Abaloparatide: Osteoporosis Treatment for Bone Density Improvement

Summary of Key Points

Abaloparatide is a medication used to treat osteoporosis and other bone-related conditions by increasing bone density and reducing the risk of fractures. It is primarily prescribed for postmenopausal women who are at high risk for fractures. Abaloparatide is administered through a daily injection. Always consult your healthcare provider before starting or adjusting your dose. Our telemedicine team is available to assist with any questions you may have.

Names of Medication

US Brand Name: Tymlos (Abaloparatide)

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, “Abaloparatide” is the generic name.

Pharmacologic Category

Parathyroid hormone-related protein (PTHrP) analogs

Dosing Information for Abaloparatide

Abaloparatide is indicated for treating various bone-related conditions. Below are the recommended doses for each condition. Always consult your healthcare provider before making any changes to your dosage. Our telemedicine providers are available to guide you through your treatment plan.

Osteoporosis Treatment

Indication: Treatment of osteoporosis in postmenopausal women at high risk for fractures.

Dosage: 80 mcg injected subcutaneously once daily.

Length of Treatment: Up to 2 years.

Osteopenia (Low Bone Density)

Indication: Off-label use for osteopenia (low bone density).

Dosage: 80 mcg injected subcutaneously once daily.

Length of Treatment: Consult your doctor for the appropriate duration.

Bone Fracture Prevention

Indication: Prevention of fractures in patients with osteoporosis.

Dosage: 80 mcg injected subcutaneously once daily.

Length of Treatment: Up to 2 years.

Hypogonadism-Related Bone Loss

Indication: Off-label use for bone loss due to hypogonadism.

Dosage: 80 mcg injected subcutaneously once daily.

Length of Treatment: Consult your doctor for the appropriate duration.

Paget’s Disease of Bone

Indication: Off-label use for Paget’s disease of bone.

Dosage: 80 mcg injected subcutaneously once daily.

Length of Treatment: Consult your doctor for the appropriate duration.

Osteogenesis Imperfecta (Brittle Bone Disease)

Indication: Off-label use for osteogenesis imperfecta (brittle bone disease).

Dosage: 80 mcg injected subcutaneously once daily.

Length of Treatment: Consult your doctor for the appropriate duration.

Bone Loss Due to Chronic Kidney Disease

Indication: Off-label use for bone loss due to chronic kidney disease.

Dosage: 80 mcg injected subcutaneously once daily.

Length of Treatment: Consult your doctor for the appropriate duration.

Bone Loss Due to Malabsorption Syndromes

Indication: Off-label use for bone loss due to malabsorption syndromes.

Dosage: 80 mcg injected subcutaneously once daily.

Length of Treatment: Consult your doctor for the appropriate duration.

Hyperparathyroidism-Related Bone Loss

Indication: Off-label use for bone loss due to hyperparathyroidism.

Dosage: 80 mcg injected subcutaneously once daily.

Length of Treatment: Consult your doctor for the appropriate duration.

Bone Loss Due to Cushing’s Syndrome

Indication: Off-label use for bone loss due to Cushing’s syndrome.

Dosage: 80 mcg injected subcutaneously once daily.

Length of Treatment: Consult your doctor for the appropriate duration.

Dosage Forms and Strengths

Injection: 80 mcg/40 mcL solution in a prefilled pen for subcutaneous use.

Administration Instructions for Abaloparatide Injection

Abaloparatide is administered via subcutaneous injection, typically into the abdomen. It is important to rotate injection sites to minimize irritation. The medication comes in a prefilled pen, making it easier to administer at home. Follow your healthcare provider’s instructions on how to use the injection pen correctly. If you have any questions, our telemedicine providers are available to assist you.

Abaloparatide Side Effects and Adverse Reactions

Like all medications, Abaloparatide may cause side effects. It’s important to be aware of these and report any unusual symptoms to your healthcare provider. Below are some potential side effects:

1. Common (1-10%): Dizziness, nausea, headache, fatigue, upper abdominal pain, and injection site reactions (such as redness, swelling, or pain).
2. Less Common (0.1-1%): Elevated calcium levels in the blood (hypercalcemia), muscle cramps, and palpitations.
3. Rare (<0.1%): Severe allergic reactions, including difficulty breathing or swelling of the face, lips, or throat. Seek immediate medical attention if these occur.

Contraindications for Abaloparatide

A contraindication is a specific condition where a medication should not be used because it may be harmful. Before starting any new medication, it’s important to know if you have any conditions that make it unsafe. Below are the contraindications for Abaloparatide:

1. Hypercalcemia (high calcium levels in the blood): Abaloparatide can increase calcium levels, potentially worsening hypercalcemia and leading to complications such as kidney stones or heart problems.
2. History of bone cancer or radiation therapy involving bones: Abaloparatide stimulates bone growth, which could increase the risk of bone tumors in individuals with a history of bone cancer or radiation exposure.
3. Unexplained high levels of alkaline phosphatase: This could indicate a bone disorder, and using Abaloparatide without understanding the cause could worsen the condition.
4. Pregnancy and breastfeeding: Abaloparatide has not been extensively studied in pregnant or breastfeeding women, and its effects on the fetus or infant are unknown (more details below).

If you have any of these conditions, discuss them with your healthcare provider before starting Abaloparatide. Our telemedicine providers are available to help determine if this medication is right for you.

Drug to Drug Interactions

Some medications may interact with Abaloparatide, potentially affecting its effectiveness or increasing the risk of side effects. Below are some known interactions:

Digoxin (Lanoxin): Abaloparatide can raise calcium levels, which may intensify the effects of digoxin, a heart medication. This could lead to serious heart rhythm disturbances.

Calcium supplements: Taking calcium supplements alongside Abaloparatide may cause calcium levels to rise too high, increasing the risk of hypercalcemia.

Thiazide diuretics (Hydrochlorothiazide): These medications can also elevate calcium levels, potentially leading to an additive effect when combined with Abaloparatide, further raising the risk of hypercalcemia.

Always inform your healthcare provider about all medications and supplements you are taking before starting Abaloparatide. Our telemedicine providers can review your medication list to ensure there are no harmful interactions.

Abaloparatide in Pregnancy

Is it Safe to Take Abaloparatide During Pregnancy?

Abaloparatide is not recommended during pregnancy. There is limited data on its safety in pregnant women, and animal studies suggest it may pose risks to the fetus. If you are pregnant or planning to become pregnant, consult your healthcare provider about alternative treatments for osteoporosis or other bone conditions. Our telemedicine providers can help you explore safer options during pregnancy.

Abaloparatide While Breastfeeding

Is it Safe to Take Abaloparatide While Breastfeeding?

It is unclear whether Abaloparatide passes into breast milk or could affect a nursing infant. Due to the lack of research, it is generally advised to avoid using Abaloparatide while breastfeeding. If you are breastfeeding, consult your healthcare provider to discuss alternative treatments. Our telemedicine providers are available to help you make informed decisions about your treatment while breastfeeding.

Estimated Cost of Abaloparatide

The estimated cost of a 30-day supply of Abaloparatide (Tymlos) without insurance is approximately $1,600 to $1,800. However, using a GoodRx coupon, you may be able to reduce the cost to around $1,400. Prices may vary depending on the pharmacy and location.

Possible Alternatives to Abaloparatide

If Abaloparatide is not suitable for you, or if you are seeking alternative osteoporosis treatments, several options are available depending on your condition. Always discuss any changes to your treatment plan with your healthcare provider. Our telemedicine providers can help you explore these alternatives.

1. Osteoporosis: Other medications, such as bisphosphonates (Alendronate, Risedronate) or Denosumab (Prolia), may be effective. Lifestyle changes, including weight-bearing exercises and calcium and vitamin D supplementation, can also improve bone health.
2. Osteopenia: Similar to osteoporosis, lifestyle changes like regular exercise, a calcium- and vitamin D-rich diet, and possibly bisphosphonates may be recommended.
3. Bone fractures: Treatment may include calcium and vitamin D supplements, physical therapy, and, in some cases, medications like bisphosphonates or Teriparatide (Forteo).
4. Hypogonadism: Hormone replacement therapy (HRT) may be considered, along with lifestyle changes such as exercise and a healthy diet to support bone health.
5. Paget’s disease: Bisphosphonates are often the first-line treatment. In some cases, calcitonin may also be used.
6. Osteogenesis imperfecta: While there is no cure, bisphosphonates and physical therapy may help strengthen bones and reduce fracture risk.
7. Chronic kidney disease: Managing bone health may involve phosphate binders, vitamin D analogs, and sometimes calcimimetics. It’s crucial to work closely with a healthcare provider to manage both kidney and bone health.
8. Malabsorption syndromes: Treating the underlying cause of malabsorption is key. Supplements of calcium, vitamin D, and other nutrients may be necessary to support bone health.
9. Hyperparathyroidism: Treatment may involve surgery to remove overactive parathyroid glands or medications like calcimimetics to manage calcium levels.
10. Cushing’s syndrome: Treating the underlying cause, such as reducing corticosteroid use or surgery, can improve bone health. Calcium and vitamin D supplements may also be recommended.

Recent Updates on Abaloparatide Research

Recent studies have focused on the long-term safety and effectiveness of Abaloparatide for osteoporosis treatment. A 2021 study published in the journal Bone found that Abaloparatide significantly increased bone mineral density in postmenopausal women over 24 months, with a continued reduction in fracture risk. Additionally, ongoing research is exploring the use of Abaloparatide in combination with other osteoporosis medications to enhance bone-building effects.

While these findings are promising, it’s important to discuss the latest research with your healthcare provider to determine if Abaloparatide is the right choice for you. Our telemedicine providers are available to review your treatment options and help you make an informed decision.

James Kingsley

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