When This Medicine Should Not Be Used:
This medicine is not right for everyone. You should not receive it if you had an allergic reaction to parathyroid hormone.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin.
• A nurse or other health provider will give you this medicine.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• Use a new needle and syringe each time you inject your medicine.
• Follow your doctor's instructions about how to take vitamin D and calcium supplements while you are using this medicine.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose. Ask your doctor if you need to take extra calcium supplements if you miss a dose.
• After you mix Natpara®, store the medication cartridge in the Q-Cliq pen in the refrigerator for up to 14 days. Store away from heat and light. Do not freeze or shake. Throw away the leftover medicine and cartridge 14 days after mixing.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some foods and medicines can affect how this medicine works. Tell your doctor if you are also using digoxin or alendronate.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, bone disease (such as Paget disease of the bone), or a history of radiation treatment.
• This medicine may cause the following problems:
  
  • Higher risk of bone tumors
  • High or low blood calcium levels
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Bone pain that does not go away
• Confusion, dry mouth, muscle weakness, stomach pain, weight loss
• Muscle twitching, numbness or tingling in your fingers, toes, or around your mouth
• Painful or tender lump under the skin

If you notice these less serious side effects, talk with your doctor:

• Diarrhea, vomiting
• Mild burning or tingling in the hands or toes

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088