Is There a Generic Substitute for Forteo? Your Guide to Teriparatide

October 10, 2025 •

3 min read

As of November 2023, a generic version of Forteo, known as teriparatide, received FDA approval in the United States, expanding treatment options for osteoporosis patients. This generic substitute for Forteo offers a more affordable alternative, though cost and insurance coverage can vary.

Quick Summary

A generic version of Forteo, called teriparatide, is available and contains the same active ingredient. While the medication is equivalent, cost and delivery devices may differ. Patients should consult their healthcare provider and insurance for details.

Key Points

Generic Substitute Available: Yes, a generic version of Forteo, known as teriparatide, is available and has been approved by the FDA since late 2023.
Therapeutically Equivalent: Generic teriparatide is considered therapeutically equivalent to brand-name Forteo, meaning it has the same active ingredient and is approved for the same uses.
Potential Cost Savings: While pricing can vary, the generic version is typically offered with lower copays by insurance plans, leading to significant savings for patients.
Different Injection Device: The delivery device (injection pen) for generic teriparatide may differ from the brand-name version, which some patients might notice.
Requires Consultation: Patients interested in switching should consult their healthcare provider and insurance company to confirm coverage and ensure a smooth transition.
Not a Biosimilar in the U.S.: In the U.S., teriparatide is classified as a generic, which is an exact copy of the active drug, unlike the biosimilar classifications seen in some other regions like Europe.

Understanding Forteo and Its Generic

Forteo is a brand-name prescription medication containing the active ingredient teriparatide, used to treat osteoporosis in individuals at high risk for bone fractures. Teriparatide is a synthetic form of parathyroid hormone (PTH) that stimulates new bone growth. Due to its complexity as an injectable medication, a generic version took time to develop.

Following the expiration of Forteo's patent, several companies, including Teva Pharmaceuticals and Ambio (marketed by Apotex), gained FDA approval for their generic teriparatide injections. These generics are considered therapeutically equivalent to Forteo, meaning they share the same active ingredient, mechanism of action, and approved uses.

The Generic vs. Biosimilar Distinction

The classification of teriparatide generics varies globally. In the U.S., Forteo is a non-biologic drug, allowing for standard generic versions. In contrast, in Europe and other regions, it is classified as a biologic, and generic versions are termed 'biosimilars'. U.S. generic teriparatide is an exact chemical copy interchangeable with Forteo, while biosimilars, though highly similar, may not always be deemed interchangeable with their reference biologic depending on local regulations.

Comparing Brand Forteo and Generic Teriparatide

Key differences between brand Forteo and generic teriparatide, beyond the name, include cost and delivery device. Both contain the identical active ingredient. While the generic is generally more affordable, especially with insurance, initial retail prices without insurance can sometimes be higher than the brand name's average price. The injection pen design also varies by manufacturer, which some users may notice.

Approved uses for Forteo and generic teriparatide include:

Treating postmenopausal women at high risk for fractures due to osteoporosis.
Increasing bone mass in men with primary or hypogonadal osteoporosis and high fracture risk.
Managing osteoporosis in men and women caused by long-term glucocorticoid use.

Switching from Forteo to Generic Teriparatide

Switching from Forteo to generic teriparatide is typically straightforward because they are therapeutically equivalent, requiring no dosage adjustments. A new prescription from your healthcare provider is needed. It's also essential to contact your insurance provider as they may prefer the generic or require prior authorization. Always follow your doctor's instructions, particularly when using a different injection device.

Comparison Table: Forteo vs. Generic Teriparatide (U.S.)


Feature	Forteo (Brand Name)	Teriparatide (Generic)
Active Ingredient	Teriparatide	Teriparatide
Equivalence	The original formulation	Considered therapeutically equivalent to Forteo by the FDA.
Manufacturer	Eli Lilly	Various (e.g., Teva Pharmaceuticals, Apotex).
Delivery Device	A specific injection pen	Manufacturer-specific injection pens, potentially feeling different to use.
Cost without Insurance	Historically very expensive (e.g., $5,125+ per month in 2025).	Retail prices can sometimes exceed brand name cost without insurance.
Insurance Coverage	Higher copays and potential restrictions (e.g., prior authorization).	Typically lower copays, often preferred by insurance plans.

Considerations and Conclusion

The availability of generic teriparatide provides a valuable, potentially more affordable option for osteoporosis patients. While the generic offers the same therapeutic benefits, cost and the injection device may vary. Patients should consult their doctor and insurance provider to determine the most suitable and cost-effective treatment plan. Effective management involves understanding both the medication and healthcare costs. For additional information, consult resources such as the Bone Health and Osteoporosis Foundation Bone Health and Osteoporosis Foundation on Teriparatide.

Potential Side Effects

Both Forteo and generic teriparatide share the same potential side effects due to the identical active ingredient. Common side effects include dizziness, nausea, and pain at the injection site. A rare but serious risk is osteosarcoma, observed in animal studies. Treatment is therefore limited to a two-year lifetime course as a precaution. Discuss potential risks thoroughly with your healthcare provider.

Frequently Asked Questions

Yes, generic teriparatide is considered just as safe and effective as brand-name Forteo because it contains the exact same active ingredient and is approved by the FDA as a therapeutic equivalent.

The cost savings of generic teriparatide depend heavily on your insurance plan. While the average retail price without insurance can vary and may even be higher, insurance plans typically cover generic medications with a lower copay, resulting in significant out-of-pocket savings for the patient.

Yes, you can switch from Forteo to generic teriparatide after speaking with your healthcare provider. The switch is generally straightforward as the medications are equivalent, but you should also check with your insurance about any coverage requirements or prior authorizations.

The main differences are typically the cost, the manufacturer, and the physical design of the injection pen used for administration. The active ingredient and therapeutic effect are the same.

Yes, the injection pens for generic teriparatide are made by different manufacturers (like Teva) and may feel or function slightly differently than the Eli Lilly Forteo pen. Your healthcare provider or pharmacist can guide you on using the new device.

In addition to seeking a generic version, you can explore financial assistance programs offered by manufacturers or third-party organizations. Using mail-order pharmacies or seeking 90-day supplies can also help reduce long-term costs.

The FDA definition for a biologic is stricter, typically involving products derived from living cells. In the U.S., teriparatide is considered a chemically synthesized drug, not meeting the biologic classification. In other regions like Europe, regulations may classify it as a biologic, which affects the terminology for its generic alternatives (biosimilars).