Calcitonin

Calcitonin is a prescription medication used for the treatment of osteoporosis in women more than 5 years after menopause (end of monthly menstrual periods) who cannot or do not want to take estrogen products. Calcitonin is a man-made version of calcitonin, a hormone that regulates bone formation and breakdown.

Calcitonin comes in two forms, a nasal spray and an injectable form. This medication guide focuses on the nasal spray. It is usually sprayed once in alternating nostrils each day.

Common side effects of calcitonin nasal spray include runny nose, back or joint pain, and headaches.

Calcitonin is a prescription medication used for the treatment of osteoporosis in women more than 5 years after menopause (end of monthly menstrual periods) who cannot or do not want to take estrogen products. It is used along with calcium and vitamin D.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Calcitonin may be found in some form under the following brand names:

• Calcimar

• Fortical

• Miacalcin

Most patients tolerate treatment with calcitonin very well; however, like all prescription drugs, calcitonin may cause some side effects in some people. These side effects are usually mild and generally do not lead to discontinuation of treatment with calcitonin. The most commonly reported side effects are:

Nasal Spray:

• Nasal symptoms such as runny nose, crusting, or nasal bleeding
• Back/joint pain
• Headache

Anytime you have a medical problem you think may be related to calcitonin, talk to your doctor or healthcare provider.

No calcitonin interactions have been identified, however, you should tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Not all drug interactions are known or reported and new drug interactions are continually being reported.

Calcitonin should not be used by patients who are allergic to the protein calcitonin-salmon, or by women who are pregnant or nursing.

You should be aware of these warnings and precautions when taking calcitonin.

Nasal Spray:

• No formal studies designed to test drug interactions with calcitonin-salmon have been done; however, no drug interactions have been observed with the use of calcitonin. You should inform your doctor and pharmacist about the other prescription and nonprescription medications you are taking.
• In clinical studies, nasal symptoms occurred in approximately 9% of postmenopausal patients taking calcitonin. For this reason, it is recommended that a nasal examination be performed prior to the start of treatment and at any time nasal complaints occur.
• Rare instances of nasal ulceration have occurred with calcitonin. In some cases, your doctor may decide to temporarily discontinue treatment with calcitonin until symptoms subside.
• Because calcitonin-salmon is a protein, the possibility of a systemic allergic reaction exists. Patients who are allergic to calcitonin-salmon should not use calcitonin.
• Calcitonin is safe to use in elderly patients. A slight increase in nasal symptoms has been observed in patients over 65 years of age, however the symptoms are usually mild. No other unusual side effects have been seen in patients over 65 years of age.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of calcitonin there are no specific foods that you must exclude from your diet when receiving calcitonin.

Tell your healthcare provider about all of your medical conditions including if:

• you are pregnant or breastfeeding
• you are allergic to calcitonin or any other medicine
• you have low blood calcium (hypocalcemia)

Tell your healthcare provider about all of the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Calcitonin has not been studied in pregnant women and may not be safe for use during pregnancy. This medication is not approved for women who are premenopausal, including pregnant women. Tell your healthcare provider if you are pregnant or plan to become pregnant.

Calcitonin is not approved for premenopausal women, including women who are breastfeeding. It is not known if calcitonin is excreted in human breast milk or if it will harm your nursing baby.

Nasal Spray:

The recommended dose of calcitonin is one spray daily in alternated nostrils, unless directed otherwise by your healthcare provider. Start with a spray in the left nostril on your first day, followed by a spray in the right nostril on the second day. Continue to alternate nostrils every day. There are at least 30 “doses” of calcitonin in each bottle.

You should keep track of the number of doses used from the bottle.

After 30 doses, each spray may not deliver the correct amount of medication, even if the bottle is not completely empty.

When taking calcitonin, it is recommended that you get at least 1000 mg of calcium and 400 I.U. (International Units) of vitamin D each day. Check with your doctor or healthcare provider to see if you are getting enough calcium and vitamin D in your diet. If not, he or she may recommend that you start taking calcium and vitamin D supplements.

Nasal Spray

A single spray contains one daily dose, which is 200 I.U. of calcitonin-salmon. The fine mist is actually 0.09 mL (milliliter) of solution. Your bottle of calcitonin nasal spray contains at least 30 doses. Priming the pump does not alter the total number of doses available in a bottle of calcitonin nasal spray. The bottle need only be primed once after assembly. Do not re-prime or “test spray” your bottle before you use your daily dose of calcitonin nasal spray. This will waste your medication.

If you take too much calcitonin, call your local Poison Control Center or seek emergency medical attention right away. Symptoms of overdose include:

• muscle twitches
• seizures
• irregular heart rhythm

Important Facts About calcitonin nasal spray:

• The bottle contains the proper amount of medication. Be aware that the entire bottle will not be filled with liquid.
• Before opening and assembling your medication bottle, keep it in your refrigerator between 2°C-8°C (36°F-46°F). Do not freeze.
• After opening and assembling a new medication bottle, keep it at room temperature between 15°C-30°C (59°F-86°F) in an upright position.
• Do not refrigerate the unit between doses.
• Do not store the unit on its side.
• Bottles left at room temperature (opened or unopened) for more than 35 days must be discarded.
• Refrigerated bottles are good until the expiration date stamped on the bottle and box.