Salmon Calcitonin

Indications

Salmon Calcitonin is used for: Hypercalcaemia, Paget's disease of bone, Postmenopausal osteoporosis.

Adult Dose

Parenteral Hypercalcemia Initial dose: 4 IU/kg SC/IM q12hr May increase to 8 IU/kg SC/IM q12hr; may increase up to a maximum 8 IU/kg q6hr if unresponsive Paget Disease Initial dose: 100 IU SC/IM qDay Maintenance: 50 IU/day or 50-100 IU every 1-3 days Osteoporosis, Postmenopausal Indicated for the treatment of postmenopausal osteoporosis in women greater than 5 yr postmenopause 100 IU SC/IM every other day with calcium and vitamin D Nasal Spray: 1 spray (200 IU) qDay, alternate nostrils daily

Child Dose

Safety and efficacy not established

Renal Dose

Administration

Contra Indications

Hypersensitivity.

Precautions

Children <18 yr, renal impairment. Pregnancy, lactation. Serious hypersensitivity reactions, including fatal anaphylaxis, reported; consider skin testing prior to treatment. Hypocalcemia associated with tetany has been reported; ensure adequate intake of calcium and vitamin D Lactation: excretion in milk unknown/not recommended

Pregnancy-Lactation

Pregnancy Miacalcin nasal spray is not indicated for use in females of reproductive potential; there are no data with use of in pregnant women; in an animal reproduction study, subcutaneous administration of calcitonin-salmon to pregnant rabbits during organogenesis at 4- 18 times the recommended parenteral human dose caused a decrease in fetal birth weights; no adverse developmental outcome was observed in rat with subcutaneous administration of cal-citonin-salmon at 9 times recommended human parenteral dose based on body surface area Lactation Nasal spray is not indicated for use in females of reproductive potential; there is no information on presence in human milk, effects on breastfed child, or on milk production; shown to inhibit lactation in rats

Interactions

Concurrent use w/ cardiac glycosides (e.g. digitalis) or Ca-channel blockers requires dosage adjustments of these drugs. May decrease serum concentration of lithium.

Adverse Effects

Side effects of Salmon Calcitonin : >10% Rhinitis (12%) 1-10% Arthralgia (4%), Back pain (5%), Expistaxis (4%), Injection site reactions (10%), Nausea (10%), Headache (3%), Flushing of face or hands (2-5%) <1% 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 Frequency Not Defined Tremors Potentially Fatal: Anaphylactic shock.

Mechanism of Action

It inhibits osteoclastic bone resorption and reduces bone turnover. It decreases tubular reabsorption and promotes renal excretion of Ca, Cl, Na, Mg, K and phosphate.