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 postmenopausal osteoporosis are 100 units per day injected into muscle or under the skin. Postmenopausal osteoporosis can also be treated with 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: Combining calcitonin salmon and lithium may reduce lithium concentrations due to increased loss of lithium in urine. The dose of lithium may require adjustment.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.
REFERENCE: FDA Prescribing Information
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