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Parathyroid Hormone: Uses, Dosage, and Side Effects Explained
Summary of Key Points
Parathyroid hormone is a medication used to manage various bone-related conditions, including osteoporosis, hypoparathyroidism, and bone loss. It plays a crucial role in regulating calcium levels and enhancing bone strength. This medication is typically administered via injection and is often prescribed when other treatments have not been effective. Always consult a healthcare provider, such as one of our telemedicine doctors, before starting or adjusting your dose.
Names of Medication
US Brand Name: Natpara (parathyroid hormone)
The generic name refers to the chemical name of the active ingredient in the medication. In this case, the generic name is listed in parentheses.
Pharmacologic Category
Parathyroid Hormone Analog
Calcium Regulator
Dosing Information for Parathyroid Hormone
Parathyroid hormone is prescribed for several conditions. The dosage and frequency depend on the specific condition being treated. Always consult your doctor before making any changes to your dose. Our telemedicine providers are available to assist with any questions or concerns.
Osteoporosis Treatment
Dosage: 20 mcg injected subcutaneously once daily.
Length of Treatment: Typically used for up to 2 years.
Hypoparathyroidism Treatment
Dosage: 50 mcg injected subcutaneously once daily. The dose may be adjusted based on calcium levels.
Length of Treatment: Long-term, depending on the patient’s response.
Osteogenesis Imperfecta Treatment
Dosage: 20 mcg injected subcutaneously once daily.
Length of Treatment: Typically used for up to 2 years.
Paget’s Disease Treatment
Dosage: 20 mcg injected subcutaneously once daily.
Length of Treatment: Typically used for up to 2 years.
Chronic Kidney Disease (CKD) Treatment
Dosage: 20 mcg injected subcutaneously once daily.
Length of Treatment: Typically used for up to 2 years.
Bone Fractures Treatment
Dosage: 20 mcg injected subcutaneously once daily.
Length of Treatment: Typically used for up to 2 years.
Osteomalacia Treatment
Dosage: 20 mcg injected subcutaneously once daily.
Length of Treatment: Typically used for up to 2 years.
Hypercalcemia Treatment
Dosage: 50 mcg injected subcutaneously once daily. The dose may be adjusted based on calcium levels.
Length of Treatment: Long-term, depending on the patient’s response.
Bone Loss Treatment
Dosage: 20 mcg injected subcutaneously once daily.
Length of Treatment: Typically used for up to 2 years.
Renal Osteodystrophy Treatment
Dosage: 20 mcg injected subcutaneously once daily.
Length of Treatment: Typically used for up to 2 years.
Dosage Forms and Strengths
Injection: 20 mcg/80 microliters in a prefilled pen
Injection: 50 mcg/80 microliters in a prefilled pen
Administration Instructions for Parathyroid Hormone
Parathyroid hormone is administered as a subcutaneous injection, typically in the thigh or abdomen. It is important to rotate injection sites to prevent irritation. Follow your healthcare provider’s instructions carefully. If you are unsure how to administer the injection, consult one of our telemedicine providers for guidance.
Adverse Reactions and Side Effects
Like all medications, parathyroid hormone can cause side effects. Some are more common, while others are rare. If you experience any severe reactions, contact your healthcare provider immediately.
Common Side Effects: Nausea, joint pain, dizziness, and injection site reactions (such as redness or swelling).
Less Common Side Effects: Increased calcium levels, muscle cramps, and headaches.
Rare Side Effects: Allergic reactions, such as rash or difficulty breathing, and an increased risk of bone cancer (osteosarcoma) with long-term use.
Contraindications for Parathyroid Hormone
A contraindication is a specific situation where a medication should not be used because it may be harmful to the patient. For parathyroid hormone, certain conditions or factors make its use unsafe. Below is a list of contraindications for taking parathyroid hormone, along with explanations for why it is not recommended in these situations.
Paget’s Disease of Bone: Patients with Paget’s disease have abnormal bone turnover, and using parathyroid hormone can increase the risk of bone cancer.
Unexplained High Levels of Alkaline Phosphatase: Elevated alkaline phosphatase levels may indicate underlying bone disease, and parathyroid hormone could worsen the condition.
History of Bone Cancer or Radiation Therapy: Parathyroid hormone may increase the risk of developing osteosarcoma (a type of bone cancer), especially in patients with a history of bone cancer or those who have undergone radiation therapy involving the bones.
Hypercalcemia: If you have high levels of calcium in your blood, taking parathyroid hormone can worsen this condition, leading to complications like kidney stones or heart issues.
Severe Kidney Disease: Patients with advanced kidney disease may have difficulty managing calcium and phosphorus levels, and parathyroid hormone could exacerbate these imbalances.
