How effective is Forteo?

February 25th, 2008

DEAR DR. GOTT: Would you kindly comment on Forteo, a bone-formation medication now being prescribed by some physicians to treat osteoporosis. Thank you.

DEAR READER: Forteo is a synthetic form of parathyroid hormone. It increases bone density and bone strength. It is used for both men and women at high risk of fractures. Forteo is given as a daily injection under the skin of the thigh or abdomen. Your physician will show you how to use the medication-dispensing pen to ensure proper dosing.

Forteo should not be used for more than 2 years by those who have bone disorders other than osteoporosis, have ever had kidney stones, bone cancer or radiation treatments involving bones, those with hyperparathyroidism, an allergy to teriparatide, and those with high blood levels of alkaline phosphatase or calcium. It may be harmful to unborn babies and it is not known if it can be passed through breast milk. Avoid alcohol and tobacco smoke while on Forteo since these substances can decrease bone density. Certain medications, such as digoxin should not be taken with Forteo.

Side effects can include allergic reactions, lightheadedness/fainting, rapid/forceful heartbeat during injection, nausea, vomiting, constipation, muscle weakness, mild dizziness, leg cramps, joint pain, headache/neck pain, and pain, swelling, itching, bruising or redness at the injection site and more.

Forteo has also been found to cause an increased risk of osteosarcomas (malignant bone tumors) in male and female rats that was dependent on dose and duration of treatment. It is not known if this risk is valid in humans. The recommended dose is 20 micrograms daily.

I have no experience with Forteo but based on the information I have, I likely would not prescribe it.

To give you related information, I am sending you a copy of my Health Report “Osteoporosis”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.