Calcitonin

Brand names

• Calcimar
• Caltine
• Cibacalcin
• Miacalcin Injection
• Miacalcin Nasal Spray

Usage

To treat symptomatic Paget's disease, a disorder in which bone tissue is broken down and restored too rapidly, resulting in bone fragility and in some cases malformation; to treat abnormally high blood calcium levels. Miacalcin is also indicated for treatment of postmenopausal osteoporosis in females with low bone mass.

How it works

Calcitonin blocks the bone-mineral-absorbing activity of the osteoclasts (bone cells), increases calcium excretion by the kidneys, and slows bone resorption (the speed at which bone is broken down before it is replaced).

Side effects

Serious

Skin rash or hives, difficulty breathing, swelling of tongue.

Common

Diarrhea, loss of appetite, nausea or vomiting, stomach pain, pain and redness at injection site, flushing or redness of face, ears, hands, or feet, runny nose, nasal dryness.

Less common

Increased output of urine, headache, dizziness, pressure in the chest, breathing difficulty, stuffy nose, nasal bleeding or crusting, tingling of hands or feet, weakness, back pain, joint pain, chills, metallic taste.

Possible interactions

Other medicaments:

Calcitonin taken concurrently with:

• ketoprofen may inhibit the calcium and uric acid distribution in the urine by calcitonin of pig origin. Changes with other calcitonins are not defined.
• lithium (Lithobid, others) may decrease lithium levels, blunting lithium therapeutic effects. Lithium levels should be checked more frequently, and dosing adjusted accordingly.
• plicamycin will cause additive loss of calcium.

Herbal medicines or minerals:

Soy or other plant-derived phytoestrogens may work to complement calcitonin, but have not been studied. Ipriflavone is a synthetic flavonoid currently investigational for osteoporosis (which both inhibits bone resorption by reducing osteoclast recruitment and encourages osteoblast function). Combined use with calcitonin has not been studied.
Adequate elemental calcium and vitamin D are needed. Calcium supplements are recommended while taking calcitonin. Effervescent calcium (resulting in a solution) may be absorbed more rapidly than other forms of calcium and can help prevent osteoporosis.

Heavy exercise or exertion:

As defined by your doctor. Remember, weight-bearing exercise (if your doctor says it's okay) helps fight osteoporosis by stimulating receptors (mechanoreceptors) to release factors that structure healthy (normal architecture) bone.

Discontinuation:

Your doctor should decide when to stop this medicament.