Forteo ® (teriparatide [rDNA origin] 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.

Mechanism of Action (MOA) of FORTEO® (teriparatide [rDNA origin] injection)

Once daily administration of Forteo preferentially stimulates osteoblastic activity over osteoclastic activity, resulting in new bone formation

New bone formation is observed on the trabecular and cortical (periosteal and/or endosteal) bone surfaces (Forteo Package Insert, 2012).

Structural histomorphometric analyses conducted on iliac crest biopsies from postmenopausal women (PMW) with osteoporosis revealed that Forteo® (teriparatide [rDNA origin] injection) improved

  • trabecular bone volume,

  • trabecular bone connectivity,

  • structure model index, and

  • cortical thickness (Jiang, 2003).

Dynamic histomorphometric analyses conducted on iliac crest biopsies from PMW with osteoporosis demonstrated that teriparatide stimulates bone formation on all bone envelopes (cancellous, endocortical, intracortical, and periosteal) as early as 3 months and remains sustained for the full 24 months of therapy. (Dempster, 2016b; Dempster, 2016c).

Radionuclide bone scan imaging has demonstrated a direct metabolic effect of teriparatide on the whole skeleton and various sub-skeletal sites (Moore, 2012).

New bone formed during teriparatide treatment has lower more heterogeneous mineral content; a property consistent with younger bone age (Dempster, 2016a).

Enclosed Prescribing Information

FORTEO® (teriparatide [rDNA origin] injection), Lilly

The published references below are available upon request by contacting 1-800-LillyRx.


FORTEO® [Package Insert]. Indianapolis, IN: Eli Lilly and Company; 2012.

Dempster DW, Roschger P, Misof BM, et al. Differential effects of teriparatide and zoledronic acid on bone mineralization density distribution at 6 and 24 months in the SHOTZ study [published online March 30, 2016]. J Bone Miner Res. 2016a.

Dempster DW, Zhou H, Recker RR, et al. A longitudinal study of skeletal histomorphometry at 6 and 24 months across four bone envelopes in postmenopausal women with osteoporosis receiving teriparatide or zoledronic acid in the SHOTZ trial [published online March 8, 2016]. J Bone Miner Res. 2016b.

Dempster DW, Zhou H, Recker RR, et al. Differential effects of teriparatide and denosumab on intact PTH and bone formation indices: AVA osteoporosis study. J Clin Endocrinol Metab. 2016c;101(4):1353-1363.

Jiang Y, Zhao JJ, Mitlak BH, et al. Recombinant human parathyroid hormone (1-34) [teriparatide] improves both cortical and cancellous bone structure. J Bone Miner Res. 2003;18(11):1932-1941

Moore AEB, Blake GM, Taylor KA, et al. Changes observed in radionuclide bone scans during and after teriparatide treatment for osteoporosis. Eur J Nucl Med Mol Imaging. 2012;39(2):326-336

Additional related information

Date of Last Review: March 08, 2017

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