LIVOGIVA (Teriparatide)
Parathyroid hormone analogue for osteoporosis treatment – bone anabolic agent
Quick Facts About LIVOGIVA
Key Takeaways About LIVOGIVA
- Bone-building medication: Unlike most osteoporosis drugs that only slow bone loss, teriparatide actively stimulates new bone formation, making it a unique anabolic therapy
- Maximum 24 months treatment: The total lifetime treatment duration must not exceed 24 months due to safety considerations from long-term animal studies
- Daily injection required: LIVOGIVA is given as a once-daily subcutaneous injection of 20 micrograms into the thigh or abdomen
- Significant fracture reduction: Clinical trials have shown teriparatide reduces vertebral fracture risk by approximately 65% and non-vertebral fractures by approximately 53%
- Follow-up treatment important: After completing teriparatide therapy, patients should transition to an antiresorptive agent (such as a bisphosphonate) to maintain the bone gains achieved
What Is LIVOGIVA and What Is It Used For?
LIVOGIVA contains teriparatide, a biosimilar form of recombinant human parathyroid hormone fragment (PTH 1-34), used to treat osteoporosis by actively stimulating new bone formation. It is indicated for postmenopausal women and men at increased risk of fractures, and for patients with glucocorticoid-induced osteoporosis.
LIVOGIVA is a biosimilar medicine that contains the active substance teriparatide, a recombinant form of the first 34 amino acids of human parathyroid hormone (PTH). Parathyroid hormone is naturally produced by the parathyroid glands and plays a critical role in regulating calcium and phosphorus metabolism in the body. When administered intermittently as a once-daily subcutaneous injection, teriparatide has a unique anabolic (bone-building) effect on the skeleton that distinguishes it from other osteoporosis treatments.
Most medications used for osteoporosis, such as bisphosphonates and denosumab, work by inhibiting bone resorption – they slow down the breakdown of existing bone. Teriparatide takes a fundamentally different approach. By mimicking the action of endogenous parathyroid hormone in an intermittent pattern, it preferentially stimulates osteoblasts (bone-building cells) over osteoclasts (bone-resorbing cells), leading to a net increase in new bone formation on both trabecular and cortical bone surfaces.
This anabolic action results in measurable improvements in bone mineral density (BMD), enhanced bone microarchitecture including increased trabecular thickness and connectivity, and a significant reduction in the risk of both vertebral and non-vertebral fractures. The reference product for LIVOGIVA is Forsteo (known as Forteo in the United States), which was first approved in 2003 and has extensive clinical experience supporting its efficacy and safety.
The pharmacokinetic profile of teriparatide is well characterised. After subcutaneous injection of 20 micrograms, peak serum concentrations are reached within approximately 30 minutes. The absolute bioavailability is approximately 95%, and the elimination half-life is approximately 1 hour. This rapid absorption and clearance are central to the drug's mechanism of action: it is the intermittent, pulsatile exposure to PTH that produces anabolic effects on bone, whereas sustained, continuous exposure (as seen in hyperparathyroidism) results in bone resorption.
Approved Indications
LIVOGIVA is indicated for the following conditions:
- Postmenopausal osteoporosis: Treatment of osteoporosis in postmenopausal women at increased risk of fractures, particularly those who have had previous vertebral fractures or who have failed or are intolerant to other osteoporosis treatments
- Osteoporosis in men: Treatment of primary or hypogonadal osteoporosis in men at increased risk of fracture
- Glucocorticoid-induced osteoporosis: Treatment of osteoporosis associated with sustained systemic glucocorticoid therapy in women and men at increased risk of fracture, including patients currently taking corticosteroids such as prednisone
A biosimilar is a biological medicine that is highly similar to another biological medicine already approved (the reference product). LIVOGIVA has been shown through comprehensive analytical, non-clinical, and clinical studies to be highly similar to the reference product Forsteo in terms of quality, safety, and efficacy. Biosimilars undergo rigorous regulatory review by the European Medicines Agency (EMA) before they are approved for use.
What Should You Know Before Taking LIVOGIVA?
LIVOGIVA must not be used in patients with pre-existing hypercalcemia, severe renal impairment, bone metabolic diseases other than osteoporosis, unexplained elevated alkaline phosphatase, prior skeletal radiation therapy, or bone malignancies. Careful medical evaluation is essential before starting treatment.
