Continuing our self-injection series, Dr. Farrell shows us how to inject Forteo (i.e., teriparatide) and Tymlos (i.e., abaloparatide).  Both these medications are used to treat osteoporosis.  Osteoporosis is a disease that causes the bones to lose their strength making them more prone to fractures.  We call these fragility fractures.  They can involve almost any bone but the hips, spine, forearm, and ribs are particularly prone.  Usually fragility fractures happen after a fall but sometimes can even happen after a bad coughing fit.  About 40% women and 13% of men sustain a fragility fracture during their lifetime.  Osteoporosis accounts for about 1.5 million fractures in the United States annually.

Treatment for osteoporosis involves building up bone density.  Weight-bearing exercise, calcium, and vitamin D supplementation are very important, but sometimes it’s not enough.  Today, we’re going to show us how you can give yourself two different osteoporosis medications: Forteo and Tymlos.  Both these medications come as auto-injector pens and both are given on a daily basis.

Preparing for your injection

• Keep your medication stored in the refrigerator until use
  • Before injecting medication, take the prefilled syringe out of the refrigerator.
  • Allow it to warm up to room temperature.
• Pick a place in your house that is clean and has room for your materials (such as the kitchen table).
• Wash your hands thoroughly with either:
  • Soap & water
  • Hand sanitizer
• Choose an area to inject – Thigh or Stomach.
  • Choose an area that is intact and clear.
  • It should not have any of the following:
    • Cuts
    • Scrapes
    • Bruises
    • Psoriasis patches
    • If you have extensive psoriasis, inject between patches
    • Moles
    • Scars
  • Please rotate area each time you inject (shown in picture below).

• Cleanse chosen area
  • Cleanse chosen area with either of the following:
    • Alcohol swab
    • Alcohol and a cotton ball
  • Use the chosen alcohol material to “swipe” area
    • Can either use a circular motion or wipe in “strips”
    • Allow the area to dry

How to inject Forteo

• Inspect the medication to make sure that it is clear (no cloudiness or crystallization)
• Remove the white cap from the autoinjector pen
• Peel off the colored paper seal from the pen needle
  • Pen needle is located inside the small plastic casing (pen needle cap)
• Push the end of the Forteo pen into the opening of the pen needle and screw on until tight, then removed pen needle cap (save for discarding)
• Take the small cap off the tip of the pen needle and discard
• Prime the pen
  • Pull the dose knob out until you see a red section below the yellow section and when you see the “0” in the dose window, turn the knob to the right until you see the number “1”
  • Push button down for 5 seconds until you see a couple drops of medication come out
  • A diamond will appear in the dose window when the device has been primed
  • Set the dose by turning the knob past “1” to “2”
• Pinch cleansed skin and insert the needle at a 90-degree angle
• Press the button and hold for 10 seconds
• Pull the needle straight out of the skin
• You may see a couple drops of the medication on your skin, but do not be concerned, your dose has been delivered

How to inject Tymlos

• Inspect the medication to make sure that it is clear (no cloudiness or crystallization)
• Take off the white cap and twist on the pen needle to the injector pen
• Take off the larger cap and prime the device by turning the knob from “0” to “80”
• Pinch the skin around the injection site and enter the skin at a 90 or 45-degree angle
  • You may release the pinched skin once the needle is in place if desired

• Press button while firmly holding the pen against the skin, you may feel a pinch as the needle enters the skin, and slight tingling while the medication is being administered
• Hold the pen in place for at least 10 seconds to ensure all the medication is administered

After the injection

• Replace the pen needle cap and turn the opposite way to unscrew the pen needle
• Properly dispose of the pen needle by discarding the pen needle inside the pen needle cap into your sharps container
  • May be provided by the drug company (depending on the medication)
  • You can purchase a sharps container at your local pharmacy
  • You may use a coffee can if you are unable to attain a sharps container
  • Disposal
    • Hospitals may take sharps
    • Pharmacies and Doctors’ offices are not allowed to take used syringes or needles

For more information regarding Forteo, please follow this link.

For more information regarding Tymlos, please follow this link.

Credits