Hypoparathyroidism Overview

Get information on hypoparathyroidism and learn about what causes the condition and how it is diagnosed.

Clinical Efficacy

Find out how NATPARA was able to affect serum calcium levels as an adjunct to calcium and vitamin D in patients with hypoparathyroidism.1

Patient Start Form

To prescribe NATPARA, complete this form. Filling out the form also registers your office and your patients with OnePath®, which helps eligible patients with hypoparathyroidism who have been prescribed NATPARA gain access to treatment.


QuickStart Form

An optional QuickStart Form (during its pilot phase) can be filled out for eligible, commercially insured patients to receive two (2) cartridges of NATPARA for up to twenty-eight (28) days at no cost during the benefits verification process.

See How

Request a Demonstration of How to Reconstitute and Administer NATPARA

Please fill out the form below to request a NATPARA demonstration.

*Required field.

  1. NATPARA [package insert]. Shire-NPS Pharmaceuticals, Inc.

Important Safety Information1


In male and female rats, parathyroid hormone caused an increase in the incidence of osteosarcoma (a malignant bone tumor) that was dependent on dose and treatment duration. A risk to humans could not be excluded.

Because of the potential risk of osteosarcoma, prescribe NATPARA only to patients who cannot be well-controlled on calcium and active forms of vitamin D and for whom the potential benefits are considered to outweigh the potential risk.

Avoid use of NATPARA in patients who are at increased baseline risk for osteosarcoma (including those with Paget's disease of bone or unexplained elevations of alkaline phosphatase, pediatric and young adult patients with open epiphyses, patients with hereditary disorders predisposing to osteosarcoma or patients with a history of prior external beam or implant radiation therapy involving the skeleton).

NATPARA is available only through a restricted program called the NATPARA REMS Program.

Warnings and Precautions

Severe Hypercalcemia: Monitor serum calcium when starting or adjusting NATPARA dose and when making changes to co-administered drugs known to raise serum calcium.

Severe Hypocalcemia: Can occur with interruption or discontinuation of NATPARA treatment. Monitor serum calcium and replace calcium and vitamin D.

Digoxin Toxicity: Hypercalcemia increases the risk of digoxin toxicity. In patients using NATPARA concomitantly with digoxin, monitor serum calcium more frequently and increase monitoring when initiating or adjusting NATPARA dose.

Adverse Events

The most common adverse reactions associated with NATPARA and occurring in greater than 10% of individuals were: paresthesia, hypocalcemia, headache, hypercalcemia, nausea, hypoaesthesia, diarrhea, vomiting, arthralgia, hypercalciuria and pain in extremity.

Drug Interactions

Alendronate: Co-administration of alendronate and NATPARA leads to reduction in the calcium sparing effect, which can interfere with the normalization of serum calcium. Concomitant use of NATPARA with alendronate is not recommended.

Use in Special Populations

There are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus.

The safety and efficacy in pediatric patients have not been established.

Indications and Usage1

NATPARA is a parathyroid hormone indicated as an adjunct to calcium and vitamin D to control hypocalcemia in patients with hypoparathyroidism.

Limitations of Use:

  • Because of the potential risk of osteosarcoma, NATPARA is recommended only for patients who cannot be well-controlled on calcium supplements and active forms of vitamin D alone.

  • NATPARA was not studied in patients with hypoparathyroidism caused by calcium-sensing receptor mutations.

  • NATPARA was not studied in patients with acute post-surgical hypoparathyroidism.

Please see full Prescribing Information , including Boxed Warning for potential risk of osteosarcoma; Medication Guide ; and Instructions for Use .

Reference: 1. NATPARA [package insert]. Shire-NPS Pharmaceuticals, Inc.