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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.
What laboratory tests are required for patients receiving FORTEO® (teriparatide injection)?
The teriparatide label does not specify any laboratory tests to monitor; however, available literature offers suggestions on clinical workup prior to, and during, therapy.
Introduction
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 Workup Prior to Initiating Teriparatide Therapy
Prior to initiating therapy with teriparatide, suggested clinical tests that may be conducted are
- lumbar spine and total hip bone mineral density (BMD) by dual energy x-ray absorptiometry (DXA)
- total serum calcium
- total serum alkaline phosphatase
- bone-specific alkaline phosphatase (BSAP) or serum osteocalcin
- N‑terminal telopeptide or C-terminal telopeptide of type I collagen
- procollagen type I N-terminal propeptide (PINP)
- serum uric acid
- 25-hydroxyvitamin D
- parathyroid hormone, and
- creatinine clearance.1,2
Monitoring While on Teriparatide Therapy
While on teriparatide therapy, it is suggested to test
Follow-up Tests to Teriparatide Therapy
Following the initiation of teriparatide therapy, it is suggested to test
- total serum calcium, and
- lumbar spine and total hip BMD by DXA after 24 months of therapy.1
If symptoms such as nausea, vomiting, constipation, fatigue, lethargy, or muscle weakness arise, it may be signs of high serum calcium.3
Enclosed Prescribing Information
References
The published references below are 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. http://dx.doi.org/10.4158/EP.10.2.139
2Park SY, Ahn SH, Yoo JI, et al. Position statement on the use of bone turnover markers for osteoporosis treatment. J Bone Metab. 2019;26(4):213-224. https://doi.org/10.11005/jbm.2019.26.4.213
3Moe SM. Disorders involving calcium, phosphorus, and magnesium. Prim Care. 2008;35(2):215-237. https://doi.org/10.1016/j.pop.2008.01.007
Date of Last Review: January 02, 2023