Before prescribing LIVOGIVA, your healthcare provider will conduct a thorough evaluation of your medical history, current medications, and overall health status. Teriparatide is a potent anabolic agent and its use requires careful consideration of both the potential benefits and contraindications. Understanding the situations in which LIVOGIVA should not be used is critical for safe and effective treatment.
Contraindications
LIVOGIVA must not be used in the following situations:
- Hypersensitivity: Known allergy to teriparatide or any of the excipients in the formulation
- Pre-existing hypercalcemia: Patients with elevated blood calcium levels prior to treatment
- Severe renal impairment: Patients with severe kidney disease (estimated glomerular filtration rate below 30 mL/min)
- Metabolic bone diseases: Conditions other than primary osteoporosis, including hyperparathyroidism and Paget's disease of bone
- Unexplained elevated alkaline phosphatase: Abnormally high levels of this enzyme that have not been investigated or explained
- Prior radiation therapy: Patients who have received external beam or implant radiation therapy involving the skeleton
- Skeletal malignancies or bone metastases: Pre-existing primary bone tumours or cancer that has spread to the bones
- Open epiphyses: Children and young adults whose bones are still growing (skeletal growth plates have not closed)
- Pregnancy and breastfeeding: LIVOGIVA is contraindicated during pregnancy and lactation
Warnings and Precautions
Several important warnings and precautions apply to the use of LIVOGIVA. Your healthcare provider should be aware of these before and during treatment:
Orthostatic hypotension: Some patients may experience a transient drop in blood pressure shortly after injection, which can cause dizziness or lightheadedness. The first several injections should ideally be administered under conditions where the patient can sit or lie down if symptoms develop. This effect typically diminishes with continued treatment.
Hypercalcemia and hypercalciuria: Teriparatide can cause mild, transient increases in serum calcium levels, typically peaking 4 to 6 hours after injection and returning to baseline within 16 to 24 hours. Serum calcium levels should be monitored before and during treatment. If persistent hypercalcemia develops, it may be necessary to reduce the dose of supplemental calcium, reduce the dose of vitamin D, or discontinue teriparatide treatment.
Urolithiasis (kidney stones): Teriparatide should be used with caution in patients with active or recent urolithiasis, as the drug can increase urinary calcium excretion. Patients with a history of kidney stones should have their calcium and kidney function monitored regularly during treatment.
Treatment duration: The maximum cumulative treatment duration with teriparatide is 24 months. This restriction stems from preclinical toxicology studies in rats, where lifelong exposure to high doses of teriparatide was associated with an increased incidence of osteosarcoma (bone cancer). This finding has not been observed in humans at therapeutic doses, but the 24-month limit is maintained as a precautionary measure. The 24-month limit applies to total lifetime use and should not be repeated.
Pregnancy and Breastfeeding
LIVOGIVA must not be used during pregnancy. Animal reproduction studies with teriparatide have shown adverse effects on foetal development, and there are no adequate data from the use of teriparatide in pregnant women. Women of childbearing potential should use effective contraception during treatment. If a patient becomes pregnant while receiving LIVOGIVA, the treatment must be discontinued immediately and the patient should consult their healthcare provider.
It is not known whether teriparatide is excreted in human breast milk. LIVOGIVA should not be used during breastfeeding, as there is insufficient information on the potential effects on the nursing infant. A decision should be made whether to discontinue breastfeeding or to discontinue LIVOGIVA therapy, taking into account the importance of the treatment to the mother.
Do not exceed the recommended 24-month maximum treatment duration. The 24-month limit is a lifetime maximum for teriparatide therapy. After completing treatment, transition to an antiresorptive agent such as a bisphosphonate to maintain bone gains. Failure to initiate follow-up therapy may result in loss of the bone density improvements achieved during teriparatide treatment.
How Does LIVOGIVA Interact with Other Drugs?
LIVOGIVA has relatively few clinically significant drug interactions. However, patients taking digoxin should be monitored carefully due to the potential for teriparatide-induced hypercalcemia to increase sensitivity to digitalis toxicity. Calcium and vitamin D supplementation may need dose adjustment.
Teriparatide has a relatively favourable drug interaction profile compared to many other medications. Because it is a peptide hormone that acts through the parathyroid hormone receptor, it is not metabolised by the cytochrome P450 enzyme system and therefore has limited potential for pharmacokinetic interactions with other drugs. However, there are several interactions of clinical relevance that prescribers and patients should be aware of.
