Teriparatide (rDNA origin) Injection

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Brand name(s): Forteo

How should this medicine be used?

Teriparatide comes as a solution to inject in the fatty layer just under the skin (subcutaneously). It is usually injected once a day. To help you remember to take teriparatide, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use teriparatide exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

You can inject teriparatide yourself or have a friend or relative perform the injections. Before you use teriparatide yourself the first time, read the written instructions that come with it. Ask your doctor or pharmacist to show you or the person who will be injecting the medication how to inject it. The instructions for use include solutions to problems you may have when you try to use teriparatide. Check the instructions if you have difficulty following the directions below.

Teriparatide comes in a pen that contains enough medication for 28 doses. Use a new needle for each injection. Needles are sold separately. Ask your doctor or pharmacist if you have questions about the type of needles to use. Dispose of used needles in a puncture-resistant container. Talk to your doctor or pharmacist about how to dispose of the puncture-resistant container.

To inject teriparatide, follow these steps:

• Remove your teriparatide pen from the refrigerator and check to be sure it is safe to use. It should be labeled with the correct name of the medication and an expiration date that has not passed and should contain a clear colorless solution. Do not use the syringe if it is expired, is cloudy, or contains flakes. Do not remove the pen from the refrigerator until you are ready to begin the injection process. There is no need to allow the medication to warm up before use.
• Wash your hands with soap and water.
• Pull off the pen cap and wipe the rubber seal on the end of the pen with an alcohol swab.
• Get a fresh needle to attach to the pen. Remove the paper tab from the outer needle shield but do not remove the cap. Place the needle over the end of the pen and turn it to the right until it is tight.
• Hold the pen with the needle pointing up and remove both needle shields. You may throw away the inner shield, but save the outer shield to use when you remove the needle.
• Turn the dose knob to the right until an arrow appears in the dose window. The raised notches on the pen and dose knob will be in line.
• Pull the dose knob out until you see a zero in the dose window.
• Turn the knob to the right until the number 1 appears in the dose window.
• Hold the pen with the needle pointing up and gently tap the clear cartridge holder with your finger so that air bubbles collect near the top.
• Push the injection button all the way up with your thumb. A small amount of liquid will come out of the needle. Keep pressing until the liquid stops coming out. A diamond will appear in the dose window. If no liquid comes out of the needle when you push the button, repeat steps 6-10.
• Turn the knob to the right until an arrow appears in the dose window. The raised notches on the dose knob and pen will be in line.
• Pull the dose knob out until you see a zero in the dose window.
• Turn the knob to the right until the number 2 appears in the dose window. The pen is now ready to inject.
• Choose an injection site on either of your thighs or your stomach, and clean it as directed by your doctor. Be sure a chair or bed is nearby so you can sit or lie down if you are dizzy after the injection.
• Gently pinch up a fold of skin, and push the needle straight in. Look at the dose window to be sure it still shows the number 2.
• Use your thumb to push the injection button all the way in. Hold the button down while counting slowly to 5.
• Remove the needle from your skin. You should see a diamond in the dose window. If you do not see a diamond, you did not receive the full dose, and you should call your doctor for directions.
• Carefully replace the outer needle shield. Your doctor will show you how to do this. Remove the capped needle by turning it to the left; throw it away.
• Put the cap back onto the pen and check the markings on the cartridge holder. These markings tell how much medication is left in the pen. Be sure your next pen is ready when the bottom of the plunger reaches the 60 mark.
• Put the pen back in the refrigerator right away.

Teriparatide controls osteoporosis but does not cure it. Continue to take teriparatide even if you feel well. Do not stop taking teriparatide without talking to your doctor.

Last Revised: 07/01/2003

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