Teriparatide dosing — approved once-daily schedule

Teriparatide is a form of parathyroid hormone (PTH) used to build bone in osteoporosis. It is a once-daily subcutaneous injection, and the key concept is that the pattern of exposure — pulsed, not continuous — is what makes it anabolic.

The standard approved regimen is straightforward:

• 20 mcg by subcutaneous injection once daily.
• Given as a fixed-dose pre-filled pen, so the amount is metered and verified.
• Total anabolic-therapy duration is time-limited per labeling, often followed by another treatment to maintain gains.

Unlike titrated incretin drugs, there is no step-up here — the daily amount is fixed by the label.

With PTH, the same molecule can have opposite effects depending on exposure:

• Intermittent, pulsed exposure (a short daily spike) favors new bone formation — the anabolic goal.
• Continuous elevation tends to drive net bone breakdown, as seen in hyperparathyroidism.

Teriparatide's short duration of action is what produces the daily pulse its benefit relies on, which is why it is dosed once daily rather than sustained.

It is injected under the skin of the thigh or abdomen, once daily, using the pre-filled pen. Because the first doses can lower blood pressure, initial injections are often taken where the person can sit or lie down if needed. The pen is refrigerated and the metered dose removes reconstitution math.

Teriparatide affects calcium metabolism and has defined contraindications and a labeled treatment-duration limit (informed by a historical rodent osteosarcoma finding). A prescriber screens for who should not use it, monitors calcium, and manages the time-limited course and what follows. The once-daily schedule above is the map; a clinician and the approved labeling are how you use it safely.