Forteo (Teriparatide [rDNA origin]) for Osteoporosis

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Forteo (teriparatide) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat certain adults with osteoporosis.

What Members Say

MHT logo These insights are based on 2,556 comments about Forteo from MyOsteoTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Daily at-home injections feel manageable once the pen routine becomes familiar.
Bone density often improves, especially in the spine.
Follow-up treatment can help maintain bone gains after Forteo ends.

Considerations:

Dizziness, nausea, joint pain, and leg cramps can happen, especially early on.
High calcium levels and kidney stone concerns come up and need medical follow-up.
The pen must stay refrigerated and be discarded after 28 days.

How Forteo Works and How It’s Taken

Forteo is a type of medicine called a parathyroid hormone analog. It acts like part of a natural hormone that helps control calcium and bone activity. Forteo helps the body form new bone, which can increase bone mass and strength.

Doctors prescribe Forteo when certain people with osteoporosis are at high risk for broken bones or cannot use or have not done well with other available osteoporosis treatments. This includes:

Postmenopausal women with osteoporosis
Men with primary or hypogonadal osteoporosis
Men and women with osteoporosis caused by long-term use of systemic glucocorticoid medicines, such as prednisone

Forteo is injected under the skin of the thigh or abdomen. A healthcare professional should teach you or your caregiver how to use the Forteo pen correctly.

For the first few doses, give the injection in a place where you can sit or lie down right away if you feel dizzy or notice a fast or unusual heartbeat.

Typical Dosing for Osteoporosis

The recommended dose of Forteo is 20 micrograms injected under the skin once a day.

Do not take more than one injection in the same day.

Forteo should generally not be used for more than two years over your lifetime. Longer treatment may be considered if your healthcare provider determines that you still have, or again have, a high risk of breaking a bone.

If you do not get enough calcium and vitamin D from your diet, your healthcare provider may recommend supplements.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Forteo

These insights are based on 2,556 comments about Forteo from MyOsteoTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Members who use Forteo often say the day-to-day routine matters as much as the medication itself. Across the community, people most often mention staying in close touch with their doctor about side effects, planning for the daily injection routine, setting realistic expectations about results, asking about follow-up treatment after Forteo, and looking into financial help if cost is a barrier.

1
Talk to your doctor about side effects that do not go away.
“My endo checked my calcium. I had developed hypercalcemia … I passed one kidney stone. Another one is starting and I called the doctor’s office to make sure she wanted me to continue with the daily injections.”
2
Find an injection routine that fits your day.
“I initially had the injection in the morning but found I was very tired all day, so, with advice, I take it at night now. I give myself a shot every night before going to bed, so I might sleep through any immediate side effects.”
3
Ask your doctor what to expect after Forteo ends.
“I gained some bone mass back and was told I would need follow-up treatment to help maintain the gain. When I came off Forteo, I did not contact my doctor, which was my mistake. I should have asked what treatment I needed next.”

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Forteo Side Effects

In clinical studies of Forteo, the most common side effects occurred in about 10 percent to 21 percent of people. These include:

Arthralgia (joint pain)
Pain
Nausea

Serious Side Effects and Warnings

Forteo can cause serious side effects that may require immediate medical attention. These include:

Hypersensitivity (severe allergic reactions) — Reactions can include anaphylaxis and angioedema, which may cause swelling of the face, lips, mouth, or tongue, trouble breathing, hives, or fainting.
Osteosarcoma (a rare bone cancer) — Cases have been reported, and the risk beyond two years of use is not well known.
Hypercalcemia (high calcium levels in the blood) — This can occur during Forteo treatment.
Calciphylaxis or worsening cutaneous calcification — Painful skin sores or wounds can occur because of calcium buildup in the skin.
Urolithiasis — Forteo may worsen active or recent kidney stones.
Orthostatic hypotension (a drop in blood pressure when you stand up) — This can cause dizziness, lightheadedness, or fainting.

Get medical help right away if you think you are having a serious reaction.

How To Save on Forteo

Lilly, the manufacturer of Forteo, offers the Forteo Savings Card Program. Eligible people with commercial drug insurance coverage for Forteo may pay as little as $4 per month. People enrolled in state, federal, or government-funded healthcare programs are not eligible for the savings card.

The Forteo Savings & Support page also provides information about the Lilly Cares Foundation Patient Assistance Program for eligible people who need financial assistance. The Forteo Savings Card is available to download from the same page.

If you begin receiving drug coverage through a state, federal, or government-funded healthcare program, call the Forteo Savings Card Program at 877-267-0513 to stop participation.

What To Know Before Taking Forteo

Before starting Forteo, tell your doctor if you:

Have had an allergic reaction to teriparatide or any ingredient in Forteo
Have Paget’s disease or another bone disease
Have bone cancer or have had bone cancer in the past
Are a young adult whose bones are still growing
Have had radiation treatment involving your bones
Have an inherited condition that may increase your risk of bone cancer
Have or have had high calcium levels in your blood
Have or have had painful skin sores or wounds caused by calcium buildup
Have or have had kidney stones
Take a medicine that contains digoxin

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Do not use Forteo if you have had a severe allergic reaction to teriparatide or any ingredient in Forteo.

Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Your doctor may consider stopping Forteo if you become pregnant. Forteo should be avoided while breastfeeding.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Forteo for osteoporosis?

Forteo was studied in postmenopausal women, men with primary or hypogonadal osteoporosis, and men and women with osteoporosis caused by long-term glucocorticoid treatment.

In a study of postmenopausal women with osteoporosis treated for a median of 19 months, new spine fractures occurred in 5 percent of women taking Forteo compared with 14.3 percent taking a placebo (an inactive treatment). This was a 65 percent relative reduction in risk. New fractures outside the spine occurred in 2.6 percent of women taking Forteo compared with 5.5 percent taking placebo.

Bone mineral density increased by 9.7 percent in the lower spine, 2.8 percent in the femoral neck, and 2.6 percent in the total hip.

In a study of men with primary or hypogonadal osteoporosis treated for a median of 10 months, Forteo increased bone mineral density by 5.9 percent in the lower spine, 1.5 percent in the femoral neck, and 1.2 percent in the total hip. Overall, 94 percent of men taking Forteo had an increase in lower spine bone mineral density. About 53 percent had an increase of at least 5 percent, and 14 percent had an increase of at least 10 percent.

In an 18-month study of men and women with osteoporosis caused by long-term glucocorticoid treatment, Forteo increased bone mineral density by 7.2 percent in the lower spine, 3.6 percent in the total hip, and 3.7 percent in the femoral neck.

How long does Forteo take to work for osteoporosis?

In clinical studies, increases in bone mineral density in the lower spine were seen by three months and continued during treatment. In postmenopausal women, Forteo’s effect on reducing fractures was studied over a median treatment time of 19 months.

Does Forteo interact with other medicines?

Forteo may interact with digoxin, a medicine used for certain heart conditions. Forteo can temporarily raise calcium levels in the blood, which may increase the risk of side effects from digoxin. Tell your doctor about all the medicines you take, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements.