Initiate Teriparatide SQ 20 mcg daily or Abaloparatide SQ 80 mcg daily with a maximum duration of 2 years

Unlike denosumab or romosozumab, teriparatide and Abaloparatide can be self administered

Administer as a subcutaneous injection into the thigh or abdominal wall
Implement monitoring:

• Orthostatic vital signs after first dose in office
• Serum calcium after 2-3 months and consider intermittent monitoring based on risk of hypercalcemia

Note: There may also be an increase in serum uric acid and renal stones.  Other common side effects include arthralgia, MSK pain, and nausea

Sources: Abaloparatide package insert, Teriparatide package insert