Return to Common Drugs Index
calcitonin (human)
Cibacalcin

calcitonin (salmon)
Calcimar, Calsynar§, Miacalcin, Miacalcin Nasal Spray, Osteocalcin, Salmonine

Pregnancy Risk Category C

How supplied
calcitonin (human)

Injection:
0.5 mg/vial
calcitonin (salmon)

Injection:
100 IU/ml, 1-ml ampules; 200 IU/ml, 2-ml ampules
Nasal spray:
200 IU/activation in 2-ml bottle

Action
Decreases osteoclastic activity by inhibiting osteocytic osteolysis; decreases mineral release and matrix or collagen breakdown in bone.

Indications & dosage
Paget's disease of bone (osteitis deformans)--

Adults:
initially, 100 IU of calcitonin (salmon) daily S.C. or I.M.; maintenance dose is 50 to 100 IU daily S.C. or I.M., every other day, or three times weekly. Or, calcitonin (human) 0.5 mg daily, reduced to 0.25 mg daily. Some patients may need up to 0.5 mg b.i.d.
Hypercalcemia--

Adults:
4 IU/kg of calcitonin (salmon) q 12 hours I.M. If response inadequate after 1 or 2 days, dosage increased to 8 IU/kg I.M. q 12 hours. If response remains unsatisfactory after 2 more days, dosage increased to maximum of 8 IU/kg I.M. q 6 hours.
Postmenopausal osteoporosis--

Adults:
100 IU of calcitonin (salmon) daily I.M. or S.C. Or, 200 IU (one activation) of calcitonin (salmon) daily intranasally, alternating nostrils daily. Patients should receive adequate vitamin D and calcium supplements (1.5 g calcium carbonate and 400 U of vitamin D daily).

Adverse reactions
CNS:
headache, weakness, dizziness, paresthesia.
EENT:
eye pain, nasal congestion.
GI:
transient nausea, unusual taste, diarrhea, anorexia, vomiting, epigastric discomfort, abdominal pain.
GU:
increased urinary frequency, nocturia.
Respiratory:
chest pressure, shortness of breath.
Skin:
facial flushing, rash, pruritus of ear lobes, inflammation at injection site.
Other:
hypersensitivity reactions (anaphylaxis), edema of feet, chills, tender palms and soles.

Interactions
None significant.

Effects on diagnostic tests
In Paget's disease, maximum reductions of serum alkaline phosphatase and urinary hydroxyproline excretion may take 6 to 24 months of continuous treatment.

Contraindications
Contraindicated in patients with hypersensitivity to salmon calcitonin. Human calcitonin has no contraindications.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

Return to Common Drugs Index