Formulary
Palopegteriparatide: Indications, Dosing, Side Effects and Interactions
Palopegteriparatide is a prodrug of teriparatide, a shortened form of human parathyroid hormone.
MedNext Academy | 3 min read
Palopegteriparatide: Indications, Dosing, Side Effects and Interactions
Palopegteriparatide is a prodrug of teriparatide, a shortened form of human parathyroid hormone.
Drug action
Palopegteriparatide is a prodrug of teriparatide, a shortened form of human parathyroid hormone.
Indications and dose
**Chronic hypoparathyroidism (under expert supervision)**
- **Adult** (By Subcutaneous Injection): Initially 18 micrograms once daily, dose should then be adjusted according to serum-calcium concentrations in steps of 3 micrograms every 7 days to a usual range of 6-60 micrograms daily. For advice on dose adjustments, treatment interruption or discontinuation, and calcium or vitamin D supplementation-consult product literature.
Cautions
Bone metastases (no information available); concomitant use of cardiac glycosides (hypercalcaemia may predispose to digitalis toxicity)-monitor cardiac glycoside levels and check for signs and symptoms of digitalis toxicity; concomitant use of drugs that affect calcium levels; current or previous radiation therapy to skeleton (no information available); increased risk factors for osteosarcoma including Paget's disease (no information available); skeletal malignancy (no information available); unexplained raised levels of bone-specific alkaline phosphatase (no information available)
Contraindications
Pseudohypoparathyroidism
Side effects
Common or very common Arthralgia; asthenia; constipation; diarrhoea; dizziness; electrolyte imbalance; gastrointestinal discomfort; headache; muscle complaints; musculoskeletal pain; nausea; oropharyngeal pain; palpitations; paraesthesia; photosensitivity reaction; postural hypotension; postural orthostatic tachycardia syndrome; rash; syncope; thirst; vomiting Uncommon Chest discomfort; hypertension; urinary disorders
Interactions
**Other interactions (2):**
- Cardiac glycosides (such as digoxin or digitoxin) have a narrow therapeutic index and are affected by calcium.
- Other medicinal products can exert effects on serum calcium and may alter the therapeutic response to Yorvipath, including but not limited to bisphosphonates, denosumab, romosozumab, thiazide and...
Pregnancy
Avoid unless potential benefit outweighs risk (limited information available). M
Breast feeding
Avoid unless potential benefit outweighs risk (no information available). No effects on the breast-fed infant are anticipated as not orally absorbed. M
Hepatic impairment
Caution in severe impairment (no information available). M
Renal impairment
Caution in moderate impairment (limited information available) and severe impairment (no information available). If eGFR less than 45 mL/minute, monitor serum-calcium concentrations more frequently when starting treatment (increased risk of hypercalcaemic reactions and transient eGFR decrease). M
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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