcoma is a rare, but well-recognized, complication in human radiotherapy patients. Patients who have had prior radiation therapy have an increased risk of developing a radiogenic second malignant neoplasm, including osteosarcoma, some years or decades after initial treatment.2,3
Teriparatide Use With Prior Radiation Therapy
Examples of Prior Radiation Therapy Where Teriparatide Should Not be Used
Use of teriparatide should be avoided in patients who previously received
external beam radiation (stereotactic radiation), and
internal radiation (brachytherapy, interstitial radiation, intracavitary radiation).1,4
Radiation affecting any area of the skeleton should be avoided.1
Examples of Prior Radiation Therapy Where Teriparatide May be Considered
Use of teriparatide may be considered in patients who previously received
radioactive iodine therapy
low doses of non-penetrative radiation
diagnostic radiation (computed tomography scans, radiographs, radionuclide scans), and
nonradioactive forms of radiation (ultraviolet radiation, phototherapy).1,5
Enclosed Prescribing Information
FORTEO® (teriparatide [rDNA origin] injection), Lilly
References
The published references below are available by contacting 1-800-LillyRx (1-800-545-5979).
1. Forteo [package insert]. Indianapolis IN: Eli Lilly and Company; 2019.
2. Kalra S, Grimer RJ, Spooner D, et al. Radiation-induced sarcomas of bone: factors that affect outcome. J Bone Joint Surg Br. 2007;89-B(6):808-813. http://dx.doi.org/10.1302/0301-620X.89B6.18729
3. Newhauser WD, Durante M. Assessing the risk of second malignancies after modern radiotherapy. Nat Rev Cancer. 2011;11(6):438-448. http://dx.doi.org/10.1038/nrc3069
4. American Cancer Society. Radiation therapy. Accessed February 4, 2020. http://www.cancer.org/acs/groups/cid/documents/webcontent/003019-pdf.pdf
5. Data on file, Eli Lilly and Company and/or one of its subsidiaries.
Date of Last Review: February 23, 2020
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