Teriparatide is the recombinant form of the first 34 amino acids of human parathyroid hormone (PTH(1-34), MW ~4117.8 g/mol), FDA-approved in November 2002 as the first anabolic agent for osteoporosis treatment. It is indicated for postmenopausal women and men at high risk for fracture, as well as glucocorticoid-induced osteoporosis. Teriparatide works by stimulating new bone formation rather than merely slowing bone loss, representing a paradigm shift in osteoporosis treatment when introduced.
Category: Bone / PTH Analog. Evidence rating: A (strong human clinical data).
Clinical status: FDA-approved (Forteo for osteoporosis, November 2002)
Teriparatide activates the PTH type 1 receptor (PTH1R) on osteoblasts and osteocytes. When administered intermittently (once daily), it produces a transient spike in PTH signaling that preferentially stimulates osteoblast-mediated bone formation over osteoclast-mediated bone resorption (the…
Safety considerations: Common: nausea (8.5%), headache (7.5%), dizziness (8%), leg cramps (3%), arthralgia; Orthostatic hypotension: transient drops in blood pressure within 4 hours of injection, especially early in treatment; Hypercalcemia: serum calcium elevations in approximately 11% of patients; usually mild and transient.
Reviewed by the PeptideAtlas Editorial Team.
| Amino-acid sequence | Ser-Val-Ser-Glu-Ile-Gln-Leu-Met-His-Asn-Leu-Gly-Lys-His-Leu-Asn-Ser-Met-Glu-Arg-Val-Glu-Trp-Leu-Arg-Lys-Lys-Leu-Gln-Asp-Val-His-Asn-Phe |
|---|---|
| Molecular weight | ~4117.8 g/mol |
| CAS number | 52232-67-4 |
| Half-life | ~1 hour |
| Bioavailability | ~95% subcutaneous |
| Production method | recombinant |
| Anti-doping status | not-listed |
| US regulatory status | FDA-approved. Forteo approved November 2002 for postmenopausal osteoporosis, male osteoporosis, glucocorticoid-induced osteoporosis. Generic teriparatide (biosimilar) available. |
Related peptides: Abaloparatide, PTH (Parathyroid Hormone).
Rats treated with teriparatide at doses 3-58 times the human dose for nearly their entire lifespan developed osteosarcoma. Although osteosarcoma risk has not been confirmed in humans after more than 20 years of clinical use and post-marketing surveillance, the FDA maintains a cumulative 2-year treatment limit as a precaution.
BMD gains achieved with teriparatide gradually decline after discontinuation. It is essential to follow teriparatide treatment with an antiresorptive agent (bisphosphonate or denosumab) to consolidate and maintain the bone gains. Omitting follow-up therapy results in significant BMD loss within 1-2 years.
Teriparatide is the bioactive N-terminal 34-amino-acid fragment of the 84-amino-acid full-length parathyroid hormone. PTH(1-34) contains the receptor-binding domain necessary for full biological activity. Full-length PTH (1-84) was previously available as Preotact in Europe but was withdrawn from the market.
Both are anabolic bone agents that work through the PTH1R receptor. Abaloparatide (Tymlos) is a PTHrP analog that may produce slightly less hypercalcemia than teriparatide. The ACTIVE trial showed abaloparatide reduced vertebral fractures by 86% vs placebo, with lower hypercalcemia rates than teriparatide. Both have the same 2-year cumulative treatment limit. Choice depends on individual risk…
While teriparatide is not FDA-approved for acute fracture healing, case reports and small studies suggest it may accelerate fracture repair. A randomized trial in distal radius fractures showed faster cortical bridging. Some orthopedic specialists use it off-label for delayed unions and nonunions, particularly in patients with impaired healing. Larger controlled trials are needed to establish…
Coverage on this site: Teriparatide: Rebuilds Bones and Cuts Osteoporosis Fractures.