The most important interaction to consider is with cardiac glycosides such as digoxin. Teriparatide can cause transient increases in serum calcium, and hypercalcemia can increase the risk of digitalis toxicity, including potentially dangerous cardiac arrhythmias. Patients taking digoxin concomitantly with LIVOGIVA should have their serum calcium and digoxin levels monitored more frequently.
| Drug/Class | Interaction Type | Clinical Significance | Recommendation |
|---|---|---|---|
| Digoxin | Hypercalcemia may predispose to digitalis toxicity | Moderate | Monitor serum calcium and digoxin levels; watch for signs of arrhythmia |
| Calcium supplements | Additive hypercalcemic effect | Low to Moderate | Monitor serum calcium; may need to reduce calcium supplement dose |
| Vitamin D analogues | Additive hypercalcemic effect | Low to Moderate | Monitor serum calcium; adjust vitamin D dosage if needed |
| Bisphosphonates | Concurrent use may attenuate anabolic effect | Moderate | Generally avoided during teriparatide treatment; sequential use recommended |
| Antihypertensives | Additive hypotensive effect | Low | Monitor blood pressure, especially after first injections |
| Hydrochlorothiazide | No clinically significant interaction in studies | Low | No dose adjustment needed |
Important Interaction Notes
Bisphosphonates and sequential therapy: Current clinical evidence suggests that using teriparatide concurrently with bisphosphonates may reduce the anabolic benefit of teriparatide therapy. The preferred approach is sequential therapy: complete the full course of teriparatide first (up to 24 months), then transition to a bisphosphonate or other antiresorptive agent to consolidate and maintain the new bone that has been formed. This sequential approach has been shown to produce the greatest sustained improvements in bone mineral density.
Denosumab: Some clinical studies have explored combining teriparatide with denosumab (a RANKL inhibitor) and have found that this combination may produce greater BMD gains than either agent alone. However, this combination is not universally recommended and should only be considered under specialist guidance. The DATA-Switch study demonstrated that transitioning from teriparatide to denosumab maintains and continues to increase BMD gains, while the reverse sequence is less effective.
What Is the Correct Dosage of LIVOGIVA?
The recommended dose of LIVOGIVA is 20 micrograms once daily, administered as a subcutaneous injection into the thigh or abdomen. Treatment should not exceed 24 months in total. Patients should also receive adequate calcium and vitamin D supplementation during treatment.
The dosage of LIVOGIVA is standardised and does not typically require adjustment based on patient weight, age, or fracture severity. The recommended dose is 20 micrograms (mcg) administered once daily by subcutaneous injection. Each pre-filled pen contains 28 doses of 20 mcg, providing approximately one month of treatment per pen. The injection should be given at approximately the same time each day.
Adults
Standard Adult Dosage
Dose: 20 micrograms (mcg) subcutaneous injection once daily
Injection sites: Thigh or abdomen (rotate sites daily)
Duration: Maximum 24 months cumulative lifetime use
Supplementation: Adequate calcium and vitamin D should be taken concurrently if dietary intake is insufficient (typically 1,000–1,200 mg calcium and 800–1,000 IU vitamin D daily)
The pre-filled injection pen is designed for patient self-administration after initial training by a healthcare professional. Before the first injection, patients should receive thorough instruction on the correct use of the pen, including how to attach and remove needles, set the dose, choose and prepare injection sites, and safely dispose of used needles. The pen should be stored in a refrigerator between 2°C and 8°C and should not be frozen.
Children
LIVOGIVA is not indicated for use in children and adolescents under 18 years of age. Teriparatide must not be used in patients with open epiphyses (growth plates that have not yet closed). The safety and efficacy of teriparatide have not been established in the paediatric population.
Elderly
No dose adjustment is required for elderly patients. The recommended dose of 20 mcg once daily applies regardless of age. In clinical trials, teriparatide has been studied in a large number of elderly patients (including those over 75 years of age) and has shown consistent efficacy and safety across age groups. However, elderly patients may be more susceptible to orthostatic hypotension, particularly during the initial phase of treatment, and appropriate precautions should be taken.
