Protocol for the use of Teriparatide

Treatment should be prescribed by doctors in the bone clinic, either from PRI or from Ninewells Hospital .

Treatment is distributed by the FORSTEO Homecare Programme – all registration forms to be sent to Ninewells Pharmacy fao Gordon Thomson.

Treatment should be considered only in postmenopausal women who are at extremely high risk of fracture.  Until a risk algorithm becomes available, extremely high risk is recognised through the patient having a very low BMD, i.e. T-score less than –3.0, and ALSO fulfilling the following criteria:

i)               fragility fractures despite having been on a bisphosphonate for at least 12 months.

           OR  

ii)              at least 2 vertebral fragility fractures with a T-score of less than –4.0 (i.e. extremely low BMD)

Patient must be willing to take daily subcutaneous injection and should NOT HAVE any of the following conditions:

         a)             Hypercalcaemia
b)             Severe Renal failure
c)             Metabolic bone disease or raised alkaline phosphatase
d)             Previous skeletal radiotherapy

Notes:

a)             Whilst taking Teriparatide the patient should not be taking a bisphosphonate con-currently, but should be on calcium and Vitamin D unless there is a good reason to the contrary.

b)      Treatment should be given for a maximum of eighteen months, and followed by a bisphosphonate or some other antiresorptive agenT

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Ó NHS Tayside; 2006; version 1.0

Disclaimer; no liability whatsoever is accepted for information given and all such information, especially with regard to drug usage (UK version provided), must be checked with a person’s health provider. ; no liability whatsoever is accepted for information given and all such information, especially with regard to drug usage (UK version provided), must be checked with a person’s health provider.