Teriparatide
FDA-approved PTH fragment — the only anabolic bone therapy (builds bone, doesn't just stop breakdown). Reduces fracture risk 65–70%.
Research facts
| Half-life | ~1 hour |
|---|---|
| Route | SubQ (daily) |
| Typical dose | 20 mcg/day |
| Frequency | Once daily SubQ |
| Solvent | Pre-filled pen |
| pH | N/A |
| Stability | Refrigerated (2-8°C), stable 28 days open |
Mechanism of action
Teriparatide is the biologically active 34-amino acid N-terminal fragment of parathyroid hormone (PTH). When administered as a daily subcutaneous pulse (mimicking physiological intermittent PTH), it activates PTH1R on osteoblasts to drive bone formation — a mechanism distinct from all other osteoporosis drugs (bisphosphonates, denosumab) which work anti-resorptively. Continuous PTH exposure causes bone resorption; intermittent pulsatile exposure causes net bone formation. FDA-approved for severe osteoporosis, teriparatide reduces vertebral fractures by 65% and non-vertebral fractures by 53% in the pivotal RCT.
Documented effects (research-model)
- FDA-approved for severe osteoporosis — 65% vertebral fracture reduction
- Only anabolic (bone-building) therapy — not just anti-resorptive
- Increases bone mineral density at spine (~9% over 18 months)
- FDA-approved for male osteoporosis and glucocorticoid-induced osteoporosis
- Established safety profile (21-month treatment limit initially, now extended to 2 years)
Research protocols
| Protocol | Dose | Frequency | Cycle | Vial |
|---|---|---|---|---|
| FDA-Approved | 20 mcg/day SubQ | Once daily (upper thigh or abdomen) | Maximum 2 years lifetime use | Forteo pre-filled pen |
Research context only. Not medical advice. Consult a qualified healthcare professional before any protocol decision.
Synergies
- BPC-157 MODERATE
BPC-157 promotes bone healing and angiogenesis; teriparatide drives osteoblast activity. Combined bone fracture recovery research.
Myths & misconceptions
Evidence gaps
- Optimal sequential therapy after teriparatide (anti-resorptive therapy needed to preserve gains).
- Whether longer treatment duration (>2 years) provides additional benefit.
- Cardiovascular effects in older, frail patients not fully characterised.
Safety notes
FDA-approved with strong safety record. Avoid in Paget's disease, prior radiation therapy to skeleton, bone metastases, elevated alkaline phosphatase, and history of osteosarcoma. Hypercalcaemia possible — monitor calcium. Not for patients at increased osteosarcoma risk (paediatric patients, young adults with open epiphyses).
Biomarkers to monitor
Primary-source citations
- PMID 11576904 — Effect of teriparatide (recombinant PTH) on fractures and bone mineral density in postmenopausal women (N Engl J Med. 2001)
Frequently asked
What is Teriparatide?
Teriparatide (PTH(1-34) / Forteo — Bone Anabolic Peptide) is a research compound classified in our library as Tier B — Some human data + strong preclinical evidence.. FDA-approved PTH fragment — the only anabolic bone therapy (builds bone, doesn't just stop breakdown). Reduces fracture risk 65–70%.
What is the evidence tier for Teriparatide?
We classify Teriparatide as Tier B: Some human data + strong preclinical evidence. See our full peptide evidence tiers explainer for how we assign S/A/B/C/D.
What is the research dose of Teriparatide?
For Teriparatide, typical research dose is 20 mcg/day, route is SubQ (daily), half-life is ~1 hour. Protocols vary by research goal — see the protocols section on this page for standard and advanced dosing schedules. Research use only, not medical advice.
Is Teriparatide safe?
FDA-approved with strong safety record. Avoid in Paget's disease, prior radiation therapy to skeleton, bone metastases, elevated alkaline phosphatase, and history of osteosarcoma. Research context only — no compound on this site is approved for human therapeutic use unless explicitly noted.