Calcitonin Salmon

DEA Class; Rx

Common Brand Names; Miacalcin

Hypersensitivity to calcitonin-salmon

• Rhinitis (12%)
• Arthralgia (4%)
• Back pain (5%)
• Expistaxis (4%)
• Injection site reactions (10%)
• Nausea (10%)
• Headache (3%)
• Flushing of face or hands (2-5%)
• Abdominal pain
• Possible allergic reactions
• Appetite decreased
• Edema of feet
• Eye pain
• Feverish sensation
• Nausea
• Nocturia
• Possible local irritative effects in the respiratory tract
• Salty taste
• Tremors

Serious hypersensitivity reactions, including fatal anaphylaxis, reported; consider skin testing prior to treatment

Hypocalcemia must be corrected before initiating therapy; also correct and treat other disorders affecting mineral metabolism (such as vitamin D deficiency); in patients at risk for hypocalcemia, provisions for parenteral calcium administration should be available during first several administrations of calcitonin salmon and serum calcium and symptoms of hypocalcemia should be monitored

Use of injection for treatment of Paget’s disease or postmenopausal osteoporosis recommended in conjunction with adequate intake of calcium and vitamin D

Overall incidence of malignancies reported to be higher in clinical trials among calcitonin-salmon-treated patients; this suggests increased risk of malignancies in calcitonin-salmon-treated patients compared to placebo-treated patients; not possible to exclude increased risk when calcitonin-salmon administered long-term subcutaneously, intramuscularly, or intravenously; benefits for individual patients should be carefully considered against possible risks

Circulating antibodies reported with treatment; consider possibility of antibody formation in any patient with an initial response to injection who later stops responding to treatment

Coarse granular casts and casts containing renal tubular epithelial cells reported in young adult volunteers at bed rest given injectable calcitonin-salmon to study effect of immobilization on osteoporosis; no other evidence of renal abnormality reported; urine sediment normalized after therapy was stopped; consider performing periodic examinations of urine sediment

Miacalcin nasal spray is not indicated for use in females of reproductive potential; there are no data with use of in pregnant women

Nasal spray is not indicated for use in females of reproductive potential; there is no information on presence in human milk