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Here are important safety precautions and warnings associated with the use of Forteo (teriparatide). It is crucial to review these points and consult with your healthcare provider if you have any concerns or questions.

• Risk of Bone Cancer (Osteosarcoma): There have been reports of individuals developing osteosarcoma, a rare type of bone cancer, while using Forteo. Although the risk is uncertain, it is advised to avoid using Forteo if you have certain bone conditions or an increased risk of bone cancer. Discuss discontinuing Forteo after two years of treatment with your healthcare provider. Individuals at risk include those with rickets, Paget's disease, growing long bones, history of bone cancer, previous bone radiation therapy, or inherited bone cancer conditions.

• Elevated Blood Calcium Levels: Forteo may lead to elevated calcium levels in the blood, which can exacerbate pre-existing conditions that cause high calcium levels. Notify your healthcare provider of any medical conditions before starting Forteo. Symptoms of high calcium may include fatigue, irregular heartbeat, muscle weakness, constipation, or appetite loss. Seek medical advice if these symptoms occur.

• Kidney Stones: Some individuals have developed kidney stones while taking Forteo, potentially due to increased calcium in the blood and urine. Inform your provider if you have a history of kidney stones or elevated urinary calcium levels, as Forteo may worsen these conditions. Symptoms of kidney stones include severe back or side pain, nausea, vomiting, or unusual urine appearance or odor. Contact your provider if these symptoms arise.

• Low Blood Pressure: Forteo may cause low blood pressure upon standing, leading to dizziness or lightheadedness, especially during initial doses. These symptoms typically occur within four hours of injection. It is advisable to sit or lie down during injection and remain in that position if you feel dizzy. If symptoms persist or worsen, consult your healthcare provider.

• Interaction with Digoxin (Lanoxin): Concurrent use of Forteo and digoxin may increase the risk of digoxin toxicity due to elevated calcium levels. This can result in stomach upset, visual changes, and irregular heart rhythms. If you are using both medications and experience a change in heartbeat, contact your healthcare provider promptly.

Please ensure you discuss these potential risks and any concerns with your healthcare provider before continuing or starting treatment with Forteo (teriparatide).

Common side effects:

• Body pain
• Joint pain
• Runny nose
• Nausea
• Body weakness
• Headache
• Dizziness
• High blood pressure

Less common but important to monitor:

• Cough
• Sore throat
• Constipation
• Diarrhea
• Vomiting
• Indigestion
• Vertigo

Serious side effects:

• Elevated calcium levels in the blood
• Tiredness
• Irregular heartbeat
• Muscle weakness
• New or worsening open wound or ulcer on the skin