Teriparatide Disease Interactions

Patients known to have an underlying hypercalcemic disorder, such as primary hyperparathyroidism, should not be treated with parathyroid hormone and its analogs because of the risk of exacerbating hypercalcemia.

Parathyroid hormone and its analogs should not be used in patients who are at increased baseline risk for osteosarcoma. These agents should only be used if the potential benefits are considered to outweigh the potential risks. Monitor these patients according to clinical guidelines. Patients with bone metastases or a history of skeletal malignancies should not be treated with these agents.

The use of teriparatide in patients with metabolic bone disease, other than osteoporosis is not recommended by the manufacturer.

There have been reports of transient episodes of symptomatic orthostatic hypotension with the use of teriparatide in short-term clinical pharmacology studies. Caution is recommended when using this agent in patients at risk.

No pharmacokinetic differences were identified in patients with mild or moderate renal impairment after a single dose of teriparatide. In patients with severe renal impairment, the AUC and half-life of teriparatide were increased by 73% and 77%, respectively. Care should be exercised in patients undergoing dialysis for chronic renal failure as no studies have been performed in this patient population.

Teriparatide should be used with caution in patients with active urolithiasis. If active or pre-existing hypercalciuria is suspected, measurement of urinary calcium excretion should be considered because of the potential to exacerbate urolithiasis in these patients.