calcitonin (Miacalcin)

Miacalcin nasal spray is a calcitonin, indicated for the treatment of postmenopausal osteoporosis in women greater than 5 years postmenopause when alternative treatments are not suitable. Fracture reduction efficacy has not been demonstrated.

Limitations of Use:

• Due to the possible association between malignancy and calcitonin use, the need for continued therapy should be re-evaluated on a periodic basis
• Miacalcin nasal spray has not been shown to increase bone mineral density in early postmenopausal women

Is calcitonin available as a generic drug?

Yes

Do I need a prescription for calcitonin?

Yes

Side effects from calcitonin are uncommon and usually are mild. Injectable calcitonin can cause: 

• nausea 
• vomiting 
• redness of the skin at the site of injection,
• flushing, and
• skin rash.

The nasal spray can cause other side effects including: 

• 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.

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

 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.

There are no adequate studies of calcitonin in nursing mothers.

What preparations of calcitonin are available?

Injection: 200 units/ml. Intranasal spray: 200 units/activation (0.09 ml/puff)

How should I keep calcitonin stored?

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 C-30 C (59 F-86 F) for 30 days.