[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Parathyroid hormone (PTH) analogues](https://durgical.com/en/pharmacology/classes/parathyroid-hormone-analogues/) › Abaloparatide

# Abaloparatide

## Parathyroid hormone (PTH) analogues?

Parathyroid hormone (PTH) analogues

## Pregnancy: contraindicated?

It is not used in pregnancy or breastfeeding.

A daily injection of a PTH-related peptide analogue that builds new bone. Used in osteoporosis at high fracture risk.

Updated Nov 1, 2026

## Quick facts

**Group**
[Parathyroid hormone (PTH) analogues](https://durgical.com/en/pharmacology/classes/parathyroid-hormone-analogues/)

**Target**
Parathyroid hormone/PTHrP receptor type 1 (PTH1R)

**Used for**
Osteoporosis at high fracture risk

**Key effects**
Dizziness · Nausea · Redness

**Monitor**
Serum calcium and · Bone mineral density

**ATC**
H05AA04

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Clinical What the labels mean

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◎**Parathyroid hormone/PTHrP receptor type 1 (PTH1R)**Abaloparatide

ⓘ The figure shows abaloparatide itself bound to the human PTH1R receptor with its Gs protein (cryo-EM).

**Target in 3D:** Parathyroid hormone/PTHrP receptor type 1 (PTH1R). PDB structure 7Y35 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7Y35) · Drag to rotate · pinch to zoom

Abaloparatide is a synthetic analogue of the first 34 amino acids of PTH-related peptide (PTHrP). Given once a day, it briefly activates the PTH1 receptor on osteoblasts and their precursors, a Gs-coupled receptor that raises cAMP. These short pulses favour bone formation over resorption, so new bone is laid down and fracture risk falls. It raises serum calcium less than teriparatide.

- Abaloparatide activates PTH1R on osteoblast-lineage cells
- Brief daily cAMP pulses favour bone formation
- New bone is added to trabecular and cortical surfaces
- Bone density rises and fractures decrease

## Indications

- Osteoporosis at high fracture risk in postmenopausal women (and in men in some approvals) [Osteoporosis →](https://durgical.com/en/conditions/osteoporosis/)

## Adverse effects

### Common

- Dizziness, fast or pounding heartbeat and light-headedness on standing, usually within hours of a dose
- Nausea, upper abdominal pain, headache and tiredness
- Redness, pain or swelling at the injection site
- Higher urine calcium and serum uric acid

### Serious (rare, important)

- Hypercalcaemia
- Worsening of kidney stones
- Osteosarcoma in rats (human risk unknown)
- Allergic reactions

## Contraindications

- Higher baseline risk of osteosarcoma: Paget's disease of bone, unexplained high alkaline phosphatase, open growth plates, previous skeletal radiotherapy, bone metastases or bone cancer
- Hypercalcaemia or hyperparathyroidism
- Pregnancy and breastfeeding

## Key interactions

**Calcium and vitamin D supplements**
Often recommended alongside; reviewed if serum calcium rises

**Bisphosphonates or denosumab**
Started after the course to keep the bone gained

## What is monitored

- Serum calcium and, in people with stones, urine calcium
- Blood pressure and pulse when starting
- Bone mineral density

## Administration and safety

- Subcutaneous injection into the lower abdomen, avoiding the area around the navel, with daily site rotation
- The first doses are given where the person can sit or lie down at once
- The pen is discarded 30 days after first use; the solution should be clear and colourless
- Total treatment time is limited

## Pregnancy and breastfeeding

It is not used in pregnancy or breastfeeding.

## Nursing care

- Teach injection technique and site rotation
- Warn about dizziness or fainting after injection and advise sitting or lying down
- Teach the signs of high calcium: nausea, constipation, weakness, low energy
- Ask about back or flank pain or blood in the urine (stones)

## Pharmacokinetics

**Absorption**
Given by subcutaneous injection into the lower abdomen once a day

## Memory aid

ABALOparatide = PTHrP's ABle LOyal copy: pulses build bone, but stand up slowly.

## Test yourself

Think of the answer, then tap the question to see it.

## Which natural peptide is abaloparatide modelled on?

Parathyroid hormone-related peptide (PTHrP), its first 34 amino acids; it acts on the PTH1 receptor.

## Why does daily abaloparatide build bone while continuous PTH excess destroys it?

Brief daily pulses of PTH1R activation favour osteoblast bone formation over resorption.

## Which early adverse effect means the first doses are given while seated or lying?

Orthostatic hypotension: dizziness, palpitations or fainting soon after the injection.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/abaloparatide/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## What the labels mean

**Pregnancy: contraindicated**
It is not used in pregnancy or breastfeeding.

## Connections

## Related drugs 3

- [Teriparatide](https://durgical.com/en/pharmacology/teriparatide/)
- [Romosozumab](https://durgical.com/en/pharmacology/romosozumab/)
- [Denosumab](https://durgical.com/en/pharmacology/denosumab/)

## Related conditions 1

- [Osteoporosis](https://durgical.com/en/conditions/osteoporosis/)

[← Back to the class: Parathyroid hormone (PTH) analogues](https://durgical.com/en/pharmacology/classes/parathyroid-hormone-analogues/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Abaloparatide Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a617038.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=H05AA04) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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