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Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-.
CASRN: 52232-67-4
Drug Levels and Effects
Summary of Use during Lactation
One infant with congenital hyperparathyroidism was breastfed during maternal use of teriparatide. The infant appeared to be protected against hypoparathyroidism by breastfeeding. Monitor breastfed infants for signs and symptoms of hypercalcemia or hypocalcemia. Monitoring of serum calcium monitoring should be considered. Because of the potential for osteosarcoma in animal studies, the manufacturer advises that breastfeeding is not recommended during treatment with teriparatide.
Drug Levels
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
A woman with autosomal dominant hypoparathyroidism type 1 (ADH1) was treated with teriparatide 28 mcg daily by continuous infusion during pregnancy. She also took vitamin D3 1000 IU daily, magnesium oxide 400 mg twice daily, and calcium carbonate 0 to 3 grams orally depending on serum calcium. The infusion was continued for 8 months postpartum in doses ranging from 27 to 30 mcg daily when calcitriol 0.5 mcg twice daily was substituted. She breastfed her infant exclusively for 6 months then with supplementation to 1 year. Her infant had no change in serum calcium when maternal calcitriol was begun. The mother began weaning at 11 months and at 1 year of age when weaning was complete, her infant developed hypocalcemia and was diagnosed with ADH1 and the same genetic mutation as her mother and other family members. Serum parathyroid hormone-related protein levels in the infant were in the mid-normal range during the first year while nursing. A single sample drawn after weaning showed her level had dropped markedly. The breastfed infant appeared to be protected from severe hypocalcemia during the first year of life by the mother’s breastmilk. Growth and development were normal at 1.5 years of age.[1]
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
References
- 1.
- Shulman D. Subcutaneous infusion of rhPTH(1-34) during pregnancy and nursing in a woman with autosomal dominant hypoparathyroidism 1. J Endocr Soc 2022;6:bvac031. [PMC free article: PMC8944315] [PubMed: 35350394]
Substance Identification
Substance Name
Teriparatide
CAS Registry Number
52232-67-4
Drug Class
Breast Feeding
Milk, Human
Parathyroid Hormone
Calcium-Regulating Hormones and Agents
Bone Density Conservation Agents
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
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- Review Parathyroid Hormone.[Drugs and Lactation Database (...]Review Parathyroid Hormone.. Drugs and Lactation Database (LactMed®). 2006
- Treatment of severe life threatening hypocalcemia with recombinant human teriparatide in patients with postoperative hypoparathyroidism - a case series.[Endokrynol Pol. 2016]Treatment of severe life threatening hypocalcemia with recombinant human teriparatide in patients with postoperative hypoparathyroidism - a case series.Andrysiak-Mamos E, Żochowska E, Kaźmierczyk-Puchalska A, Popow M, Kaczmarska-Turek D, Pachucki J, Bednarczuk T, Syrenicz A. Endokrynol Pol. 2016; 67(4):403-12. Epub 2016 Jul 8.
- Teriparatide (rhPTH 1-34) treatment in the pediatric age: long-term efficacy and safety data in a cohort with genetic hypoparathyroidism.[Endocrine. 2020]Teriparatide (rhPTH 1-34) treatment in the pediatric age: long-term efficacy and safety data in a cohort with genetic hypoparathyroidism.Tuli G, Buganza R, Tessaris D, Einaudi S, Matarazzo P, de Sanctis L. Endocrine. 2020 Feb; 67(2):457-465. Epub 2019 Nov 8.
- Successful treatment of vitamin D unresponsive hypoparathyroidism with multipulse subcutaneous infusion of teriparatide.[Eur J Endocrinol. 2008]Successful treatment of vitamin D unresponsive hypoparathyroidism with multipulse subcutaneous infusion of teriparatide.Puig-Domingo M, Díaz G, Nicolau J, Fernández C, Rueda S, Halperin I. Eur J Endocrinol. 2008 Nov; 159(5):653-7. Epub 2008 Aug 14.
- Review Drug safety evaluation of parathyroid hormone for hypocalcemia in patients with hypoparathyroidism.[Expert Opin Drug Saf. 2017]Review Drug safety evaluation of parathyroid hormone for hypocalcemia in patients with hypoparathyroidism.Marcucci G, Della Pepa G, Brandi ML. Expert Opin Drug Saf. 2017 May; 16(5):617-625. Epub 2017 Apr 3.
- Teriparatide - Drugs and Lactation Database (LactMed®)Teriparatide - Drugs and Lactation Database (LactMed®)
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