Parathyroid Hormone Injection

Parathyroid hormone injection may cause osteosarcoma (bone cancer) in laboratory rats. It is possible that parathyroid hormone injection may also increase the chances that humans will develop this cancer. Tell your doctor if you or a family member has or has ever had a bone disease such as Paget’s disease, bone cancer, or a cancer that has spread to the bone, and if you have or have ever had radiation therapy of the bones, high levels of alkaline phosphatase (an enzyme in the blood), or if you are a child or young adult whose bones are still growing. If you experience any of the following symptoms, call your doctor immediately: pain in any area of the body that does not go away or new or unusual lumps or swelling under the skin that are tender to touch.

Because of the risk of osteosarcoma with this medication, parathyroid hormone injection is only available through a special program called Natpara REMS. You, your doctor, and your pharmacist must be enrolled in this program before you can receive parathyroid hormone injection. All people who are prescribed parathyroid hormone injection must have a prescription from a doctor who is registered with Natpara REMS and have the prescription filled at a pharmacy that is registered with Natpara REMS in order to receive this medication. Ask your doctor for more information about this program and how you will receive your medication.

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with parathyroid hormone injection and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( or the manufacturer’s website to obtain the Medication Guide.

Talk to your doctor about the risks of receiving parathyroid hormone injection.

🔔 Why is this medication prescribed?

Parathyroid hormone injection is used along with calcium and vitamin D to treat low levels of calcium in the blood in people with certain types of hypoparathyroidism (condition in which the body does not produce enough parathyroid hormone [PTH; a natural substance needed to control the amount of calcium in the blood].) Parathyroid hormone injection should not be used to treat low levels of calcium in the blood in people whose condition can be controlled by calcium and vitamin D alone. Parathyroid hormone injection is in a class of medications called hormones. It works by causing the body to absorb more calcium into the blood.

🔔 How should this medicine be used?

Parathyroid hormone injection comes as a powder to be mixed with a liquid and injected subcutaneously (under the skin). It is usually given once a day into your thigh. Use parathyroid hormone injection at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use parathyroid hormone injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

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You can inject parathyroid hormone injection yourself or have a friend or relative perform the injections. Before you use parathyroid hormone injection yourself the first time, carefully read the manufacturer’s instructions. Ask your doctor or pharmacist to show you or the person who will be injecting the medication how to mix the medication properly and how to inject it. Be sure to ask your pharmacist or doctor if you have any questions about how to inject this medication.

Parathyroid hormone injection comes in a cartridge to be mixed in a separate mixing device and then placed in a pen injector. Do not transfer the medication from the cartridge to a syringe. After mixing, each medicine cartridge can be used for 14 doses. Throw away the cartridge 14 days after it was mixed even if it is not empty. Do not throw away the pen injector. It can be used for up to 2 years by changing the medication cartridge every 14 days.

Do not shake the medication. Do not use the medication if it has been shaken.

Always look at your parathyroid hormone injection before you inject it. It should be colorless. It is normal to see small particles in the liquid.

You should inject the medication into a different thigh each day.

Be sure you know what other supplies, such as needles, you will need to inject your medication. Ask your doctor or pharmacist what type of needles you will need to inject your medication. Never reuse needles and never share needles or pens. Always remove the needle right after you inject your dose. Throw away needles in a puncture-resistant container. Ask your doctor or pharmacist how to dispose of the puncture-resistant container.

Your doctor may start you on a low dose of parathyroid hormone injection and gradually adjust your dose depending on how your body responds to the medication. Your doctor may also change your doses of calcium and vitamin D while you are taking this medication.

Parathyroid hormone injection controls hypoparathyroidism but does not cure it. Continue to use parathyroid hormone injection even if you feel well. Do not stop using parathyroid hormone injection without talking to your doctor. If you suddenly stop using parathyroid hormone injection, you may develop severe low levels of calcium in the blood. Your doctor will probably decrease your dose gradually.