Comprehensive medication guide to Tymlos including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0/month for eligible commercially insured patients using the Tymlos Savings Card; $32.50–$82.50 copay on plans covering Tymlos without savings card assistance. Tier 5 on Medicare Part D; 2026 Part D $2,100 annual OOP cap applies.
Estimated Cash Pricing
Retail list price exceeds $4,000/month; with GoodRx coupons as low as $2,577–$2,852/month for a 30-day supply. No generic available as of 2026.
Medfinder Findability Score
42/100
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Tymlos is the brand name for abaloparatide, a prescription injectable medication used to treat osteoporosis in adults at high risk of bone fracture. It is classified as a parathyroid hormone-related protein (PTHrP) analog — a synthetic version of a naturally occurring protein in the human body that regulates bone formation.
Unlike most osteoporosis medications, which work by slowing bone breakdown (antiresorptive agents), Tymlos is an anabolic agent that actively stimulates osteoblasts — the bone-building cells — to produce new bone tissue. This results in measurable increases in bone mineral density at the spine and hip, and significant reductions in both vertebral and nonvertebral fracture risk.
Tymlos was developed by Radius Health (now part of Ipsen) and first approved by the FDA in April 2017 for postmenopausal women with osteoporosis. In January 2023, the FDA expanded its indication to include men with osteoporosis at high fracture risk. It is given as an 80 mcg once-daily subcutaneous injection using a prefilled pen device, with a maximum lifetime use of 2 years.
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Tymlos (abaloparatide) is a 34-amino acid synthetic analog of human parathyroid hormone-related protein (PTHrP). It works by selectively binding to the PTH1 receptor (PTH1R) — a G protein-coupled receptor found on the surface of osteoblasts, the cells responsible for building new bone tissue. When abaloparatide binds to PTH1R, it preferentially activates the RG conformational state of the receptor, triggering a short-lived cyclic AMP (cAMP) signaling response.
This brief signal pushes the cellular response toward bone formation (anabolic) rather than bone resorption. Osteoblast activity, lifespan, and recruitment are all increased, leading to net new bone production. The drug is given as a daily injection so that blood levels rise briefly and fall quickly — this pulsatile pattern of PTH1R stimulation is essential for its anabolic effect. Continuous stimulation would promote bone breakdown instead.
Compared to teriparatide (PTH analog), abaloparatide's preference for the RG receptor state produces a shorter cAMP signal that is more anabolic and less resorptive. This is why Tymlos is associated with lower rates of hypercalcemia than teriparatide and may produce greater hip bone density gains. Abaloparatide reaches peak plasma concentration at approximately 0.51 hours after injection and has a half-life of approximately 1–1.7 hours.
80 mcg / 40 mcL — subcutaneous injection (prefilled pen)
Single dose delivered once daily into the periumbilical abdomen. Each pen contains 30 doses (3,120 mcg / 1.56 mL). Maximum lifetime use: 2 years cumulative (including teriparatide).
Tymlos is not on the FDA or ASHP drug shortage lists as of 2026. However, it is a specialty medication that is only dispensed through specialty pharmacy networks — not at standard retail pharmacies. Most patients cannot simply walk into a CVS or Walgreens and pick it up. The medication requires refrigerated storage and cold-chain shipping, and most insurance plans require prior authorization before coverage is approved.
The combination of specialty-only distribution, prior authorization requirements, insurance step therapy policies, high cost, and no available generic makes Tymlos significantly harder to access than most medications. Patients who know to work through specialty pharmacies, get their PA started proactively, and enroll in savings programs can typically fill their prescription within 1–2 weeks.
If you are struggling to find a pharmacy with Tymlos in stock, medfinder can help. medfinder calls specialty pharmacies near you to check which ones have Tymlos available and can fill your prescription — so you don't have to call pharmacy after pharmacy yourself.
Because Tymlos (abaloparatide) is not a controlled substance, it does not require a special DEA registration to prescribe. Any licensed healthcare provider with prescribing authority can write a Tymlos prescription — including physicians, nurse practitioners, and physician assistants. In practice, Tymlos is most commonly prescribed by specialists experienced in managing osteoporosis and assessing fracture risk, as it requires a current DXA scan and clinical judgment about high-risk patient candidacy.
Provider types who commonly prescribe Tymlos:
Endocrinologists — most familiar with anabolic bone agents; manage hormone-related bone disease
Rheumatologists — frequently treat osteoporosis in patients with inflammatory arthritis or chronic steroid use
Orthopedic surgeons — particularly those specializing in metabolic bone disease or fracture liaison services
Primary care physicians (PCPs) — some PCPs experienced with osteoporosis management prescribe Tymlos for established patients
Geriatricians — specialists in older adult care who frequently manage high-risk fracture patients
Nurse practitioners and physician assistants — NPs/PAs within endocrinology, rheumatology, and primary care practices regularly prescribe Tymlos
Telehealth prescribing is possible for patients who have an existing DXA scan on file for specialist review. Tymlos requires a valid prescription and is dispensed exclusively through specialty pharmacy networks — shipping is typically required rather than in-store pickup.