Drug Interactions with Parathyroid Hormone
Parathyroid hormone can interact with other medications, which may affect how well it works or increase the risk of side effects. Be sure to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with parathyroid hormone:
Digoxin (Lanoxin): Parathyroid hormone can increase calcium levels, which may enhance the effects of digoxin and raise the risk of toxicity.
Calcium Supplements: Taking calcium supplements along with parathyroid hormone can elevate calcium levels too much, leading to hypercalcemia.
Vitamin D Supplements: Like calcium supplements, Vitamin D can increase calcium absorption, which may result in dangerously high calcium levels when combined with parathyroid hormone.
Loop Diuretics (Furosemide, Lasix): These medications can affect calcium levels in the body, and combining them with parathyroid hormone may result in imbalances.
Parathyroid Hormone in Pregnancy
Is it safe to take Parathyroid hormone when pregnant?
There is limited information available regarding the safety of Parathyroid hormone use during pregnancy. While animal studies have indicated potential risks, there is not enough human research to provide a clear recommendation. If you are pregnant or planning to become pregnant, it’s crucial to have a detailed discussion with your healthcare provider about the risks and benefits of using Parathyroid hormone. Your provider will help you carefully weigh the potential risks to your baby against the benefits of treating conditions such as hyperparathyroidism or other related health issues.
Parathyroid Hormone While Breastfeeding
Is it safe to take Parathyroid hormone while breastfeeding?
Currently, there is no available data on whether Parathyroid hormone passes into breast milk. Given this uncertainty, it is recommended to exercise caution when considering Parathyroid hormone while breastfeeding. Be sure to consult your healthcare provider to determine the safest approach for both you and your baby. You can also schedule a telemedicine appointment with one of our providers for personalized guidance on managing Parathyroid hormone levels while ensuring your child’s well-being.
Estimated Cost of Parathyroid Hormone Medication
The cost of a 30-day supply of Parathyroid hormone without insurance can vary significantly. With a GoodRx coupon, the price typically ranges from $3,500 to $4,000. Prices may fluctuate depending on the pharmacy and location, so it’s a good idea to explore discounts or assistance programs that could help reduce the cost. If you are managing conditions like hyperparathyroidism or osteoporosis, it’s important to investigate all available financial options to ensure you can maintain your treatment.
Possible Alternatives to Parathyroid Hormone
There are several alternative treatments and lifestyle changes available for conditions commonly treated with Parathyroid hormone. It’s essential to discuss these options with your healthcare provider before making any changes to your treatment plan. You can also consult one of our providers through telemedicine to explore these alternatives.
- Osteoporosis: Alternatives include bisphosphonates (e.g., Alendronate, Fosamax), selective estrogen receptor modulators (SERMs), and lifestyle modifications such as weight-bearing exercises and calcium/vitamin D supplementation.
- Hypoparathyroidism: Calcium and active vitamin D supplements are commonly used to manage this condition. In some cases, recombinant human parathyroid hormone (Natpara) may be considered.
- Osteogenesis Imperfecta: Bisphosphonates and physical therapy are often recommended to strengthen bones and improve mobility.
- Paget’s Disease: Bisphosphonates and calcitonin are frequently used to slow bone turnover and alleviate symptoms.
- Chronic Kidney Disease: Managing calcium and phosphorus levels through diet, medications like phosphate binders, and vitamin D analogs may help. Dialysis may also be necessary in more advanced cases.
- Bone Fractures: In addition to Parathyroid hormone, treatments may include calcium and vitamin D supplements, physical therapy, and, in some cases, surgery.
- Osteomalacia: The primary treatments are vitamin D and calcium supplementation. Addressing underlying causes, such as malabsorption, may also be necessary.
- Hypercalcemia: Treatment options may include intravenous fluids, diuretics, and medications like bisphosphonates or calcitonin to lower calcium levels.
- Bone Loss: Lifestyle changes, such as regular exercise and a diet rich in calcium and vitamin D, along with medications like bisphosphonates or SERMs, may help slow bone loss.
- Renal Osteodystrophy: This condition is managed by controlling phosphorus and calcium levels, often through diet, phosphate binders, and vitamin D analogs.
Recent Updates on Parathyroid Hormone Research
Recent studies have focused on the long-term safety and effectiveness of Parathyroid hormone, particularly in treating osteoporosis and hypoparathyroidism. New research is exploring the potential for Parathyroid hormone to be used in combination with other osteoporosis treatments to further enhance bone density and reduce the risk of fractures. Additionally, ongoing studies are investigating the use of Parathyroid hormone in patients with chronic kidney disease to better manage bone health and calcium levels.
As research continues to evolve, staying informed about new developments is important. You can always schedule a telemedicine appointment with one of our providers to discuss the latest treatment options and how they may apply to your condition, whether it involves managing Parathyroid hormone levels, addressing hyperparathyroidism, or exploring new therapies for bone health.
