Forteo (Teriparatide) is the only Anabolic osteoporosis medication in the USA. It acts by directly stimulating the Osteoblast cells that make new bone matrix. It is the only type of osteoporosis medication which actually grows substantial new bone. See my post about “Osteoclasts Gone Wild”.
Forteo is a daily shot with a tiny needle that I cannot see without my glasses. Maximum time on Forteo is 2 years. Most osteoporosis doctors follow 2 years of Forteo with 3 years of an Antiresorptive medication. That preserves the new bone matrix while waiting for all of the calcium to be deposited in the new bone. Total increase in bone matrix and in Bone Mineral Density averages 30 to 35 percent.
Possible side effects include dizziness if you stand up immediately after taking your shot. This and other problems, including aches and pains, happened at the about same rate in patients who were given Forteo or given a placebo (fake) shot during testing.
Although humans have not had an increase in bone cancer while on Forteo, laboratory rats did, when they were given much higher doses of the same drug, and for the equivalent of 70 human years. We do not give Forteo to persons who have: bones that are still growing, Paget’s disease, other cancers which have spread to bone, or high dose radiation to bone. No increase in the rate of bone cancers has been found in over 500,000 humans taking Forteo.
Forteo is often my first choice in patients who already have fractures. Those can be fractures which they knew about, or spine fractures that we detect with VFA. Forteo is the only medicine which stimulates substantial new bone matrix formation. Forteo is often the best choice when the bones have proven that they are not “good enough” by Fragility Fracture. As an orthopedic surgeon, my view of osteoporosis treatment is all about fracture prevention.
Jay Ginther, MD
2008 / Revised Feb 2011