Meta Information
ID:teriparatide
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/intervention/digoxin
Target name:
Digoxin
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Teriparatide can cause a temporary increase in blood calcium levels, which significantly enhances the effects of digoxin and can lead to serious, life-threatening heart rhythm problems (digoxin toxicity).
Actionable advice:
Avoid using with digoxin; if unavoidable, it requires extremely close monitoring of calcium levels and heart function by a physician.
Target id:
/condition/hypercalcemia
Target name:
Hypercalcemia (High Blood Calcium)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Teriparatide's primary mechanism involves increasing serum calcium levels, making it strictly contraindicated in individuals who already have high blood calcium.
Actionable advice:
Do not use this medication if you have pre-existing hypercalcemia.
Target id:
/procedure/long-term-use-over-24-months
Target name:
Cumulative Use Beyond 24 Months
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Due to a theoretical risk of osteosarcoma observed in animal studies, the cumulative lifetime use of teriparatide and related drugs is limited to a maximum of 24 months.
Actionable advice:
Do not use teriparatide for more than a total of 2 years over your entire lifetime.
Target id:
/condition/bone-malignancy-risk
Target name:
Increased Risk for Osteosarcoma
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Teriparatide is contraindicated in conditions with an increased baseline risk of osteosarcoma, such as Paget's disease of bone, prior skeletal radiation, bone metastases, or unexplained high alkaline phosphatase.
Actionable advice:
Do not use if you have Paget's disease, bone cancer, or have had radiation therapy to your bones.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
The effects of teriparatide on a developing fetus are unknown and potential risks cannot be ruled out.
Actionable advice:
Avoid completely during pregnancy.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
It is not known if teriparatide passes into breast milk, so its use is contraindicated to avoid potential harm to the infant.
Actionable advice:
Avoid completely while breastfeeding.
Target id:
/condition/pediatric
Target name:
Pediatric Patients (Children/Adolescents)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Teriparatide is contraindicated in children and young adults with open epiphyses (growing bones) due to the theoretical risk of osteosarcoma.
Actionable advice:
Do not use in children or adolescents whose bones are still growing.
Target id:
/class/calcium-supplements
Target name:
Calcium Supplements
Severity:
major
Interaction type:
requirement
Nature:
absolute
Description:
Teriparatide builds new bone, a process that requires adequate calcium as a fundamental building block to be effective.
Actionable advice:
Ensure adequate daily calcium intake (typically 1200 mg total from diet and supplements) as recommended by your doctor.
Target id:
/intervention/vitamin_d3_systemic_healthspan
Target name:
Vitamin D
Severity:
major
Interaction type:
requirement
Nature:
absolute
Description:
Vitamin D is necessary for the body to absorb calcium from the gut; sufficient levels are required for teriparatide to effectively build new bone.
Actionable advice:
Ensure adequate daily Vitamin D intake to maintain sufficient blood levels, as recommended by your doctor.
Target id:
/biomarker/serum-calcium
Target name:
Serum Calcium Test
Severity:
major
Interaction type:
assay_interference
Nature:
temporal
Temporal spacing:
Hours before target:
16
Hours after target:
null
Description:
Teriparatide causes a temporary rise in blood calcium, peaking 4-6 hours after injection. Measuring calcium too soon after a dose will give a falsely elevated result not reflective of your baseline.
Actionable advice:
Schedule blood draws for serum calcium at least 16 hours after your last teriparatide injection.
Target id:
/class/thiazide-diuretics
Target name:
Thiazide Diuretics
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Thiazide diuretics reduce the amount of calcium excreted by the kidneys. When combined with teriparatide's calcium-increasing effect, this can lead to hypercalcemia.
Actionable advice:
Use with caution and ensure your doctor is monitoring your blood calcium levels closely.
Target id:
/intervention/bisphosphonates
Target name:
Bisphosphonates
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Description:
Concurrent use is generally not recommended as bisphosphonates (which prevent bone breakdown) may blunt the bone-building (anabolic) effect of teriparatide.
Actionable advice:
Do not take concurrently; these therapies are typically used sequentially, not together.
Target id:
/intervention/denosumab
Target name:
Denosumab (Prolia)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Description:
Concurrent use is not recommended as denosumab (an anti-resorptive agent) may interfere with the primary bone-building mechanism of teriparatide.
Actionable advice:
Do not take concurrently; these therapies are typically used sequentially, not together.
Target id:
/condition/renal-impairment
Target name:
Moderate to Severe Renal Impairment
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
In patients with poor kidney function, teriparatide is cleared more slowly and may lead to more significant and prolonged increases in blood calcium.
Actionable advice:
Use with caution in moderate kidney disease and avoid in severe kidney disease.
Target id:
/procedure/standing-up-quickly
Target name:
Standing Up Quickly
Severity:
moderate
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
null
Hours after target:
4
Description:
Teriparatide can cause a temporary drop in blood pressure upon standing (orthostatic hypotension), especially within the first few hours after the initial doses.
Actionable advice:
For the first few doses, inject where you can sit or lie down, and rise slowly for 4 hours after injection.
Target id:
/class/antihypertensives
Target name:
Antihypertensive Medications
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
Teriparatide can cause a temporary drop in blood pressure upon standing, an effect that may be additive with other blood pressure-lowering drugs.
Actionable advice:
Be cautious when standing up for the first few hours after injection, especially when also taking blood pressure medication.
Target id:
/condition/gout
Target name:
Gout or High Uric Acid Levels
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
Teriparatide can cause transient increases in serum uric acid, which may precipitate or worsen gout attacks in susceptible individuals.
Actionable advice:
Use with caution if you have a history of gout and monitor for symptoms of a flare-up.
Target id:
/intervention/raloxifene
Target name:
Raloxifene
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
Co-administration of raloxifene and teriparatide has not shown additional benefit on bone density and was associated with small increases in serum calcium and uric acid.
Actionable advice:
Concurrent use is generally not recommended as it offers no extra benefit and may slightly increase side effects.
Target id:
/biomarker/alkaline-phosphatase
Target name:
Alkaline Phosphatase (ALP)
Severity:
minor
Interaction type:
assay_interference
Nature:
absolute
Description:
Teriparatide stimulates bone formation, which is expected to increase levels of bone-specific alkaline phosphatase. This is a sign of therapeutic effect, not pathology.
Actionable advice:
Be aware that elevated ALP is an expected finding during therapy and reflects bone-building activity.