What are the contraindications for use of teriparatide (Forteo) in the treatment of osteoporosis?

Updated: Sep 26, 2019
  • Author: Monique Bethel, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Before treatment with teriparatide, levels of serum calcium, PTH, and 25(OH)D need to be monitored. Teriparatide cannot be given for more than 2 years. Contraindications include the following:

  • Pre-existing hypercalcemia
  • Severe renal impairment
  • Pregnancy
  • Breast-feeding mothers
  • History of bone metastases or skeletal malignancies
  • Increased baseline risk for osteosarcoma (eg, Paget disease, unexplained elevated alkaline phosphatase level)
  • Children and young adults with open epiphyses or prior radiotherapy of the skeleton [147]
  • Monoclonal gammopathies of uncertain significance (MGUS) [148]

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