Compare Supplements

Approved regimen (Tymlos): 80 µg once daily by subcutaneous injection (abdomen), via a metered prefilled pen. This is a prescription drug — dose, duration and monitoring are set by a prescriber. The original 2-year cumulative-lifetime-use limit was REMOVED from the US label in 2021; duration is now an individualized clinical decision. There is no validated use outside osteoporosis fracture prevention.

Any time

Tymlos prefilled injector pen (prescription, via a clinician)

500-1000mcg daily for maintenance; higher for deficiency

Morning · with food (preferred)

Methylcobalamin (sublingual)

• Conditions with increased baseline osteosarcoma risk — Paget's disease of bone, unexplained elevated alkaline phosphatase, prior external-beam or implant skeletal radiation, open epiphyses (pediatric/young-adult), or bone metastases / skeletal malignancy
• Pre-existing hypercalcemia or conditions predisposing to hypercalcemia
• Pregnancy and breastfeeding (not for use)

• Digoxin
• Antihypertensives / drugs causing orthostatic hypotension
• Other PTH1-receptor agonists (teriparatide) and other anabolic agents

• Leber's hereditary optic neuropathy (may worsen)
• Cobalt or cobalamin hypersensitivity

• Metformin
• PPIs (proton pump inhibitors)