Bonsity

Brand names: Forteo, Bonsity
Drug class(es): parathyroid hormone and analogs

Medically reviewed by A Ras MD.

What is Bonsity?

Bonsity is a prescription medicine that is like a hormone made by the body called parathyroid hormone or PTH. Bonsity may help to form new bone, increase bone mineral density and bone strength. Bonsity can lessen the number of fractures of the spine and other bones in postmenopausal women with osteoporosis. The effect on fractures has not been studied in men.

Bonsity is used in both men and postmenopausal women with osteoporosis who are at high risk for having fractures. Bonsity can be used by people who have had a fracture related to osteoporosis, or who have several risk factors for fracture, or who cannot use other osteoporosis treatments.

Bonsity is used in both men and women with osteoporosis due to use of glucocorticoid medicines, such as prednisone, for several months, who are at high risk for having broken bones (fractures). These include men and women with either a history of broken bones, who have several risk factors for fracture, or who cannot use other osteoporosis treatments.

It is not known if Bonsity is safe and effective in children.

Bonsity should not be used in children and young adults whose bones are still growing.

Description

BONSITY (teriparatide injection) is a recombinant human parathyroid hormone analog (PTH 134). It has an identical sequence to the 34 N-terminal amino acids (the biologically active region) of the 84-amino acid human parathyroid hormone.

The molecular formula of teriparatide is C₁₈₁H₂₉₁N₅₅O₅₁S₂ and the molecular weight is 4117.8 daltons. Its amino acid sequence is shown below:

Teriparatide is manufactured using a strain of Pseudomonas fluorescens modified by recombinant DNA technology. BONSITY is supplied as a sterile, colorless, clear, isotonic solution in a glass cartridge which is pre-assembled into a single-patient-use delivery device (pen) for subcutaneous injection. Each pen is filled to deliver 2.48 mL. Each mL contains 250 mcg teriparatide (as a free base), 0.41 mg glacial acetic acid, 0.10 mg sodium acetate, 45.4 mg mannitol, 3 mg metacresol, and water for injection. The drug product is a pH 4.0 solution.

What is the most important information I should know about Bonsity?

Possible bone cancer. During drug testing, the medicine in Bonsity caused some rats to develop a bone cancer called osteosarcoma. In people, osteosarcoma is a serious but rare cancer. Osteosarcoma has rarely been reported in people who took Bonsity. It is not known if people who take Bonsity have a higher chance of getting osteosarcoma.
You should not take Bonsity for more than 2 years over your lifetime.

Who should not take Bonsity?

Do not use Bonsity if you are allergic to any of the ingredients in Bonsity. See the end of this Medication Guide for a complete list of the ingredients in Bonsity.

What should I tell my healthcare provider before taking Bonsity?

Before you take Bonsity, tell your healthcare provider if you:

have the condition listed in the section “Who should not use Bonsity?”
have Paget’s disease or other bone disease
have cancer in your bones
have trouble injecting yourself and do not have someone who can help you
are a child or young adult whose bones are still growing
have or have had kidney stones
have had radiation therapy
have or have had too much calcium in your blood
have any other medical conditions
are pregnant or thinking about becoming pregnant. It is not known if Bonsity will harm your unborn baby.
are breast-feeding or plan to breast-feed. You should not breast-feed while taking Bonsity.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Your healthcare provider needs this information to help keep you from taking Bonsity with other medicines that may harm you.

Especially tell your doctor if you take medicines that contain digoxin (Digoxin, Lanoxicaps, Lanoxin).

How should I take Bonsity?

Inject Bonsity one time each day in your thigh or abdomen (lower stomach area). Talk to a healthcare provider about how to rotate injection sites.
Before you try to inject Bonsity yourself, a healthcare provider should teach you how to use the Bonsity delivery device to give your injection the right way.
Read the detailed User Manual.
You can take Bonsity with or without food or drink.
The Bonsity delivery device has enough medicine for 28 days. It is set to give a 20-microgram dose of medicine each day. Do not inject all the medicine in the Bonsity delivery device at any one time.
Do not transfer the medicine from the Bonsity delivery device to a syringe. This can result in taking the wrong dose of Bonsity. If you do not have pen needles to use with your Bonsity delivery device, talk with your healthcare provider.
Bonsity should look clear and colorless. Do not use Bonsity if it has particles in it, or if it is cloudy or colored.
Inject Bonsity right away after you take the delivery device out of the refrigerator.
After each use, safely remove the needle, recap the delivery device, and put it back in the refrigerator right away.
You can take Bonsity at any time of the day. To help you remember to take Bonsity, take it at about the same time each day.
If you forget or cannot take Bonsity at your usual time, take it as soon as you can on that day. Do not take more than one injection in the same day.
If you take more Bonsity than prescribed, call your healthcare provider. If you take too much Bonsity, you may have nausea, vomiting, weakness, or dizziness.
Follow your healthcare provider’s instructions about other ways you can help your osteoporosis, such as exercise, diet, and reducing or stopping your use of tobacco and alcohol. If your healthcare provider recommends calcium and vitamin D supplements, you can take them at the same time you take Bonsity.

What are the possible side effects of Bonsity?

Bonsity can cause serious side effects, including:

See “What is the most important information I should know about Bonsity?”
Decrease in blood pressure when you change positions. Some people feel dizzy, get a fast heartbeat, or feel faint right after the first few doses. This usually happens within 4 hours of taking Bonsity and goes away within a few hours. For the first few doses, take your injections of Bonsity in a place where you can sit or lie down right away if you get these symptoms. If your symptoms get worse or do not go away, stop taking Bonsity and call your healthcare provider.
Increased calcium in your blood. Tell your healthcare provider if you have nausea, vomiting, constipation, low energy, or muscle weakness. These may be signs that there is too much calcium in your blood.

Common side effects of Bonsity include:

nausea
joint aches
pain

Your healthcare provider may take samples of blood and urine during treatment to check your response to Bonsity. Also, your healthcare provider may ask you to have follow-up tests of bone mineral density.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of Bonsity. For more information, ask your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

General information about the safe and effective use of Bonsity

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use Bonsity for a condition for which it was not prescribed. Do not give Bonsity to other people, even if they have the same condition you have.

This Medication Guide summarizes the most important information about Bonsity. If you would like more information, talk with your healthcare provider. You can ask your pharmacist or healthcare provider for information about Bonsity that is written for healthcare professionals. For more information, go to www.Bonsity.com or call Pfenex, Inc., at 1-833-266-7489.

How should I store Bonsity?

Keep your Bonsity delivery device in the refrigerator between 36°F to 46°F (2°C to 8°C).
Do not freeze the Bonsity delivery device. Do not use Bonsity if it has been frozen.
Do not use Bonsity after the expiration date printed on the delivery device and packaging.
Throw away the Bonsity delivery device after 28 days even if it has medicine in it.

Keep Bonsity and all medicines out of the reach of children.

What are the ingredients in Bonsity?

Active ingredient: teriparatide

Inactive ingredients: glacial acetic acid, sodium acetate, mannitol, metacresol, and water for injection.

SRC: NLM .

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