teriparatide injection
Bonsity (teriparatide) is a parathyroid hormone analog that helps build bone. It's used for adults with osteoporosis who have a high risk of breaking a bone or have tried certain other treatments. This includes women who've gone through menopause, men, and people with weak bones caused by long-term steroid use. Bonsity (teriparatide) comes as a prefilled pen that you use for injections under the skin once a day. Some side effects include body pain, joint pain, and nausea.
What is Bonsity (teriparatide)?
What is Bonsity (teriparatide) used for?
- Osteoporosis in women who've gone through menopause (postmenopausal)
- Osteoporosis in men
- Osteoporosis caused by long-term steroid use
How Bonsity (teriparatide) works
Bonsity (teriparatide) is a parathyroid hormone (PTH) analog. It works like PTH, a hormone your body makes to help keep your bones healthy.
By working like PTH, Bonsity (teriparatide) helps your body build new bone. This raises your bone mineral density (BMD), which is a measure of how strong your bones are. Stronger bones are less likely to break.
Drug facts
| Common Brands | Bonsity |
|---|---|
| Drug Class | Parathyroid hormone analog |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Bonsity (teriparatide)
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
- Body pain (21%)
- Joint pain (10%)
- Runny or stuffy nose (10%)
- Nausea (9%)
- Weakness (9%)
- Headache (8%)
- Dizziness (8%)
- High blood pressure (7%)
Less Common Side Effects
- Cough
- Sore throat
- Constipation
- Diarrhea
- Vomiting
- Indigestion
- Trouble breathing
- Pneumonia
- Depression
- Feeling like your surroundings are spinning (vertigo)
- Rash
Bonsity (teriparatide) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- High calcium levels: tiredness, abnormal or irregular heartbeat, muscle weakness
- New or worsening open wound or ulcer on your skin
The following Bonsity (teriparatide) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Confusion
headache
incoherent speech
increased urination
loss of appetite
metallic taste
muscle weakness
stomach pain
thirst
unusual tiredness
vomiting
Less common
Arm, back, or jaw pain
chest pain, discomfort, tightness, or heaviness
fainting
fast or irregular heartbeat
fever or chills
sweating
trouble breathing
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Acid or sour stomach
belching
blurred vision
body aches or pain
difficulty having a bowel movement (stool)
difficulty with moving
dizziness
hoarseness
indigestion
lack or loss of strength
muscle pain, stiffness, or spasm
nervousness
pain in the joints
pounding in the ears
runny or stuffy nose
tender, swollen glands in the neck
trouble with swallowing
voice changes
Less common
Back pain
discomfort
discouragement
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
feeling of constant movement of self or surroundings
feeling sad or empty
indigestion
irritability
lack of appetite
leg cramps
loss of interest or pleasure
neck pain
sensation of spinning
stomach cramps
swollen mouth and tongue
tiredness
tooth disorder
trouble concentrating
trouble sleeping
unpleasant taste
urge to have bowel movement
Incidence not known
Bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
flushing
unusually warm skin
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Bonsity (teriparatide)
Pros
- A first-choice option for postmenopausal women at very high risk of broken bones
- Can be used if other osteoporosis medications haven't worked well or caused bothersome side effects
- Helps lower the risk of broken bones in the spine and other areas in postmenopausal women
Cons
- Must be injected under the skin every day
- Can cause dizziness or low blood pressure after injections
- Usually limited to 2 years of lifetime treatment, except in certain situations
Pharmacist tips for Bonsity (teriparatide)
How to use Bonsity (teriparatide):
- Review the User Manual that comes with Bonsity (teriparatide) before your first injection. Your care team should show you how to use the pen. Ask your prescriber or pharmacist if you need help.
- Only use your Bonsity (teriparatide) pen and needles for yourself. Never let anyone else use the pen, even with a new needle. Sharing can spread infections.
- Check the liquid in your Bonsity (teriparatide) pen before each injection. It should be clear and have no color. Don't use it if it looks cloudy, has changed color, or has particles in it.
- Use a new needle for each injection to help prevent infection. Ask your pharmacist which needles work with your Bonsity (teriparatide) pen.
- Inject Bonsity (teriparatide) once a day under the skin of your thigh or lower stomach. Use a different spot each day to help prevent skin irritation. Clean the area with an alcohol swab before injecting.
- Sit or lie down when you give yourself Bonsity (teriparatide), especially during your first few injections. You might feel dizzy or lightheaded after the injection. If this feeling happens, lie down and rest until it passes.
- To inject Bonsity (teriparatide), pull out the black button. You should see a red stripe and a red arrow in the instruction window that points toward the needle. Take off the inner needle cover and insert the needle straight into a fold of skin in the injection area. Press and hold the black button down while you slowly count to 5. Then, pull the needle straight out. Take your thumb off the button and check that the button is pushed all the way in and the red arrow points towards the button.
- Remove the needle after each Bonsity (teriparatide) injection and throw it away in a sharps container. This helps prevent injuries from used needles.
