Pharmacological action Forteo Injection
Forteo Injection Recombinant human parathyroid hormone. Is the active fragment of an endogenous human parathyroid hormone (PTH). Physiological effect of PTH is to stimulate bone formation by direct effects on osteoblasts. PTH indirectly increases intestinal absorption and tubular reabsorption of calcium, phosphate and the excretion by the kidneys.
The biological effect of PTH is carried out by binding to specific PTH receptors on the cell surface. Teriparatide is associated with the same receptors and has the same effect on bone and kidney as well as PTH.
The introduction of teriparatide stimulates new bone formation on trabecular and cortical (periosteal and / or endosteal) bone surfaces with preferential stimulation of osteoblastic activity in relation to the activity osteolkalastov.
2 hours after administration of teriparatide observed transient increase in serum calcium, which reaches its maximum at 4-6 h and returned to baseline levels within 16-24 h. In addition, there may be a transient phosphaturia and a slight short-term decline of phosphorus in the blood serum .
The treatment teriparatide increases bone mineral density (BMD) of the whole body of 5-10% (including the lumbar spine, femoral neck and femur).
Mineralization occur without signs of toxic effects on bone cells, and formed under the influence of teriparatide bone has a normal structure (no retikulofibroznoy tissue and fibrosis of bone marrow).
Teriparatide reduces the risk of fractures, regardless of age, baseline bone metabolism or bone mineral density values (relative risk reduction of new fractures was 65%).
Pharmacokinetics Forteo Injection
It is well absorbed after s / c injection. At a dose of 20 mg Cmax plasma levels achieved within 30 min and decreased to undetectable values within 3 hours does not accumulate in the bones and other tissues. Metabolized primarily in the liver by nonspecific T1 / 2 is about 1 hour of enzymatic mechanisms. Excreted by the kidneys.
Statement Forteo Injection
Treatment of osteoporosis in women postmenopauznom period.
Treatment of primary osteoporosis or osteoporosis caused by hypogonadism in men.
Dosage regimen Forteo Injection
Enter n / a (in the thigh area or abdomen) at a dose of 20 mg once / day. The maximum duration of treatment – 18 months.
Side effect Forteo Injection
On the part of the musculoskeletal system, most often – the pain in the extremities and often – muscle cramps.
From the hemopoietic system: common – anemia.
From the central and peripheral nervous system: Frequent – depression, headache, dizziness, sciatica.
The respiratory system: often – shortness of breath, dyspnea, rarely – emphysema.
From the digestive system: common – nausea, vomiting
Cardio-vascular system: common – palpitations, rarely – tachycardia, decreased blood pressure.
From a metabolism: common – high cholesterol, increased sweating.
Urinary system: rarely – incontinence, polyuria, painful urination.
Local reactions: seldom – erythema and allergic reactions at the injection site.
Other: often – weakness, chest pain, asthenia.
Contraindications Forteo Injection
Prior hypercalcaemia, severe renal insufficiency, metabolic bone disease, except for primary osteoporosis (including hyperparathyroidism and Paget’s disease), elevated alkaline phosphatase of unknown origin, prior radiation therapy bone metastases and bone tumors in history, pregnancy, lactation (breastfeeding), children and adolescence to 18 years of hypersensitivity to teriparatide.
Cautions Forteo Injection
Used with caution in patients with exacerbation of existing or recent urolithiasis (should monitor the level of urinary calcium excretion) with moderate renal impairment, with hypovitaminosis D, clinically significant hypocalcemia, as well as on the background of therapy with digitalis.
In the application of teriparatide may be occasional brief episodes of orthostatic hypotension, which occur within 4 h after injection and are on their own within a few minutes to several hours (in these cases, the patient should be put in the position of lying on his back).
Drug Interactions Forteo Injection
With the simultaneous use of drugs increases the risk of digitalis glycoside intoxication with hypercalcemia.