No. Tymlos (abaloparatide) is not a controlled substance and has no DEA schedule. It does not require a special DEA registration to prescribe, and there are no restrictions on the number of refills per prescription based on controlled substance rules.
However, Tymlos is a prescription-only medication and can only be obtained with a valid prescription from a licensed healthcare provider. It is dispensed exclusively through specialty pharmacies, which adds access steps even though there are no controlled substance requirements. Patients do not need to see a special prescriber type or use a paper prescription — any licensed provider can prescribe Tymlos electronically or by phone to a specialty pharmacy.
The following side effects were commonly reported in clinical trials and post-marketing experience:
Hypercalciuria (excess calcium in urine) — most common lab abnormality
Dizziness — especially in first few doses; often related to orthostatic hypotension
Nausea
Palpitations (fast or irregular heartbeat)
Headache
Back pain and joint pain (arthralgia)
High blood pressure (hypertension)
Injection site reactions (redness, bruising, mild pain)
Orthostatic hypotension: Blood pressure drop on standing, typically within 4 hours of injection. Sit or lie down if dizzy.
Hypercalcemia: Symptoms include nausea, vomiting, muscle weakness, excessive thirst, confusion. Contact doctor promptly.
Kidney stones (urolithiasis): Severe flank pain, blood in urine. Seek care promptly.
Anaphylaxis: Rare but serious allergic reaction. Call 911 if you experience difficulty breathing, severe rash, or facial swelling.
Osteosarcoma (theoretical risk): Seen in animals at high doses; not confirmed in human observational studies. Report new persistent localized bone pain to your doctor.
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Teriparatide (Forteo / Generic)
Closest alternative — PTH(1-34) analog with similar anabolic mechanism. FDA-approved generic available (Teva, Alvogen) at significantly lower cost (~$1,146/month with GoodRx). Slightly higher hypercalcemia rate than Tymlos. Also approved for glucocorticoid-induced osteoporosis.
Romosozumab (Evenity)
Anti-sclerostin monoclonal antibody with dual anabolic and antiresorptive mechanism. 12 months of monthly in-office injections. Boxed warning for cardiovascular events; contraindicated in patients with recent MI or stroke.
Denosumab (Prolia)
Anti-RANKL monoclonal antibody. Antiresorptive only. SC injection every 6 months. Must transition to bisphosphonate on discontinuation to prevent rebound vertebral fractures.
Bisphosphonates (Alendronate, Risedronate, Zoledronic Acid)
First-line antiresorptive therapy. Generic alendronate ~$10–$30/month. Oral weekly/monthly or annual IV infusion options. Commonly used after anabolic therapy to preserve bone density gains.
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Teriparatide (Forteo/generic)
majorConcurrent use not recommended. Both are PTH1R agonists with overlapping mechanisms. Cumulative PTH analog therapy (Tymlos + teriparatide) limited to 24 months lifetime total.
Romosozumab (Evenity)
majorConcurrent use with another anabolic agent not recommended. No clinical benefit demonstrated; use sequentially.
Bisphosphonates (alendronate, risedronate, zoledronic acid)
moderateNot recommended for concurrent use during Tymlos therapy. Initiate after completing the Tymlos course to preserve bone density gains.
Denosumab (Prolia)
moderateConcurrent use during Tymlos therapy not recommended. Use sequentially — denosumab after Tymlos to maintain bone gains.
Antihypertensives / Blood Pressure Medications
moderatePharmacodynamic interaction: Tymlos can cause orthostatic hypotension within 4 hours of injection, which may be additive with antihypertensive medications. Monitor BP and counsel patients on fall precautions.
Calcium supplements (high-dose)
minorTymlos increases calcium absorption and may increase hypercalcemia risk when combined with very high-dose calcium supplementation. Use only recommended amounts (1,000–1,200 mg/day total).
Digoxin
moderateHypercalcemia caused by Tymlos can increase digoxin sensitivity, potentially causing arrhythmias. Monitor calcium levels closely in patients taking digoxin.
Tymlos (abaloparatide) is one of the most effective bone-building medications available for patients with severe osteoporosis. Its Phase 3 ACTIVE trial demonstrated an 86% reduction in vertebral fractures and 43% reduction in nonvertebral fractures compared to placebo over 18 months — results that place it among the most impactful osteoporosis therapies in the clinical toolkit. The January 2023 FDA approval for men with osteoporosis further broadened its eligible patient population.
The primary barriers to Tymlos access are structural — specialty pharmacy distribution, cold chain requirements, mandatory prior authorization, and high list price — rather than supply issues. For most commercially insured patients, the Tymlos Savings Card can eliminate out-of-pocket cost entirely. Uninsured patients may qualify for the Radius Assist patient assistance program for up to 24 months of treatment at no cost.
If you've been prescribed Tymlos and are having trouble finding it at a pharmacy near you, medfinder can help. medfinder calls specialty pharmacies in your area to check which ones have Tymlos available and can fill your prescription — saving you hours of hold time and uncertainty.
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