Renal Impairment
Dosage Adjustment for Renal Impairment
Mild impairment (eGFR 60–89 mL/min): No dose adjustment required
Moderate impairment (eGFR 30–59 mL/min): Use with caution; monitor serum calcium and renal function
Severe impairment (eGFR <30 mL/min): Contraindicated – do not use
Missed Dose
If you miss a dose of LIVOGIVA, take it as soon as you remember on the same day. Do not take a double dose to make up for a missed injection. If an entire day has been missed, simply resume the normal dosing schedule the following day. Missing an occasional dose is unlikely to significantly impact the overall therapeutic benefit, but patients should aim for consistent daily administration to maximise the treatment effect.
Overdose
In the event of an overdose with LIVOGIVA, the primary concerns are hypercalcemia and orthostatic hypotension. Symptoms of overdose may include nausea, vomiting, dizziness, and headache. Treatment is supportive – serum calcium levels should be monitored and corrected if elevated. There is no specific antidote for teriparatide overdose. In clinical experience, isolated cases of accidental overdose (up to 560 mcg) have been reported without lasting adverse effects. Patients who suspect an overdose should seek medical advice and monitoring.
| Patient Group | Recommended Dose | Administration | Special Considerations |
|---|---|---|---|
| Postmenopausal women | 20 mcg once daily | SC injection (thigh or abdomen) | Max 24 months; supplement calcium & vitamin D |
| Men with osteoporosis | 20 mcg once daily | SC injection (thigh or abdomen) | Max 24 months; evaluate underlying cause |
| GC-induced osteoporosis | 20 mcg once daily | SC injection (thigh or abdomen) | Max 24 months; continue GC as needed |
| Elderly (>75 years) | 20 mcg once daily | SC injection (thigh or abdomen) | Monitor for orthostatic hypotension |
| Moderate renal impairment | 20 mcg once daily | SC injection (thigh or abdomen) | Use with caution; monitor calcium & renal function |
| Children (<18 years) | Not indicated | N/A | Contraindicated in patients with open epiphyses |
What Are the Side Effects of LIVOGIVA?
The most common side effects of LIVOGIVA include pain in the extremities, nausea, headache, and dizziness. Transient orthostatic hypotension may occur shortly after injection. Most side effects are mild to moderate and tend to diminish with continued treatment.
Like all medicines, LIVOGIVA can cause side effects, although not everybody gets them. The safety profile of teriparatide has been well characterised through extensive clinical trials involving thousands of patients and many years of post-marketing surveillance with the reference product. Most side effects are mild to moderate in severity and are manageable without treatment discontinuation.
Side effects are classified below according to their frequency of occurrence, based on data from clinical trials and post-marketing reports. Understanding the frequency and nature of potential side effects can help patients and their healthcare providers make informed treatment decisions and recognise adverse effects early if they occur.
Very Common
Affects more than 1 in 10 patients
- Pain in the extremities (limb pain, especially in the legs)
- Nausea
Common
Affects 1 to 10 in 100 patients
- Headache
- Dizziness and vertigo
- Palpitations and tachycardia
- Orthostatic hypotension (low blood pressure upon standing)
- Fatigue and asthenia (weakness)
- Depression
- Dyspnoea (shortness of breath)
- Gastroesophageal reflux and vomiting
- Arthralgia (joint pain)
- Muscle cramps and myalgia (muscle pain)
- Injection site reactions (pain, redness, swelling, bruising)
- Hypercalcemia (elevated blood calcium)
- Hypercholesterolaemia (elevated cholesterol)
- Hypercalciuria (increased urinary calcium)
- Chest pain
- Sciatica
Uncommon
Affects 1 to 10 in 1,000 patients
- Increased heart rate (sustained tachycardia)
- Cardiac murmur
- Weight increase
- Anaemia
- Haemorrhoids
- Increased sweating (hyperhidrosis)
- Urinary frequency or urgency
- Muscle weakness
Rare
Affects fewer than 1 in 1,000 patients
- Anaphylaxis (severe allergic reaction)
- Acute kidney failure or deterioration of renal function
- Severe hypercalcemia requiring hospitalisation
Orthostatic Hypotension
One of the notable side effects of teriparatide is transient orthostatic hypotension, which typically occurs within 4 hours of injection. In clinical trials, episodes of postural hypotension were reported in approximately 5% of patients. Most episodes were mild and self-limiting, resolving without intervention within minutes. Patients who experience dizziness or lightheadedness after their injection should sit or lie down until the symptoms pass. This effect usually diminishes with continued treatment and rarely requires discontinuation of therapy.
