Does Tymlos Cause Rapid Heart Rate?
Yes, Tymlos (abaloparatide) does cause tachycardia as a documented side effect, with adverse reactions of tachycardia (including sinus tachycardia) reported in 2% of patients receiving the medication compared to 1% in placebo groups. 1
Cardiovascular Effects of Tymlos
Heart Rate Increases
Tymlos causes a dose-dependent increase in heart rate that develops within 15 minutes after injection and typically resolves within approximately 6 hours. 1
In clinical trials, the mean heart rate change from pretreatment to 1 hour post-treatment was 7.9 beats per minute (bpm) for abaloparatide, compared to 1.2 bpm for placebo. 2
Among the 13 patients receiving Tymlos who experienced tachycardia, symptoms occurred within 1 hour of administration in 5 patients. 1
In healthy volunteers, the heart rate increase resolved within 4 hours of administration. 2
Palpitations
Palpitations were reported in 5% of Tymlos-treated patients versus 0.4% in placebo groups, making this one of the most common adverse reactions leading to study drug discontinuation (1% of patients). 1
Palpitations and increased heart rate represent a somewhat higher occurrence of adverse effects with abaloparatide compared to teriparatide, contributing to treatment discontinuation. 3, 4
Blood Pressure Effects
Tymlos causes small decreases in blood pressure alongside the heart rate increases. 2
The mean change in supine systolic and diastolic blood pressure 1 hour post-treatment was -2.7/-3.6 mmHg for abaloparatide, compared to -1.5/-2.3 mmHg for placebo. 2
Orthostatic hypotension was reported in 1% of Tymlos-treated patients versus 0.5% receiving placebo. 1
The incidence of orthostatic blood pressure decline ≥20 mmHg systolic or ≥10 mmHg diastolic at 1 hour after the first injection was 4% in the Tymlos group and 3% in the placebo group. 1
Overall Cardiovascular Safety Profile
Despite the transient increases in heart rate, there was no increase in risk of serious cardiac adverse events, major adverse cardiovascular events (MACE), or heart failure with Tymlos. 2
The percentage of participants with serious cardiac adverse events was similar among all treatment groups (0.9%-1.0%). 2
In a post hoc analysis, time to first incidence of MACE plus heart failure was actually longer with abaloparatide compared to placebo (P = 0.02). 2
Clinical Implications
Common Cardiovascular Side Effects
The most frequently reported cardiovascular-related adverse reactions include:
- Palpitations: 5% (vs 0.4% placebo) 1
- Dizziness: 10% (vs 6% placebo) 1
- Tachycardia: 2% (vs 1% placebo) 1
Discontinuation Rates
Overall, 10% of Tymlos-treated patients discontinued due to adverse events compared to 6% in the placebo group. 1
The most common adverse reactions leading to discontinuation were nausea (2%), dizziness (1%), headache (1%), and palpitations (1%). 1
Patient Counseling
Patients should be informed that heart rate increases are transient, typically developing within 15 minutes and resolving within 4-6 hours after injection. 1, 2
The cardiovascular effects are generally mild and self-limiting, with no evidence of increased serious cardiac complications. 2
Patients experiencing persistent or concerning palpitations or tachycardia should be evaluated, though these symptoms do not indicate increased cardiovascular risk based on clinical trial data. 2