Teriparatide injection is used to treat osteoporosis (a condition in which the bones become thin and weak and break easily). Teriparatide injection contains a synthetic form of natural human hormone called parathyroid hormone (PTH). It works by causing the body to build new bone and by increasing bone strength and density (thickness).

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Teriparatide injection comes as a solution (liquid) in a prefilled pen to inject subcutaneously (under the skin) in your thigh or lower stomach area. It is injected once a day for up to 2 years. Use it at around the same time every day.

Use teriparatide injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

You can inject teriparatide injection yourself or have a caregiver perform the injections. Before you use teriparatide injection yourself the first time, carefully read the manufacturer's instructions. Ask your doctor or pharmacist to show you or the caregiver how to inject it. Be sure to ask your pharmacist or doctor if you have any questions about how to inject this medication.

You should inject teriparatide injection into the lower stomach area or upper thigh. Avoid giving your injection within the 2-inch area around your belly button. Rotate the injection site every day. Do not give teriparatide injection into your veins or muscles. Do not inject into areas where the skin is tender, bruised, red, scaly, hard, or where you have scars or stretch marks.

Always look at your teriparatide injection before you inject it. It should be clear and colorless. Do not use teriparatide injection if it has particles in it, or if it is cloudy or colored.

Teriparatide injection comes in a pen that contains enough medication for 28 doses. Do not transfer the medication to a syringe. Use a new needle for each injection. Needles are sold separately. Ask your doctor or pharmacist if you have questions about the type of needles to use. Dispose of used needles in a puncture-resistant container. Talk to your doctor or pharmacist about how to dispose of the puncture-resistant container.

You should know thatteriparatide injection may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position as well as a fast or pounding heartbeat and nausea. This usually occurs within 4 hours after receiving your dose and generally goes away within a few hours. You should receive your first several doses of teriparatide injection where you can sit or lie down right away if necessary.

Teriparatide injection controls osteoporosis but does not cure it. Continue to use teriparatide injection even if you feel well. Do not stop using teriparatide injection without talking to your doctor.

Before using teriparatide injection,

• tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while using teriparatide injection. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you have or have ever had a bone disease such as Paget's disease, bone cancer or a cancer that has spread to the bone, or radiation therapy of the bones, any condition that causes you to have too much calcium in your blood, such as disease of the parathyroid gland; kidney or urinary tract stones; and liver, kidney, or heart disease.

• you should know that teriparatide injection should only be used by women once they have passed menopause and, therefore, cannot become pregnant or breast-feed. Teriparatide injection should not be used during pregnancy or while breast-feeding.

• you should know that teriparatide injection may cause fast heartbeat, dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start using teriparatide injection. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Be sure a chair is nearby when you inject teriparatide injection so you can sit down if you get dizzy.

You should eat and drink plenty of foods and drinks that are rich in calcium and vitamin D while you are using teriparatide injection. Your doctor will tell you which foods and drinks are good sources of these nutrients and how many servings you need each day. If you find it difficult to eat enough of these foods, tell your doctor. In that case, your doctor may prescribe or recommend a supplement.

Use the missed dose as soon as you remember it that day. However, if the day has already passed, skip the missed dose and continue your regular dosing schedule. Never inject more than one dose per day.

Keep this medication in the pen it came in with the cap on and without a needle attached, tightly closed, and out of reach of children. Store it in the refrigerator but do not freeze it. Protect it from light. Discard the pen after 28 days of use, even if it is not empty.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• nausea
• vomiting
• dizziness
• headache
• lightheadedness and fainting on standing
• constipation
• lack of energy
• muscle weakness

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to teriparatide injection.

Do not let anyone else use your medication. Never share a teriparatide injection pen. Ask your pharmacist any questions you have about refilling your prescription.

Talk to your doctor about the risks of using teriparatide injection.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.