peptide wiki

Teriparatide

aka PTH 1-34 · Parathyroid Hormone (1-34) · rhPTH(1-34) · Forteo · Bonsity

Healing & Recovery fda-approved

Mechanism

Recombinant human parathyroid hormone fragment consisting of the biologically active N-terminal 34 amino acids of endogenous PTH (PTH 1-34). It is a PTH1 receptor (PTH1R) agonist; when administered as a once-daily intermittent injection it preferentially stimulates osteoblast-mediated bone formation, increasing bone mineral density and reducing fracture risk. Teriparatide is FDA-approved (originally as Forteo, approved 2002) for osteoporosis at high fracture risk in postmenopausal women, men, and glucocorticoid-induced osteoporosis, and was the first anabolic (bone-building) osteoporosis therapy. It is one of the few peptides in this directory with full FDA marketing approval.

Studied uses

Identification

CAS number52232-67-4
Molecular formulaC181H291N55O51S2
SequenceSVSEIQLMHNLGKHLNSMERVEWLRKKLQDVHNF
Typical dose20 mcg once daily subcutaneous (approved labeling); maximum cumulative use historically limited to ~2 years
Half-life~1 hour after subcutaneous injection (serum), though the systemic exposure window is short; longer than after intravenous administration (~5 minutes)

Safety

FDA-approved. Labeling carried a boxed warning for osteosarcoma based on rat studies (the 2-year cumulative-use limit and boxed warning were removed by the FDA in 2020 after long-term human data did not show increased osteosarcoma risk). Contraindicated/cautioned in patients at increased baseline osteosarcoma risk (e.g., Paget disease, prior skeletal radiation, unexplained elevated alkaline phosphatase). Common effects include orthostatic hypotension and transient hypercalcemia. Not a WADA-prohibited substance.

Vendors selling Teriparatide

VendorSizePriceListed purityTrust
Arcane Peptides 10 mg $15.00 88
Atomik Labz 1 mg $130.00
Solution Peptides 1 mg $140.00

Research

Comparison of Structurally Related Impurity Profiles in Teriparatide From Synthetic and Recombinant DNA Origin Using Liquid Chromatography-High Resolution Mass Spectrometry
Wu P, Cheng Y, Li D, Tan H, Li J, Zhang D. · Rapid communications in mass spectrometry : RCM (2026) · cohort

Rationale Teriparatide (TPT) is a synthetic peptide primarily used in the clinical treatment of osteoporosis, with its reference materials available from both synthetic and recombinant DNA origin used for generic drug preparations.

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Influence of bisphosphonate pretreatment on bone mineral density gains and fracture outcomes with teriparatide: A systematic review and meta-analysis
Pal R, Banerjee M, Yadav U, Patra S, Bhadada SK. · Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (2026) · review

Purpose Teriparatide is a potent anabolic therapy for osteoporosis and is frequently prescribed after prior bisphosphonate (BP) treatment in routine clinical practice. Whether such pretreatment alters teriparatide efficacy, particularly with respect to fracture outcomes, remains uncertain.

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The Effect of Teriparatide in a Brown Tumor Patient With Pathological Hip Fracture: A Case Report and Literature Review
Abdel-Hadi D, Al Lawati A, Al Farkani A, Al Badaai Y, Al Farii H. · JBJS case connector (2026) · review

Case A 32-year-old man with end-stage renal disease (ESRD) from anti-neutrophil cytoplasmic antibody-associated vasculitis and tertiary hyperparathyroidism, presented with progressive right hip pain. A giant cell-rich lesion biopsy confirmed Brown tumor.

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Use of teriparatide for treatment of a 3-year-old child with an activating calcium sensing receptor mutation
Christensen S, Crossen S. · Hormone research in paediatrics (2026) · case-report

Calcium sensing receptor (CaSR) variants are a rare cause of congenital hypoparathyroidism. Current standard treatment consists of calcitriol and calcium supplements, but this regimen increases the risk of kidney complications due to hypercalciuria.

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Teriparatide for the treatment of primary hypoparathyroidism in children
Huang S, Song F. · American journal of translational research (2026) · case-report

In this retrospective case series, the clinical data of four pediatric patients with primary hypoparathyroidism (PHPT) treated with teriparatide at the Endocrinology Department of Capital Center for Children's Health, Capital Medical University, from May 2018 to May 2025, were analyzed.

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Teriparatide Plus Zoledronic Acid for Osteogenesis Imperfecta: A Randomized Clinical Trial
Hald JD, Weir CJ, Keerie C, Dewar L, MacLean M, Milne L, Keen R, Walsh JS, Poole KES, Langdahl BL, Lindsay JR, Ghouri N, Hollick R, Aspray T, Crowley RK, Cohen-Solal M, Hassan-Smit, et al. · JAMA (2026) · rct

Importance Osteogenesis imperfecta causes multiple fractures throughout life, causing substantial morbidity. Objective To determine whether the parathyroid hormone analogue teriparatide followed by zoledronic acid reduces the risk of fractures in adults with osteogenesis imperfecta.

