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Natpara

parathyroid hormone
Used for Calcium Deficiency
Used for Calcium Deficiency

Natpara (parathyroid hormone) works well to treat low blood calcium levels (hypocalcemia) in people with hypoparathyroidism (low levels of parathyroid hormone), but you have to be comfortable with giving yourself daily injections.

Last reviewed on May 31, 2021
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What is Natpara (parathyroid hormone)?

What is Natpara (parathyroid hormone) used for?

  • Hypoparathyroidism

How Natpara (parathyroid hormone) works

Natpara (parathyroid hormone) is a man-made version of parathyroid hormone (PTH); it raises your calcium levels by working on your kidneys, intestines, and bones.

Drug Facts

Common BrandsNatpara
Drug ClassParathyroid hormone analog
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of Natpara (parathyroid hormone)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Paresthesia (tingling or pricking sensation usually on hands) (31%)
  • Hypocalcemia (low levels of calcium) (27%) or hypercalcemia (high levels of calcium) (19%)
  • Headache (25%)

Other Side Effects

  • Nausea, vomiting, diarrhea
  • Hypoesthesia (numbness or poor sense of touch)
  • Joint pain
  • Too much calcium in the urine
  • Pain in arms and legs

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Allergic reaction

Source: FDA

pros-and-cons

Pros and cons of Natpara (parathyroid hormone)

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Pros

Good medication for controlling low blood calcium levels with low blood parathyroid levels

Can be used even if you have kidney or liver problems

Only injected once daily

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Cons

Not available as a cheaper generic medication

You might develop a new, tender lump or lasting pain in 1 spot, due to this injection.

For safe use of this medication, it's only available through a special pharmacy that your healthcare provider works with to send you the medication.

pharmacist-tips

Pharmacist tips for Natpara (parathyroid hormone)

pharmacist
  • Inject Natpara (parathyroid hormone) into your thigh (alternate thighs each day) using the provided Q-Cliq pen. One Q-Cliq pen may be used for up to 2 years, but be sure to change the cartridge every 2 weeks.

    • Before mixing Natpara (parathyroid hormone), store it in the original container in the refrigerator. However, after mixing it, store the cartridge in the provided pen in the refrigerator. After mixing, the cartridge will only last 14 days so throw it away after 14 days even if there's still some medication left. Don't freeze or shake Natpara (parathyroid hormone), and it should be protected from heat and light.

      • To gain the most benefit from this medication, don't miss a dose. If you miss a dose, take it as soon as you remember unless it's close to the time of your next scheduled dose. In this case, skip the missed dose and continue your regular routine.

        • Let your healthcare provider know if you are planning to become or have become pregnant because this might not be the best option for you. Your healthcare proivider will discuss the risks and benefits with you.

          faqs

          Frequently asked questions about Natpara (parathyroid hormone)

          Why does Natpara (parathyroid hormone) have a warning for bone cancer?
          During testing in male and female rats, Natpara (parathyroid hormone) caused bone cancers called osteosarcoma. The osteosarcoma was dependent on the dose of Natpara (parathyroid hormone) as well as how long the rats received the medication for. The dose used in the animals was 3 to 71 times higher than the amount used for humans, however, so the risk to humans is unclear. People who have a higher risk of bone problems, such as those with Paget's disease or other bone diseases, should avoid using this medication.
          Do I need any blood work before starting Natpara (parathyroid hormone)?
          Yes, your healthcare provider will order your labs to check your levels of vitamin D and calcium in your blood before starting Natpara (parathyroid hormone). This medication is only recommended for those people who are not able to control their parathyroid hormone and calcium levels with calcium supplements and other forms of vitamin D.
          How do I store the Natpara (parathyroid hormone) pens?
          Medication that has not been mixed can be stored in the refrigerator until its expiration date. If you have mixed one of the cartridges, your pen is good for 14 days but still must be kept inside the refrigerator when it's not in use. Don't shake or freeze Natpara (parathyroid hormone).
          How do I inject Natpara (parathyroid hormone)?
          You will inject Natpara (parathyroid hormone) under the skin of your thigh once daily. It's important to alternate thighs each day. Make sure to receive training from your pharmacist or healthcare provider before you use it for the first time.
          Is Natpara (parathyroid hormone) expensive?
          Currently, Natpara (parathyroid hormone) is only available as a brand-name drug. This means that it's usually more expensive, however, your insurance might pay for a large portion of the costs. Also, the drug manufacturer might have some assistance if you're unable to afford it.
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          What are the risks and warnings for Natpara (parathyroid hormone)?

          Natpara (parathyroid hormone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

          risk-warning

          Bone cancer

          • Risk factors: Paget disease | Hereditary disorders putting you at risk for bone cancer | Prior external beam or implant radiation therapy | Higher alkaline phosphatase levels | Open epiphyses

            In studies performed in animals, Natpara (parathyroid hormone) has been linked to bone cancer. Be sure to talk to your healthcare provider about all your medical conditions. This medication should be avoided if you're at a greater risk of bone cancer (including Paget disease, hereditary disorders, prior external beam or implant radiation therapy, higher alkaline phosphatase levels, or if you have open epiphyses).

            risk-warning

            High calcium levels

            Natpara (parathyroid hormone) can cause high calcium levels. You're at the highest risk of this during the start of therapy and when your dose is raised. If you experience signs and symptoms of high calcium levels, such as weakness, confusion, feeling tired, headache, upset stomach, hard stools (constipation), or bone pain, be sure to contact your healthcare provider right away. Your healthcare provider will likely monitor your calcium levels during treatment.

            risk-warning

            Low calcium levels

            Natpara (parathyroid hormone) can cause low calcium levels. This can happen at any time during therapy; the risk is highest when a dose is missed or when treatment is being held or stopped suddenly. If you experience signs and symptoms of low calcium levels such as a change in thinking, cramping of feet or hands, depression, memory problems, seizures, tingling of your lips, tongue, fingers, or feet, or twitching of face muscles, be sure to contact your healthcare provider right away who will likely monitor your calcium levels during treatment.

            risk-warning

            Digoxin toxicity

            • Risk factors: Taking the medication digoxin

              If you're taking digoxin or any digitalis compound medications, your healthcare provider will likely monitor your calcium levels very closely. The effects of digoxin are affected by blood calcium levels. High calcium levels can put you at risk for digoxin toxicity. Be sure to contact your healthcare provider if you experience any signs of high or low calcium levels; your dose of digoxin and/or Natpara (parathyroid hormone) will likely have to be adjusted.

              dosage

              Natpara (parathyroid hormone) dosage forms

              Typical dosing for Natpara (parathyroid hormone)

              The starting dose of Natpara (parathyroid hormone) is 50 mcg injected subcutaneously (under your skin) in the thigh once daily.

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