Hypercalcemia
Teriparatide causes a mild, transient rise in serum calcium that peaks approximately 4 to 6 hours after injection and returns to baseline within 16 to 24 hours. In the pivotal Fracture Prevention Trial, serum calcium levels were mildly elevated (above the upper limit of normal) at some point during treatment in approximately 11% of patients receiving teriparatide, compared to 2% in the placebo group. Persistent hypercalcemia requiring treatment discontinuation is uncommon. Serum calcium should be monitored at baseline and periodically during treatment.
Contact your healthcare provider if you experience any of the following: persistent nausea or vomiting, severe dizziness or fainting, signs of an allergic reaction (rash, swelling, difficulty breathing), muscle weakness or confusion (which may indicate high calcium levels), or any side effects that are persistent, severe, or concerning. In rare cases of severe allergic reaction, seek emergency medical attention immediately.
How Should You Store LIVOGIVA?
LIVOGIVA must be stored in a refrigerator at 2°C to 8°C. Do not freeze. After first use, the pen should be returned to the refrigerator immediately after each injection. Each pen should be discarded 28 days after first use, even if it still contains solution.
Proper storage of LIVOGIVA is essential to maintain the stability and effectiveness of the teriparatide solution. As a biological product containing a peptide hormone, LIVOGIVA is sensitive to temperature extremes and must be handled carefully throughout its shelf life.
Before first use: Store the pre-filled pen in a refrigerator at 2°C to 8°C. Keep the pen in the outer carton to protect from light. Do not freeze LIVOGIVA. If the solution has been frozen, it must be discarded and not used, as freezing may damage the peptide structure and affect the drug's efficacy and safety.
After first use (in-use storage): After the first injection, the pen should be returned to the refrigerator immediately after each use. The pen may be used for a maximum of 28 days after first use. After 28 days, any remaining solution must be discarded, even if the pen still contains unused doses. This time limit ensures the microbiological safety and chemical stability of the product during use.
General storage guidelines:
- Keep the pen cap on when not in use
- Do not store the pen with a needle attached, as this may cause air bubbles, contamination, or leakage
- Do not use the medicine if the solution is cloudy, coloured, or contains visible particles – it should be a clear and colourless solution
- Keep out of the sight and reach of children
- Do not use after the expiry date printed on the carton and pen label
- Do not throw the pen in household waste; ask your pharmacist about proper disposal in accordance with local requirements for sharps and medicinal waste
What Does LIVOGIVA Contain?
LIVOGIVA contains teriparatide (recombinant human parathyroid hormone fragment, amino acids 1-34) as the active substance. Each pre-filled pen delivers 20 micrograms per dose in a clear, colourless solution with excipients including glacial acetic acid, sodium acetate, mannitol, metacresol, and water for injections.
Active Ingredient
The active substance in LIVOGIVA is teriparatide, which is the recombinant form of the 1-34 fragment of human endogenous parathyroid hormone. Teriparatide is produced by recombinant DNA technology using Escherichia coli (E. coli) as the host organism. Each dose of 80 microlitres contains 20 micrograms of teriparatide. The pre-filled pen contains 2.4 mL of solution, providing 28 doses.
Excipients (Inactive Ingredients)
The following excipients are included in the LIVOGIVA formulation:
- Glacial acetic acid: Used as a pH-adjusting agent to maintain the optimal acidity of the solution
- Sodium acetate (trihydrate): Buffer component that helps maintain solution stability
- Mannitol: Used as a tonicity agent to ensure the solution has the appropriate osmolality for subcutaneous injection
- Metacresol: Antimicrobial preservative that maintains the sterility of the multi-dose pen during the 28-day in-use period
- Hydrochloric acid and/or sodium hydroxide: Used for pH adjustment during manufacturing
- Water for injections: Solvent for the solution
Patients with known hypersensitivity to any of these excipients should inform their healthcare provider before starting treatment. The solution should be a clear and colourless liquid. Do not use the medicine if the solution appears cloudy, discoloured, or contains particles.
Frequently Asked Questions About LIVOGIVA
LIVOGIVA (teriparatide) is used for the treatment of osteoporosis in postmenopausal women and men at increased risk of fractures. It is also indicated for glucocorticoid-induced osteoporosis. Unlike most osteoporosis drugs that only slow bone loss, LIVOGIVA is an anabolic agent that actively stimulates new bone formation, increasing bone mineral density and reducing fracture risk. It is typically reserved for patients with severe osteoporosis, those who have had previous fractures, or those who have not responded to other treatments.
