Forsteo ® (teriparatide)

This information is intended for UK registered healthcare professionals only as a scientific exchange in response to your search for information. Please refer to the link for full prescribing information: Forsteo Summary of Product Characteristics (SmPC)

Forsteo® (teriparatide): The Pen does not work, perhaps it is empty?

If the pen does not work as expected, please check whether the pen is empty or blocked. Further information is provided below. If you can’t resolve the issue, please place the pen in the refrigerator and contact us.

First step: check the injection button

A very first sign is provided by the position of the injection button, see Table 11

Table 1. Position of injection button and possible conclusion1

If you check the injection button and...

...this might indicate...

...the Black injection button is completely pushed in empty pen

...the Yellow shaft is visible

...a blocked pen

How to confirm if the pen is empty?

The pen is empty, if

  • You can’t pull out the black injection button, and

  • The stopper in the cartridge has been moved forward to the needle-end of pen.

Even though there might be still some medicine left in the cartridge, all the medicine that can be injected accurately has been used. Please change to a new pen to administer the next dose.1

How to confirm if the pen is blocked?

The pen is blocked, if1

  • The injection button has not been pushed down all the way and some yellow shaft is still showing, and

  • The cartridge shows an amount of injection solution that is enough for the next injection.

How to reset a blocked pen?

When the yellow shaft is showing after the black injection button has been pushed in, Forsteo MUST be reset. To reset Forsteo, follow the steps below.1

  1. If Forsteo has already been injected, DO NOT inject a second time on the same day.

  2. Remove the needle.

  3. Attach a new needle, pull off the large needle cover and save it.

  4. Pull out the black injection button until it stops. Check to make sure the red stripe shows.

  5. Pull off the small needle protector and throw away.

  6. Point the needle down into an empty container. Push in the black injection button until it stops. Hold it in and count to 5 s-l-ow-l-y. You may see a small stream or drop of fluid. When you have finished, the black injection button should be all the way in.

  7. If you still see the yellow shaft showing, please contact us.

  8. Put the large needle cover on needle. Unscrew the needle all the way by giving the needle cover 3 to 5 complete turns. Pull off needle cover and dispose of it. Push the white cap back on, and place Forsteo in the refrigerator.

How to prevent a blocked pen?

You can prevent this problem by1

  • always using a NEW needle for each injection, and by

  • pushing the black injection button all the way in and counting to 5 s-l-o-w-l-y.

How to contact us?

Ask Lilly


1. Forsteo [user manual]. Eli Lilly Nederland B.V., The Netherlands.

Date of Last Review: October 11, 2019

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