Calcitonin Salmon

Calcitonin Salmon is a prescription medication used to treat Hypercalcemia, Paget Disease, and Osteoporosis after menopause.  

• Calcitonin Salmon is available under the following different brand name: Miacalcin

Adult dosage

Injectable solution

• 200 IU/mL

Nasal spray

• 200 IU/actuation

Hypercalcemia

Adult dosage

• Initial dose: 4 IU/kg SC/IM every 12 hours
• May increase to 8 IU/kg SC/IM every 12 hours; may increase up to a maximum 8 IU/kg every 6 hours if unresponsive

Paget Disease

Adult dosage

• Initial dose: 100 IU SC/IM once daily
• Maintenance: 50 IU/day or 50-100 IU every 1-3 days

Osteoporosis, Postmenopausal

Adult dosage

• 100 IU SC/IM every other day with calcium and vitamin D
• Nasal Spray: 1 spray (200 IU) once daily, alternate nostrils daily

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Calcitonin Salmon include:

• bone pain, 
• flushing (warmth, redness, or tingling feeling), 
• nausea, 
• vomiting, and
• swelling at the injection site

Serious side effects of Calcitonin Salmon include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• lightheadedness, 
• muscle spasms or contractions, and
• numbness or tingling feeling (around the mouth, or in the fingers and toes)

Rare side effects of Calcitonin Salmon include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Calcitonin Salmon has severe interactions with no other drugs.
• Calcitonin Salmon has serious interactions with no other drugs.
• Calcitonin Salmon has moderate interactions with no other drugs.
• Calcitonin Salmon has minor interactions with the following drugs:
  • magnesium chloride
  • magnesium citrate
  • magnesium hydroxide
  • magnesium oxide
  • magnesium sulfate

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Hypersensitivity to calcitonin-salmon

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Calcitonin Salmon?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Calcitonin Salmon?”

Cautions

• Serious hypersensitivity reactions, including fatal anaphylaxis, reported; consider skin testing prior to treatment
• Hypocalcemia must be corrected before initiating therapy; also correct and treat other disorders affecting mineral metabolism (such as vitamin D deficiency); in patients at risk for hypocalcemia, provisions for parenteral calcium administration should be available during first several administrations of calcitonin salmon and serum calcium and symptoms of hypocalcemia should be monitored
• Use of injection for treatment of Paget’s disease or postmenopausal osteoporosis recommended in conjunction with adequate intake of calcium and vitamin D
• Overall incidence of malignancies reported to be higher in clinical trials among calcitonin-salmon-treated patients; this suggests increased risk of malignancies in calcitonin-salmon-treated patients compared to placebo-treated patients; not possible to exclude increased risk when calcitonin-salmon administered long-term subcutaneously, intramuscularly, or intravenously; benefits for individual patients should be carefully considered against possible risks
• Circulating antibodies reported with treatment; consider possibility of antibody formation in any patient with an initial response to injection who later stops responding to treatment
• Coarse granular casts and casts containing renal tubular epithelial cells reported in young adult volunteers at bed rest given injectable calcitonin-salmon to study effect of immobilization on osteoporosis; no other evidence of renal abnormality reported; urine sediment normalized after therapy was stopped; consider performing periodic examinations of urine sediment

Pregnancy and Lactation

• Miacalcin nasal spray is not indicated for use in females of reproductive potential; there are no data with use of in pregnant women; in an animal reproduction study, subcutaneous administration of calcitonin-salmon to pregnant rabbits during organogenesis at 4-18 times the recommended parenteral human dose caused a decrease in fetal birth weights; no adverse developmental outcome was observed in rat with subcutaneous administration of cal-citonin-salmon at 9 times recommended human parenteral dose based on body surface area
• Nasal spray is not indicated for use in females of reproductive potential; there is no information on presence in human milk, effects on breastfed child, or on milk production; shown to inhibit lactation in rats.