Two medicines, side by side
Denosumab vs teriparatide
Denosumab and teriparatide are both labeled for osteoporosis. Drugs@FDA records approvals of denosumab since 2010 and of teriparatide since 2002. Pharmacies paid $1,862.74 per mL (Prolia 60 mg/mL syringe) and $479.95 per mL (Teriparatide 560 mcg/2.24 mL pen) (NADAC, October 7, 2026); the strengths differ and one is a brand and one a generic, so the two prices are not like for like. In FDA's classes, denosumab is a rank ligand inhibitor and teriparatide a parathyroid hormone analog.
Check it at the source: the denosumab FDA label on DailyMed (effective June 23, 2026); the teriparatide FDA label on DailyMed (effective August 3, 2026).
Highlights of the denosumab record
Denosumab (Prolia) · label of June 23, 2026
Used for
From the label: indicationsXgeva is a RANK ligand (RANKL) inhibitor indicated for: Prevention of skeletal-related events in patients with multiple myeloma and in patients with bone metastases from solid tumors. ( 1.1 ) Treatment of adults and skeletally mature adolescents with giant cell tumor of bone that is unresectable or where surgical resection is likely to result in severe morbidity. […]
On the market
- Earliest approval on file
- June 1, 2010
- Generic labelers
- none listed
- Pharmacy cost
- $1,862.74 per mL
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Highlights of the teriparatide record
Teriparatide (Forteo) · label of August 3, 2026
Used for
From the label: indicationsFORTEO is indicated: For the treatment of postmenopausal women with osteoporosis at high risk for fracture (defined herein as having a history of osteoporotic fracture or multiple risk factors for fracture) or who have failed or are intolerant to other available osteoporosis therapy. In postmenopausal women with osteoporosis, FORTEO reduces the risk of vertebral and nonvertebral fractures. […]
On the market
- Earliest approval on file
- November 26, 2002
- Generic labelers
- 4 labelers
- Pharmacy cost
- $479.95 per mL
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Source: FDA drug labels via openFDA (Denosumab label of June 23, 2026, Teriparatide label of August 3, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do denosumab and teriparatide differ on the record?
In FDA's classes, denosumab is a rank ligand inhibitor and teriparatide a parathyroid hormone analog.
How each works, in its label's words: Denosumab, “Xgeva binds to RANKL, a transmembrane or soluble protein essential for the formation, function, and survival of osteoclasts, the cells responsible for bone resorption, thereby modulating calcium …”; Teriparatide, “Endogenous 84-amino acid parathyroid hormone (PTH) is the primary regulator of calcium and phosphate metabolism in bone and kidney.”
Generics: denosumab none approved; teriparatide since 2023 (Drugs@FDA).
| Denosumab | Teriparatide | |
|---|---|---|
| Labeled for | Osteoporosis | Osteoporosis |
| Pharmacologic class | RANK Ligand Inhibitor | Parathyroid Hormone Analog |
| How it works (label) | Xgeva binds to RANKL, a transmembrane or soluble protein essential for the formation, function, and survival of osteoclasts, the cells responsible for bone resorption, thereby modulating calcium release from bone. | Endogenous 84-amino acid parathyroid hormone (PTH) is the primary regulator of calcium and phosphate metabolism in bone and kidney. |
| Half-life (label) | The mean elimination half-life was 28 days. | n/a |
| Earliest approval on file (Drugs@FDA) | June 1, 2010 | November 26, 2002 |
| First generic approved | none | November 16, 2023 |
| Generic labelers (NDC) | none listed | 4 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $1,862.74 per mL (Prolia 60 mg/mL syringe) | $479.95 per mL (Teriparatide 560 mcg/2.24 mL pen) |
| 12-month price change | +3% | -43% |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 2 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 201,378 | 112,087 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to denosumab
- every medicine labeled for the same conditions