The maximum cumulative treatment duration with LIVOGIVA is 24 months (2 years). This is a lifetime limit – the 24-month course of teriparatide should not be repeated. After completing treatment, patients are typically transitioned to an antiresorptive medication such as a bisphosphonate (e.g., alendronate) or denosumab to maintain and consolidate the bone gains achieved. Without follow-up antiresorptive therapy, the beneficial effects of teriparatide on bone density may gradually diminish over time.
Yes, LIVOGIVA is designed for self-administration at home. The pre-filled pen makes it straightforward to self-inject once you have received proper training from your healthcare provider or nurse. The injection is given subcutaneously (under the skin) into the thigh or abdomen. You should rotate injection sites to minimise the risk of local reactions. The first few injections may be supervised by a healthcare professional to ensure you are comfortable with the technique and to monitor for any initial side effects such as dizziness.
LIVOGIVA is a biosimilar of Forsteo (marketed as Forteo in the US). Both contain the same active substance, teriparatide, at the same strength (20 mcg per dose) and are given in the same way (daily subcutaneous injection). LIVOGIVA has undergone rigorous comparative studies demonstrating that it is highly similar to Forsteo in terms of quality, efficacy, and safety. The primary difference is the manufacturer and potentially the cost, as biosimilars are generally more affordable than the original reference product, helping to improve patient access to this important treatment.
Yes, it is generally recommended that patients taking LIVOGIVA also take adequate calcium and vitamin D supplementation, unless their dietary intake is sufficient to meet recommended levels. Typical supplementation includes 1,000–1,200 mg of elemental calcium and 800–1,000 IU of vitamin D daily. However, because teriparatide can increase serum calcium levels, your healthcare provider may adjust the supplementation dose based on your blood calcium levels during treatment. It is important to have your calcium levels monitored regularly.
The efficacy of teriparatide in reducing fractures is well established. In the landmark Fracture Prevention Trial (FPT), which studied the reference product, teriparatide reduced the risk of new vertebral fractures by 65% and non-vertebral fractures by 53% compared to placebo over a median treatment period of 19 months. Treatment also resulted in significant increases in bone mineral density at the lumbar spine (approximately 9–10%) and femoral neck (approximately 3–4%). As a biosimilar, LIVOGIVA has been demonstrated to have comparable efficacy to the reference product.
References
All medical information on this page is based on peer-reviewed clinical evidence, international guidelines, and regulatory documents. The following sources have been used:
- European Medicines Agency (EMA). LIVOGIVA – Summary of Product Characteristics. www.ema.europa.eu. Accessed January 2026.
- Neer RM, Arnaud CD, Zanchetta JR, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001;344(19):1434-1441. doi:10.1056/NEJM200105103441904
- Saag KG, Shane E, Boonen S, et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med. 2007;357(20):2028-2039. doi:10.1056/NEJMoa071408
- Camacho PM, Petak SM, Binkley N, et al. American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis – 2020 Update. Endocr Pract. 2020;26(Suppl 1):1-46.
- Kanis JA, Cooper C, Rizzoli R, Reginster JY; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2019;30(1):3-44.
- Leder BZ, Tsai JN, Uihlein AV, et al. Denosumab and teriparatide transitions in postmenopausal osteoporosis (the DATA-Switch study). Lancet. 2015;386(9999):1147-1155. doi:10.1016/S0140-6736(15)61120-5
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List (2023). www.who.int. Accessed January 2026.
- U.S. Food and Drug Administration (FDA). Forteo (teriparatide) – Prescribing Information. www.fda.gov. Accessed January 2026.
- National Institute for Health and Care Excellence (NICE). Technology Appraisal Guidance: Teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. www.nice.org.uk. Accessed January 2026.
- International Osteoporosis Foundation (IOF). Osteoporosis Treatment Guidelines. www.osteoporosis.foundation. Accessed January 2026.
About the Medical Editorial Team
This article has been written and reviewed by the iMedic Medical Editorial Team, comprising licensed specialist physicians with expertise in endocrinology, bone metabolism, and clinical pharmacology. All medical content follows the GRADE evidence framework and adheres to international guidelines from the WHO, EMA, FDA, IOF, and AACE/ACE.
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