Teriparatide
Also known as: Forteo, Bonsity, PTH 1-34, LY333334
Key Facts: Teriparatide
- Category
- Hormonal
- FDA Status
- FDA Approved
- Clinical Status
- FDA Approved - Osteoporosis (postmenopausal women, men with primary or hypogonadal osteoporosis, glucocorticoid-induced osteoporosis)
- Banned in Sport (WADA)
- Not on the WADA Prohibited List (2026).
- Administration
- Subcutaneous injection daily
- Typical Dose
- 20 mcg daily
- Frequency
- Once daily
- Duration
- Usually up to 2 years; per the 2020 label, longer lifetime use only if fracture risk remains or becomes high again
How does Teriparatide work?
Teriparatide activates the PTH/PTHrP type 1 receptor, a G-protein-coupled receptor on bone cells, switching on the adenylate cyclase/protein kinase A pathway and, secondarily, phospholipase C signaling. The timing is everything: a brief once-daily spike preferentially stimulates osteoblasts, the cells that lay down new bone, and tips the remodeling balance toward formation. Continuously high PTH, by contrast, favors osteoclast-driven bone breakdown, which is why chronic hyperparathyroidism weakens bone while intermittent teriparatide strengthens it. The result is increased bone mineral density and, importantly, improved bone microarchitecture and strength, not just denser-looking scans.
What does the research show?
Teriparatide is backed by a landmark randomized human trial, not preclinical extrapolation. The Fracture Prevention Trial by Neer and colleagues in the New England Journal of Medicine in 2001 enrolled postmenopausal women with prior vertebral fractures and showed teriparatide cut new vertebral fractures by about 65 percent and nonvertebral fragility fractures by roughly half over a median 19 months. Those results drove its 2002 FDA approval as the first anabolic osteoporosis agent. Early rat studies had flagged osteosarcoma at high lifetime doses, prompting an initial boxed warning and a 2-year use limit. After a 15-year post-marketing surveillance study and claims-based studies found no human signal, the FDA removed the boxed warning in November 2020 and loosened the 2-year cap: longer use is now allowed only if fracture risk stays or becomes high again. An osteosarcoma warning remains in the label (avoid with Paget's disease or prior skeletal radiation), and gains are usually locked in afterward with an antiresorptive. It is well-established medicine for severe osteoporosis, typically reserved for high fracture risk given its cost and injection burden.
What doses have been studied?
Typical Dosingⓘ
Community experience
20 mcg daily
20 mcg daily
Once daily
An approved PTH analog for osteoporosis. Courses usually run up to 2 years; the label allows longer lifetime use only for patients who remain at or return to high fracture risk. Often followed by an antiresorptive drug to hold the gains.
Research Dosingⓘ
Scientific studies
FDA-approved dosing
Doses from Studies
20 mcg subcutaneous daily
Duration
Usually up to 2 years; per the 2020 label, longer lifetime use only if fracture risk remains or becomes high again
Administration
Subcutaneous injection daily
When and how is Teriparatide taken?
Best Time to Take
Morning or as directed
Follow recommended protocol
Food Recommendation
With or without food
Why This Timing?
Timing may vary based on individual response and goals. Consistency is generally more important than specific timing.
What are the side effects of Teriparatide?
Not everyone experiences these effects. Individual responses vary based on dosage, duration, and personal factors.
- ●Joint pain (10%)
- ●Nausea
- ●Headache
- ●Dizziness
- ●Leg cramps
- ●Injection site reactions
- ●Orthostatic hypotension
- ●Hypercalcemia
- ●Skin calcification, including calciphylaxis (rare)
- ●Osteosarcoma warning (rat data; boxed warning removed 2020)
References
- https://www.ncbi.nlm.nih.gov/books/NBK559248/
- https://en.wikipedia.org/wiki/Teriparatide
- https://pubmed.ncbi.nlm.nih.gov/19604460/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC3756865/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9465003/
- https://www.accessdata.fda.gov/drugsatfda_docs/nda/2022/021318Orig1s054.pdf
Research This Peptide Further
Frequently Asked Questions
What does Teriparatide do?
Teriparatide (brand names Forteo and Bonsity) is the first 34 amino acids of human parathyroid hormone, made by recombinant DNA, and it was the first drug approved that actually builds new bone rather than just slowing its loss. FDA-approved in 2002, it is used for osteoporosis at high fracture risk in postmenopausal women and men (primary or hypogonadal), and for glucocorticoid-induced osteoporosis, given as a once-daily self-injection. The counterintuitive trick is that the same hormone which strips calcium from bone when high around the clock instead grows bone when delivered in a short daily pulse.
How does Teriparatide work?
Teriparatide activates the PTH/PTHrP type 1 receptor, a G-protein-coupled receptor on bone cells, switching on the adenylate cyclase/protein kinase A pathway and, secondarily, phospholipase C signaling. The timing is everything: a brief once-daily spike preferentially stimulates osteoblasts, the cells that lay down new bone, and tips the remodeling balance toward formation. Continuously high PTH, by contrast, favors osteoclast-driven bone breakdown, which is why chronic hyperparathyroidism weakens bone while intermittent teriparatide strengthens it. The result is increased bone mineral density and, importantly, improved bone microarchitecture and strength, not just denser-looking scans.
Is Teriparatide FDA approved?
Yes, Teriparatide is FDA approved. FDA Approved - Osteoporosis (postmenopausal women, men with primary or hypogonadal osteoporosis, glucocorticoid-induced osteoporosis)
Is Teriparatide banned in sport?
Not on the WADA Prohibited List (2026).
What are the side effects of Teriparatide?
Reported side effects include: Joint pain (10%), Nausea, Headache, Dizziness, Leg cramps. Individual responses vary based on dosage, duration, and personal health factors.
What is the typical dose of Teriparatide?
Community-reported common dose: 20 mcg daily (Once daily). Range: 20 mcg daily. Administration: Subcutaneous injection daily. Prescription drug. Dose set by prescriber per label. Not medical advice.
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Peptides commonly compared with Teriparatide or used in similar applications.
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