Severe cramps or back pain have been observed for a few minutes after injection. Description of the individual reactions. Following phenomena encountered in clinical studies with teriparatide group at 1% as compared to the placebo group: vertigo, nausea, pain in the limbs, dizziness, depression, dyspnea.
In the application testosterone enanthate dose of teriparatide may increase the concentration of uric acid in the blood serum. According to clinical studies, teriparatide group 2.8% of patients at increased concentration of uric acid in the blood is above the upper limit of normal as compared with 0.7% in the placebo group. However, the increase in the concentration of uric acid in the blood does not have a negative impact on the course of gout, arthralgia, or urolithiasis.
In large clinical studies, 2.8% of the patients had antibodies to cross-reacting with teriparatide. Typically, the antibody appeared after 12 months of treatment and disappeared after discontinuation of therapy. In connection with the appearance of antibodies, there were no signs of hypersensitivity reactions, allergic reactions, effects on calcium concentration or a therapeutic effect on the response against bone mineral density.
In clinical studies, teriparatide cases of overdose have been reported.
Teriparatide applied in a single dose to 100 ug doses, and repeated at 60 micrograms per day for 6 weeks.
From post-marketing data on known cases of errors in the application, in which at one time was put all the contents of the pen at a dose of 800 micrograms of teriparatide. nausea, weakness / lethargy and decreased blood pressure: The following transient effects have been reported. In some cases, an overdose no side effects have been reported. About the deaths associated with overdose have been reported.
Symptoms of overdose may include hypercalcemia with delayed onset and development of orthostatic hypotension. Also nausea, vomiting, dizziness, headache.
no specific antidote exists. If you suspect an overdose, it is recommended the abolition of teriparatide, monitoring of serum testosterone enanthate dose calcium and symptomatic therapy.
Interaction with other drugs
Clinically significant interactions with hydrochlorothiazide, furosemide, digoxin, atenolol, as well as sustained release preparations – diltiazem, nifedipine, felodipine, nisoldipine was observed.
Co-administration of raloxifene or teriparatide with hormone replacement therapy does not affect the calcium content in serum and urine.
A single dose of teriparatide does not affect the effect of digoxin on the systole period (from the start of wave of the electrocardiogram before the closure of the aortic valve, which is indicative of the effect of digoxin on the cardiac effect of calcium). However, as teriparatide may cause a transient increase in blood calcium concentration (and thus be a predisposing factor to the development of digitalis intoxication of drugs), caution should be exercised in the application of teriparatide in patients taking digoxin.
Combined use teriparatide hydrochlorothiazide and 25 mg did not influence the effect of 40 ug teriparatide on serum calcium concentration. Effect of hydrochlorothiazide teriparatide use higher doses of calcium concentration in blood was not studied.
Combined use intravenous furosemide in doses from 20 to 100 mg with teriparatide in a dose of 40 mg in healthy volunteers and in patients with mild, moderate or severe renal failure (creatinine clearance of 13 to 72 ml / min) resulted in a slight increase in the concentration of calcium in blood serum (2%) and an increase in calcium concentration testosterone enanthate dose in urine during the 24 hour study (37%), but this change is not clinically significant.
The blood was taken to determine the concentration of calcium in the blood should be performed not earlier than 16 hours after the last administration Forsteo®, as there may be a transient increase in the concentration of calcium in the blood serum after teriparatide injection. Keeping the calcium concentration during treatment is not required.