General tips:
- Keep Bonsity (teriparatide) in the fridge at 36°F to 46°F. Use it right after taking it out and put it back in the fridge after each injection. Don't let it freeze or use it if it's been frozen. Recap the pen when you're not using it to protect the medication from light and any damage.
- Throw away your Bonsity (teriparatide) pen 28 days after your first use, even if there's medication left inside.
- Ask your care team if you need calcium or vitamin D supplements while taking Bonsity (teriparatide). These can help support bone health, but taking too much can raise your calcium levels. Your prescriber can tell you how much calcium or vitamin D to take.
- Get your bone density scans when your prescriber tells you to. A DEXA scan helps show how well Bonsity (teriparatide) is working. How often you need one depends on your health, but it's usually every few years.
- If you're pregnant or plan to become pregnant: Tell your prescriber right away. There isn't enough information to know if Bonsity (teriparatide) is safe during pregnancy. Your prescriber can help you decide if you need to stop treatment or use another medication.
- If you're breastfeeding or plan to breastfeed: Avoid using Bonsity (teriparatide) while breastfeeding. It's not known if the medication passes into breast milk or how it might affect your baby. Your prescriber can discuss other options.
Risks and warnings for Bonsity (teriparatide)
Bonsity (teriparatide) 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.
Possible risk of bone cancer (osteosarcoma)
- Risk factors: Rickets | Paget's disease | Bones that are still growing | History of bone cancer | Cancer that has spread to the bones | Past radiation treatment to the bones | Inherited conditions that rise the risk of bone cancer
In animal studies, some rats treated with Bonsity (teriparatide) developed a rare type of bone cancer called osteosarcoma. This cancer has been reported in some people taking Bonsity (teriparatide). But studies haven't found that the medication raises the risk of this cancer in people.
To be safe, people at higher risk of bone cancer should avoid Bonsity (teriparatide). This includes people with certain bone conditions (like Paget's disease) or a history of bone cancer. It also includes people who've had radiation treatment to their bones.
There isn't enough information about the risk of bone cancer after using Bonsity (teriparatide) for more than 2 years. Because of this, it's usually used for no more than 2 years in your lifetime. Your prescriber might recommend longer treatment if you're still at high risk of broken bones or become high risk again. Your prescriber will help decide how long your treatment will be based on your risk of broken bones.
High calcium levels
- Risk factors: Conditions that can raise calcium levels | High PTH levels
Bonsity (teriparatide) can cause high calcium levels in your blood. Avoid Bonsity (teriparatide) if you already have high calcium or a condition that causes this. Bonsity (teriparatide) can make it worse. Tell your care team if you have signs of high calcium while taking Bonsity (teriparatide). This can include feeling tired, weak muscles, constipation, or not feeling hungry.
In rare cases, people taking Bonsity (teriparatide) have had calcium build up in their skin and blood vessels. Your risk might be higher if you have an autoimmune condition or kidney failure. Taking Bonsity (teriparatide) with warfarin or steroids like prednisone can also raise your risk. Stop taking Bonsity (teriparatide) and tell your care team right away if you notice new or worsening sores on your skin, especially on your thighs or buttocks.
Risk of worsening kidney stones
- Risk factors: History of kidney stones | History of high calcium levels in your urine
Bonsity (teriparatide) might make kidney stones worse if you already have them or have had them recently. Tell your prescriber if you have kidney stones or high calcium levels in your urine before starting Bonsity (teriparatide). They might check your urine calcium levels to make sure this medication is safe for you.
Tell your care team right away if you have signs of a kidney stone. Watch for severe pain in your back or side, nausea, vomiting, or dark, cloudy, or bloody urine.
Low blood pressure when standing up
Bonsity (teriparatide) can cause a drop in blood pressure when you stand up. This can make you feel dizzy or lightheaded. It can usually happen within 4 hours after your first few doses.
Sit or lie down when you inject Bonsity (teriparatide) in case you feel dizzy or your heart races. If this happens, lie down until you feel better. Symptoms usually go away within a few minutes to a few hours. Tell your prescriber if your symptoms don't go away or get worse before taking your next dose.
Higher risk of serious side effects from digoxin (Lanoxin)
- Risk factors: Taking digoxin (Lanoxin) at the same time as Bonsity (teriparatide)
Bonsity (teriparatide) can raise calcium levels in your blood. This can raise your risk of serious side effects from the heart medication digoxin (Lanoxin). Signs include nausea, vomiting, changes in vision, or an uneven heartbeat.
Tell your prescriber if you take digoxin (Lanoxin) before starting Bonsity (teriparatide). Also, let your cardiologist know if you start Bonsity (teriparatide). Tell your care team right away if you notice any symptoms of serious digoxin side effects while taking both medications.
Bonsity (teriparatide) dosage
Pen| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 20mcg/dose | 1 pen | $1,146.04 | $1,146.04 |
Typical dosage for Bonsity (teriparatide)
The typical dose is 20 mcg injected once a day under the skin of the thigh or lower stomach.
Interactions between Bonsity (teriparatide) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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