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Efficacy and safety of abaloparatide, denosumab, teriparatide, oral bisphosphonates, and intravenous bisphosphonates in the treatment of postmenopausal osteoporosis: a systematic review and Bayesian network meta-analysis
Wang Y, Wang X, Yu G, Zhang L, Xue C, Gong W, Luo J, Lu C, Wang L. · Frontiers in endocrinology (2026) · review

Background Postmenopausal osteoporosis increases the risk of fractures, particularly in the lumbar spine, femoral neck, and total hip.

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Off-Label Use of Teriparatide for Osteotomy Healing in an Adolescent with Osteogenesis Imperfecta Type VIII: A Case Report
Günay A, Kaygusuz SB, Akgülle AH, Bavaneh MK, Helvacıoğlu D, Yavaş Abalı Z, Turan S. · Journal of clinical research in pediatric endocrinology (2026) ·

Osteogenesis imperfecta (OI) type VIII is an autosomal recessive skeletal dysplasia caused by P3H1 variants, resulting in defective collagen post-translational modification and increased bone fragility.

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Case report and medication implications: bilateral atypical femoral fractures in a patient with long-term bisphosphonate use after breast cancer surgery
Liu J, Zhu X, Liu Z, Li R. · Archives of osteoporosis (2026) · case-report

Background The incidence of atypical femoral fractures in breast cancer patients is theoretically expected to be significantly higher than in those with primary osteoporosis. This is due to the prolonged and higher dosages of bisphosphonates used for post-operative bone protection and secondary osteoporosis.

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Biological Augmentation of Reamed Intramedullary Nailing for Aseptic Tibial Shaft Nonunion: An Exploratory Multicenter Retrospective Comparative Cohort Study
Coviello M, Meccariello L, Rovere G, Caiaffa V, Rollo G, Liuzza F, Ronga M, Ippolito F, Smakaj A, Mancini ML, Colella A, Maccagnano G. · Journal of functional morphology and kinesiology (2026) ·

Background : Despite stable fixation, aseptic tibial shaft nonunion represents a severe orthopedic complication. Teriparatide and adipose-derived stem-cell augmentation have been proposed as biological supports, but comparative clinical evidence remains limited.

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Mechanisms limiting the long-term anabolic effects of teriparatide (PTH 1-34) on bone
Schmal C, Wu JY, Jafari A. · JBMR plus (2026) · review

Teriparatide, (recombinant human PTH 1-34) is an Food and Drug Administration (FDA)-approved anabolic therapy for osteoporosis.

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Pre-teriparatide anti-osteoporosis medication therapy and fracture-related hospitalization in patients at very high fracture risk
Fu SC, Lu YC, Sie NH, Hung CC, Li CY, Yang RS, Fu SH, Wang CY. · Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (2026) ·

This study evaluated whether prior anti-osteoporosis medication (AOM) use influences fracture risk in patients at very high fracture risk who subsequently initiated teriparatide. Using a nationwide cohort of 14,770 patients, participants were categorized based on prior AOM exposure.

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Efficacy of WJ-derived Mesenchymal Stem Cells in Combination With Parathyroid Hormone for Vertebral Compression Fracture
· ClinicalTrials.gov (2020) · rct

Osteoporotic vertebral compression fractures (OVCFs) are serious health problems.

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Recombinant Human rhPTH(1-34) VS Association Alfacalcidol/Hydrochlorothiazide in Severe Primary Hypoparathyroidism
· ClinicalTrials.gov (2017) · rct

Hypoparathyroidism is a rare condition in which the parathyroid glands fail to produce sufficient amount of parathyroid hormone or the parathyroid hormone produced lacks biologic activity.

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Secondary Prevention of Osteoporotic Fractures: a Multiple Center Fracture Liaison Service in Greece
· ClinicalTrials.gov (2015) · cohort

This is multiple center, prospective study aiming to investigate the tracking and outcome of patients attending Greek General hospitals with low-trauma fractures.

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A Phase I Study of AK159 in Healthy Postmenopausal Women
· ClinicalTrials.gov (2013) · rct

The objective of this study is to investigate the pharmacokinetics, safety, and tolerability of AK159 administered to healthy postmenopausal women.

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Comparison Study of PTHrP and PTH to Treat Osteoporosis
· ClinicalTrials.gov (2009) · rct

This is a three month comparison trial of standard dose parathyroid hormone (PTH) (1-34) and two different doses of Parathyroid Hormone-related Protein (PTHrP) (1-36).

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Study to Evaluate Effect of Intranasal Teriparatide on Bone Mineral Density in Postmenopausal Women With Low BMD
· ClinicalTrials.gov (2008) · rct

This study is being conducted to compare the effect of increasing nasal teriparatide dosing on percent change in Bone Mineral Density (BMD) of the lumbar spine after 24 weeks of therapy in postmenopausal women with low bone mineral density.

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Phase 3 Clinical Trial of Teriparatide in Japan
· ClinicalTrials.gov (2007) · rct

To evaluate the efficacy of teriparatide based on measurements of bone mineral density at lumbar spine

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Study of Teriparatide (FORTEO) to Treat Adults With Osteogenesis Imperfecta
· ClinicalTrials.gov (2005) · rct

The purpose of this study is to determine the effectiveness of teriparatide (FORTEO), which is human parathyroid hormone 1-34, for increasing bone mass and improving bone structure in adults affected with Osteogenesis Imperfecta (OI).

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