Drug reference
Parathyroid hormone is produced by recombinant DNA technology; endogenous parathyroid hormone is involved in modulating serum calcium and phosphate levels, regulating renal calcium and phosphate excretion, activating vitamin D, and maintaining normal bone turnover.
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Chronic hypoparathyroidism (specialist use only) ▶BY SUBCUTANEOUS INJECTION ▶Adult: (consult product literature)
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Bone metastases. current or previous radiation therapy to skeleton. increased risk factors for osteosarcoma (including Paget’s disease or hereditary disorders). pseudohypoparathyroidism. skeletal malignancy. unexplained raised levels of bone- specific alkaline phosphatase
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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. young adults with open epiphyses—increased risk of osteosarcoma
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Manufacturer advises confirm sufficient 25-hydroxyvitamin D stores and normal serum magnesium before treatment.
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Manufacturer advises record the brand name and batch number after each administration. l HANDLING AND STORAGE Manufacturer advises store in a refrigerator (2–8 °C); reconstituted solution may be stored for up to 14 days in a refrigerator, and up to 3 days outside of a refrigerator (below 25 °C), during the 14-day use period.
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→Appendix 1: parathyroid hormone
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▶Common or very common Abdominal pain upper. anxiety. arthralgia. asthenia. chest pain. cough. diarrhoea. drowsiness. electrolyte imbalance. headache. hypercalciuria. hypertension. insomnia. muscle complaints. nausea. pain. palpitations. sensation abnormal. tetany. thirst. urinary frequency increased. vomiting SIDE-EFFECTS, FURTHER INFORMATION Hypercalcaemia is more likely during initial dose titration; if severe hypercalcaemia develops, hydrate and consider suspending treatment (including calcium supplement and active vitamin D).
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Manufacturer advises use only if potential benefit outweighs risk—no information available.
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Manufacturer advises avoid—present in milk in animal studies.
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Manufacturer advises caution in severe impairment (no information available).
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Manufacturer advises caution in severe impairment—no information available.
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▶Manufacturer advises monitor serum calcium and assess for signs and symptoms of hypocalcaemia and hypercalcaemia—adjust active vitamin D and calcium supplement as necessary; consult product literature. ▶Manufacturer advises periodic monitoring of the response of serum calcium to treatment (response may decrease over time—if 25-hydroxyvitamin D is low, supplementation may restore serum calcium response).
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There can be variation in the licensing of different medicines containing the same drug. Powder and solvent for solution for injection ELECTROLYTES: May contain Sodium ▶Natpar (Shire Pharmaceuticals Ltd) A Parathyroid hormone 25 microgram Natpar 25micrograms/dose powder and solvent for solution for injection cartridges | 2 cartridge P £4,880.00 Parathyroid hormone 50 microgram Natpar 50micrograms/dose powder and solvent for solution for injection cartridges | 2 cartridge P £4,880.00 Parathyroid hormone 75 microgram Natpar 75micrograms/dose powder and solvent for solution for injection cartridges | 2 cartridge P £4,880.00 Parathyroid hormone 100 microgram Natpar 100micrograms/dose powder and solvent for solution for injection cartridges | 2 cartridge P £4,880.00 1.2 Low blood volume BLOOD AND RELATED PRODUCTS › PLASMA PRODUCTS
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Abrupt interruption or discontinuation can result in severe hypocalcaemia— manufacturer advises to monitor serum calcium and adjust calcium supplement and active vitamin D treatment.
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Patients may self-administer Natpar ®, after appropriate training in subcutaneous injection technique. Missed doses Manufacturer advises missed doses should be administered as soon as possible, and additional treatment with calcium and/or active vitamin D must be taken, based on symptoms of hypocalcaemia.
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(consult product literature)
First-line fragment. Read the complete Indications and Dose section above.
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