Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
BRAND NAME: Miacalcin, Fortical (Calcimar brand no longer available)
DRUG CLASS: Calcitonin-salmon is a man-made version of the hormone,
calcitonin, that is found in salmon. Calcitonin is used for treating
postmenopausal (after menopause) osteoporosis (bone loss),
Paget's disease of
bone, and hypercalcemia (high blood calcium levels). In humans, calcitonin is
produced by the thyroid gland. It acts primarily on bone, but the mechanism of
its action is not well understood. Bone is in a constant state of remodeling,
whereby old bone is removed by cells called osteoclasts, and new bone is laid
down by cells called osteoblasts. Calcitonin inhibits bone removal by
osteoclasts, and promotes bone formation by osteoblasts.
After menopause, the
rate of bone loss accelerates. In women with osteoporosis, calcitonin has been
shown to increase bone density and strength.
Paget's disease is a bone disease
characterized by a disorderly and accelerated remodeling of the bone, leading to
bones that are weak and painful. Calcitonin reduces the turnover of bone and
pain in patients with Paget's disease. The FDA approved calcitonin intranasal
spray in March 1991.
STORAGE: Calcitonin should be stored in a refrigerator between 2-8 C
(36-46 F). It should be protected from freezing. Bottles of intranasal spray
that are being used may be stored at room temperature between 15-30 C (59-86 F)
for 30 days.
PRESCRIBED FOR: Injectable calcitonin is used to treat osteoporosis
and Paget's disease. Injectable calcitonin also is used to treat seriously
elevated blood calcium levels. The nasal spray is used only for osteoporosis in
women who are at least 5 years postmenopausal.
DOSING: Injectable calcitonin is injected under the skin or into the
muscle. The nasal spray is administered into the nostril. To achieve optimal
results, patients with osteoporosis should simultaneously receive adequate
amounts of calcium and vitamin D.
The recommended regimens for Paget's disease and post menopausal osteoporosis
are 100 units per day injected into muscle or under the skin or 1 spray (200
units) per day administered in alternate nostrils. Increased blood calcium
(hypercalcemia) is treated with 4-8 units/kg of injectable calcitonin every 6-12
hours
DRUG INTERACTIONS: Calcitonin is not associated with significant drug
interactions.
PREGNANCY: There are no adequate studies of calcitonin in
pregnant
women.
NURSING MOTHERS: There are no adequate studies of calcitonin in
nursing mothers.
SIDE EFFECTS: Side effects from calcitonin are uncommon and usually
are mild. Injectable calcitonin can cause nausea with or without
vomiting in 10%
of patients. Nausea can occur with initial treatment and tends to disappear with
continued use. Injectable calcitonin also can cause local redness of the skin at
the site of injection. Flushing and skin rash are also seen. The nasal spray can
cause runny nose (rhinorrhea),
nose-bleeding, bone pain and
headaches. The
nausea that can occur with injectable calcitonin is unlikely to occur with the
nasal spray. In rare instances, the nasal spray can cause an upset stomach.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Learn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.
Paget's disease is a chronic bone disorder due to irregular breakdown and formation of bone tissue. Symptoms of Paget's disease include bone pain, headaches and hearing loss, pressure on nerves, increased head size, hip pain, and damage to cartilage of joints.
Osteopenia is a bone condition characterized by bone loss that is not as severe as in osteoporosis. Bone fracture is the typical symptom of osteopenia, though the condition may be present without symptoms. Treatment involves lifestyle modifications (quitting smoking, not drinking in excess) and ensuring an adequate intake of vitamin D and calcium.
Hypercalcemia is a condition in which calcium levels in the blood are elevated. Hypercalcemia is associated with other conditions such as hyperparathyroidism, lung cancer, breast cancer, kidney failure, and elevated levels of vitamin D. Symptoms of hypercalcemia include constipation, nausea, abdominal pain, kidney stones, to name a few. Treatment depends on the cause of hypercalcemia.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
Menopause is defined as the state of an absence of menstrual periods for 12 months. The
menopausal transition starts with varying
menstrual cycle length
and ends with the final menstrual period. Perimenopause means "the time around menopause"
and is often used to refer to the menopausal transitional period. It is not officially a medical term, but is sometimes used to
explain certain aspects of the menopause transition in lay terms. Postmenopause
is the entire
period of time that comes after the last menstrual period.
Menopause is the time in a woman's life when the function of the ovaries
ceases. The ovary (female gonad), is one of a pair of reproductive glands in
women. They are located in the pelvis, one on each side of the uterus. Each
ovary is about the size and shape of an almond. The ovaries produce eggs (ova) and female
hormones such as estrogen. During each
monthly menstrual cycle, an egg is released f...
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