Abaloparatide (Tymlos)

medicine injection

Abaloparatide (Tymlos) is a liquid medicine containing a parathyroid hormone protein. While continuously high parathyroid hormone levels cause bone loss, tiny daily doses of parathyroid hormone increase bone formation and improve bone density. In clinical trials, abaloparatide reduced the chance of breaking a bone in women past menopause with low bone density. In 2017, the FDA approved abaloparatide for the treatment of osteoporosis in postmenopausal women at high risk of breaking a bone. Currently, trials are testing how well abaloparatide works for men with osteoporosis.

How to Take It

Abaloparatide comes in a pen containing four weeks of medication. Abaloparatide is injected under the skin of the stomach every day with a tiny needle. The site of your daily injection should change every day to reduce skin irritation. You should inject the medicine about the same time every day. Once the pen is used, it can remain outside of the refrigerator for the next month. Please keep unopened pens in your refrigerator, just like you would store any other protein, if not stored properly, it can cause the medication to be ineffective.

There are some things you can do to get the most benefit from taking abaloparatide. Be sure to eat enough calcium-rich foods and/or take a calcium supplement. Your total calcium intake from food and supplements should be at least 1200 mg a day. Please also take vitamin D as recommended by your provider. Avoid drinking more than 2 alcoholic drinks per day or smoking tobacco. Work on strength and balance to reduce your risk of falling and breaking a bone.

Side Effects

The most common side effect (58%) is redness of the skin where the medicine is injected. Up to 20% of people can get high blood or urine calcium levels from taking the drug. If you get high calcium levels, your provider might ask you to consume less calcium or vitamin D. Some people get high uric acid levels, but most do not get gout. Within four hours of injecting the medicine, some people have a low blood pressure or feel dizzy. If this happens, your provider might ask you to inject the medicine at bedtime or when sitting or laying down. In rats, this medication caused bone cancer (osteosarcoma). A related medication (teriparatide or Forteo) has been used since 2002, with no evidence that it increases bone cancer in humans. To be cautious, the FDA has limited use of abaloparatide to two years in a person’s life. Use of abaloparatide is not recommended for people at high risk of bone cancer.

Tell Your Rheumatology Provider

Please contact your provider if you get pregnant while taking abaloparatide, which should not be used during pregnancy. Excess thirst can indicate high calcium levels. If you have sudden redness, warmth, swelling and/or pain in a joint, you might have gout. Abaloparatide is an expensive medication and if your insurance won’t cover its cost, there are other ways to get this medication through foundations that help support the cost of the medicine.

Written June 2022 by Karen Hansen, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.

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