Forsteo

teriparatide (recombinant)

Forsteo, Forteo

Pharmacologic class: Biosynthetic fragment of human parathyroid hormone

Therapeutic class: Parathyroid hormone

Pregnancy risk category C

FDA Box Warning

In male and female rats, drug increased incidence of osteosarcoma (malignant bone tumor). Because of uncertain relevance of this finding to humans, use drug only in patients for whom potential benefits outweigh potential risk. Don't administer to patient at increased baseline risk for osteosarcoma.

Action

Stimulates new bone growth by binding to specific high-affinity cell-surface receptors

Availability

Injection: Multidose prefilled delivery device (pen) with 28 daily doses of 20 mcg/dose (600 mcg/2.4 ml)

Indications and dosages

Osteoporosis in patients at high risk for bone fracture

Adults: 20 mcg/day subcutaneously for up to 2 years

Contraindications

• Hypersensitivity to drug

• Conditions that increase osteosarcoma risk (such as Paget's disease, unexplained alkaline phosphatase elevation, open epiphyses, skeletal radiation therapy)

• Bone cancer metastases or history of bone cancer

• Metabolic bone disease other than osteoporosis

• Hypercalcemia

Precautions

Use cautiously in:

• urolithiasis, hypotension

• concurrent use of cardiac glycosides

• pregnant or breastfeeding patients.

Administration

• Inject subcutaneously into thigh or abdominal wall, with patient lying down.

• Know that prefilled injection pen delivers 20 mcg of drug per actuation and may be reused for up to 28 days after first injection. Discard pen in protected container after 28 days, even if it's not empty.

Adverse reactions

CNS: dizziness, headache, insomnia, depression, vertigo, asthenia

CV: hypertension, angina, syncope

EENT: rhinitis, pharyngitis

GI: nausea, vomiting, diarrhea, dyspepsia, anorexia

Metabolic: hyperuricemia

Musculoskeletal: joint pain, cramps

Respiratory: cough, dyspnea, pneumonia

Skin: rash, sweating

Other: pain

Interactions

Drug-drug. Digoxin: increased digoxin toxicity

Drug-diagnostic tests. Calcium: increased level

Patient monitoring

• Monitor respiratory and neurologic status and assess patient's mood.

• Monitor bone mineral density tests and calcium level.

Patient teaching

• Instruct patient to promptly report such adverse reactions as cough and difficulty breathing.

• Tell patient that prefilled injection pen delivers 20 mcg of drug per actuation. Inform him that he may reuse it for up to 28 days after first injection, and should then discard it in appropriate receptacle, even if it's not empty.

• Advise patient to establish effective bedtime routine to minimize insomnia.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects strength and balance.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

Forsteo

A brands name for TERIPARATIDE.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
Terrosa, Eli Lilly's Forsteo, is used for the treatment of osteoporosis in postmenopausal women and in men at increased risk of fracture and treatment of osteoporosis associated with sustained systemic glucocorticoid therapy in women and men at increased risk for fracture.
PTH (Forsteo, Eli Lilly, Houten, Netherlands) was used to stimulate bone healing.
Jakob et al., "Reduction in fracture rate and back pain and increased quality of life in postmenopausal women treated with teriparatide: 18-month data from the European Forsteo Observational Study (EFOS)," Calcified Tissue International, vol.
Within a second development program, Synthes and Lilly jointly will conduct and fund the evaluation of additional orthopedic uses for Lilly's osteoporosis drug Forteo (teriparatide [rDNA origin] injection), marketed as Forsteo in some countries outside of the United States.
The medication, called Forsteo, or teriparatide, is made from a potent bone and joint-mending hormone.
Dr John Verrier Jones, 75, suffers from brittle bone disease osteoporosis and wants to use the drug Forsteo to fight it.
The product is approved in adults for the same indications as Eli Lilly's Forsteo and is used for the treatment of osteoporosis in postmenopausal women and in men at increased risk of fracture and treatment of osteoporosis associated with sustained systemic glucocorticoid therapy in women and men at increased risk for fracture.
One, Forsteo, is recommended by The National Osteoporosis Society.
Earlier this year osteoporosis campaigners complained that another bone-building drug, Forsteo, would only be available for over-65s under draft guidance by the National Institute for Clinical Excellence (NICE).
The research trials have shown teriparatide (Forsteo) is most successful in preventing the worst types of spinal fractures by 90 per cent.