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Back Pain & Osteoporosis


Calcitonin — Salmon

Brand Name: Calcimar, Miacalcin
Drug Class: Hormone/bone resorption inhibitor
Available in: Injection, nasal spray
Available OTC? No
As Generic? No

Side Effects

Serious: Skin rash or hives. Call your doctor immediately.

Common: Diarrhea, loss of appetite, nausea or vomiting, stomach pain, pain and redness at injection site, flushing or redness of face, ears, hands, or feet.

Less Common: Increased output of urine, headache, dizziness, pressure in the chest, breathing difficulty, stuffy nose, nasal bleeding or crusting, tingling of hands or feet, weakness, back pain, joint pain, chills.

Principal Uses

To treat Paget’s disease, a disorder in which bone tissue is broken down and restored too rapidly, resulting in bone fragility and in some cases malformation; to prevent bone loss in women with postmenopausal osteoporosis; to treat abnormally high blood calcium levels; to treat osteoporosis resulting from hormonal disturbances, drug therapy, and immobilization; to relieve compression of nerves that may occur with Paget’s disease of bone.

How the Drug Works

Calcitonin blocks the bone-mineral-absorbing activity of the osteoclasts (bone cells), increases calcium excretion by the kidneys, and slows bone resorption (the speed at which bone is broken down before it is replaced).


Injection— For Paget’s disease: 100 international units (IU) injected under the skin once a day to start. The dosage may be reduced depending on results. To prevent postmenopausal bone loss: 100 IU injected into muscle or under the skin once a day, once every other day, or 3 times a week. For excessive blood calcium: 1.8 IU per lb of body weight injected every 12 hours to start. Dose may be increased or decreased by your doctor. Nasal spray— 200 IU (1 spray) a day delivered in alternating nostrils, 1 spray a day.

Onset of Effect

Within 15 minutes.

Duration of Action

8 to 24 hours.

Dietary Advice

If you are using this drug to lower blood calcium, your doctor may want you to follow a low-calcium diet. An injection is best administered at bedtime.


Store in a tightly sealed container away from heat and direct light.

If You Miss a Dose

If you take 2 doses a day: Take the missed dose if you remember within 2 hours. If not, skip the missed dose and resume your regular dosage schedule. If you take 1 dose a day: Take the missed dose if you remember it the same day, then resume your regular dosage schedule. If you remember the next day, skip the missed dose and resume your regular dosage schedule. If you take one dose every other day: Take the missed dose if you remember the same day. Otherwise, take the dose the next day, skip a day and resume your regular dosage schedule. If you take 1 dose 3 times a week: Take the missed dose the next day, set each dose back a day for the rest of the week, then resume your regular dosage schedule. In no cases should you double the next dose.

Stopping the Drug

The decision to stop taking the drug should be made by your doctor.

Prolonged Use

Development of antibodies to the medicine may diminish its effectiveness with prolonged use.


Over 60: Fluid balance should be monitored if the drug is given to reduce blood levels of calcium.

Driving and Hazardous Work: The use of calcitonin should not impair your ability to perform such tasks safely.

Alcohol: Avoid alcohol.

Pregnancy: In animal studies, large doses of calcitonin reduced birth weight. Before you take calcitonin, tell your doctor if you are pregnant or plan to become pregnant.

Breast Feeding: Calcitonin may pass into breast milk; caution is advised. Consult your doctor for specific advice.

Infants and Children: Studies of calcitonin use in infants and children have not been done. Consult your doctor for specific advice.

Special Concerns: You should not take calcitonin if you have a recently healed bone fracture.


Symptoms: No specific ones have been reported.

What to Do: An overdose of calcitonin is unlikely to be life-threatening. However, if someone takes a much larger dose than prescribed, call your doctor, emergency medical services (EMS), or the nearest poison control center.

Drug Interactions

There are no known drug interactions.

Food Interactions

No known food interactions.

Disease Interactions

Caution is advised when taking calcitonin. Consult your doctor for specific advice if you have a kidney problem or a history of allergies.

From The Johns Hopkins Consumer Guide to Drugs. You can order this book now on our secure server.



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