Short answer: The Forteo label has no missed-dose instruction, but its Medication Guide says not to take more than 1 injection in the same day. Forteo is 20 mcg under the skin once a day, and each pen holds 28 daily doses. The pen is thrown away 28 days after first use, even if doses were missed.
| Situation | What the label says |
|---|---|
| Schedule | 20 mcg under the skin once a day (2.1) |
| Missed-dose rule | None in the label |
| Doses per day | No more than 1 injection in the same day (Medication Guide) |
| Pen | 28 daily doses of 20 mcg; discard 28 days after first use (3, 16.2) |
| Half-life | About 1 hour (12.3) |
Not directly. We checked the prescribing information, Medication Guide and User Manual on DailyMed, and none gives a catch-up rule. The Medication Guide does say: do not take more than 1 injection in the same day. The User Manual repeats it: do not inject more than one dose of Forteo in the same day.
Each pen holds 560 mcg, intended to deliver 28 daily doses of 20 mcg (section 3). Section 16.2 says to throw away the device 28 days after first use, and the Medication Guide says to do so even if it still has medicine in it. Missed days do not extend that, so a pen may have some medicine left on day 28. The User Manual has a space to write the first-use date and the throw-away date.
Section 12.3 gives a half-life of about 1 hour after an injection under the skin. Each daily dose acts on its own. A second injection on the same day to make up is exactly what the Medication Guide rules out.
The User Manual says that if the pen has been left out of the refrigerator, do not throw it away: put it back in the refrigerator and call Eli Lilly at 1-800-545-5979. Section 16.2 says Forteo is kept refrigerated at all times except when giving a dose.
The label does not say. Section 2.3 says use for more than 2 years during a patient's lifetime should only be considered if fracture risk remains or has returned to high. Your prescriber tracks that total.
This page summarizes FDA labeling. It is not personalized medical advice; confirm what to do with your prescriber or pharmacist.