Teriparatide Dosage: The FDA Label Schedule
Teriparatide dosage exactly as the FDA label states it: 20 mcg once daily, duration limits, injection instructions and who should not use it.
The short version
Teriparatide has one approved dose: 20 mcg by subcutaneous injection once daily, from a prefilled pen, at roughly the same time each day. The label recommends against more than 2 years of lifetime use unless a patient remains at, or has returned to, high fracture risk. None of this applies to an unlabelled "research" vial, which has no FDA-reviewed dose at all.
- 20 mcg once daily, subcutaneous injection, from a prefilled pen - the only approved dose.
- No titration: the dose does not change over the course of treatment.
- The label recommends against more than 2 years of lifetime use unless fracture risk remains high.
- The label gives no missed-dose timing instructions. It says only not to take more than one injection in the same day.
Teriparatide dosage chart
The FDA-approved Teriparatide product is dosed as its label directs and a prescriber sets the dose. For vials that need mixing, this is each label dose in units on a U-100 insulin syringe, by vial size.
750 mcg vialwith 2 mL water
| Dose | Units | Volume | Doses per vial |
|---|---|---|---|
| 20 mcg | 5.5 units | 0.055 mL | 37 |
Full 750 mcg vial page: other water volumes, mixing, storage →
U-100 insulin syringe (100 units = 1 mL), to the nearest half unit. Arithmetic only. Other numbers: peptide calculator.
Teriparatide dosage has one approved number. This page states the label’s dose, duration limit and administration instructions. For what it is approved for and its full safety profile, see the teriparatide guide.
US legal status - FDA-approved · prescription only
FDA-approved as Forteo and generic teriparatide, requiring a prescriber who sets and monitors the treatment course.
AU legal status - TGA-registered · prescription only
Schedule 4 of the Poisons Standard - prescription only.
Regulators reach their own conclusions on their own timelines. Where these two disagree, the difference is the point - not an error.
Teriparatide dosage: the FDA-approved schedule
The dose is 20 mcg by subcutaneous injection once daily, from a prefilled pen, at approximately the same time each day. There is no titration. The dose does not change over the course of treatment, and no higher dose is approved for any indication.
How it’s injected
Teriparatide is injected subcutaneously into the thigh or abdominal wall, rotating the injection site. Per the label, the first several doses should be given where the patient can immediately sit or lie down if symptoms of orthostatic hypotension occur.
Duration of use
The label recommends against use for more than 2 years during a patient’s lifetime unless the patient remains at, or has returned to, high fracture risk. That is a call for the prescriber managing treatment, based on ongoing fracture risk. It is not a hard stop for everyone at 2 years.
Missed dose
The label does not give specific instructions for the timing of a missed dose. It does state not to take more than one injection in the same day, and to call a healthcare provider if more teriparatide is taken than prescribed. For what to do about a specific missed dose, contact your prescriber or pharmacist rather than guessing.
What is not established
There is no approved dose for teriparatide outside this labelled 20 mcg schedule. An unlabelled “research” vial with dosing instructions printed on a sheet has not gone through the review that produced this schedule. This page does not describe or endorse dosing such a product.
Who should not use it
The label advises against use in anyone at increased baseline osteosarcoma risk. That includes open epiphyses, metabolic bone diseases other than osteoporosis (including Paget’s disease of bone), prior skeletal radiation therapy, bone metastases or skeletal malignancies, and hereditary disorders predisposing to osteosarcoma. Its only formal contraindication is a history of severe hypersensitivity to teriparatide or any inactive ingredient. See the main guide for the osteosarcoma boxed-warning history and its 2020 removal.
When to stop and get medical care
Seek emergency care (call 911 in the US) for signs of a severe allergic reaction. Do the same for symptoms of a thyroid mass, such as a neck lump, hoarseness or difficulty swallowing. For questions about an accidental extra dose, the US National Poison Control Center is reachable at 1-800-222-1222, free and confidential, 24 hours a day.
Related
Where to get Teriparatide legally
Teriparatide is an FDA-approved prescription medicine, so the legal route is a licensed prescriber, in person or by telehealth, and a licensed pharmacy.
How telehealth prescribing works, what it costs and what to check: telehealth peptide prescribing.
Common questions
What is the usual teriparatide dose?
20 mcg once daily by subcutaneous injection, delivered from a prefilled pen, per the FDA label for Forteo and generic teriparatide. It is a single fixed dose with no titration schedule.
Is there an FDA-approved teriparatide dose?
Yes. 20 mcg once daily subcutaneously is the only approved dose, for all approved indications: osteoporosis in postmenopausal women and men at high fracture risk, and glucocorticoid-induced osteoporosis.
How long can I take teriparatide?
The label recommends against use for more than 2 years during a patient's lifetime unless the patient remains at, or has returned to, high risk of fracture. That is a decision for the prescriber managing treatment, not a fixed cutoff for everyone.
What if I miss a dose of teriparatide?
The label does not give specific missed-dose timing instructions. It does state not to take more than one injection in the same day, and to call your healthcare provider if you take more teriparatide than prescribed. For what to do about a specific missed dose, contact your prescriber or pharmacist.
Who should not use teriparatide?
The label advises against use in anyone at increased baseline osteosarcoma risk. That includes open epiphyses, metabolic bone diseases other than osteoporosis (including Paget's disease of bone), prior skeletal radiation therapy, bone metastases or skeletal malignancies, and hereditary disorders predisposing to osteosarcoma. A prescriber who knows the full medical history is the person to make this call.
References (2 sources)
Bibliographic detail is fetched from PubMed, not written by me - so a citation here cannot drift from the paper it names. Study design comes from PubMed's own tags rather than my judgement.
- 1.FORTEO (teriparatide) injection - full prescribing information, including the 20 mcg daily dose, administration instructions and duration-of-use language.- DailyMed, US National Library of Medicinelabel
- 2.National Poison Control Center - 1-800-222-1222, free and confidential.- America's Poison Centersother