Calcitonin

(kal-sih-toe-nin)

Trade/other name(s): Miacalcin, calcitonin-salmon

Why would this drug be used?

Calcitonin is used to lower high blood calcium levels in people who have cancer that is in the bones. It is also used to treat other conditions, including osteoporosis in women past menopause and Paget’s disease of the bone.

How does this drug work?

Multiple myeloma and some cancers that spread to the bones can break down bone materials and release large amounts of calcium into the blood. This condition, known as hypercalcemia, can be dangerous.

Calcitonin is a hormone normally made by the thyroid gland. It helps keep calcium levels in the body from getting too high. It does this mainly by blocking the breakdown (absorption) of bone, which slows the release of more calcium into the blood. It also helps the kidneys rid the body of the excess calcium in the blood. It affects the intestines as well, lowering the amount of calcium entering the body through food.

As a drug, calcitonin-salmon is a man-made version of the hormone as it is found in salmon (which is more potent and lasts longer than the human form). Taking the drug raises calcitonin levels in the body, which leads to lower blood calcium levels within a few hours.

Before taking this medicine

Tell your doctor…

• If you are allergic to any medicines, dyes, additives, or foods.
• If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, lung disease, diabetes, gout, or infections. You may need closer monitoring of these conditions while being treated.
• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. It is not known if this drug might cause problems if either the male or female is taking it at the time of conception or during pregnancy. Check with your doctor about what kinds of birth control can be used with this medicine. This drug should be used during pregnancy only if the potential benefit is thought to justify the potential risk to the fetus.
• If you are breast-feeding. While no studies have been done, this drug may pass into breast milk and affect the baby. Talk with your doctor about the possible risks of breast-feeding while taking this drug.
• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

No serious interactions with other drugs are known at this time. But this does not necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about all of your medicines, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with foods are known at this time. Check with your doctor, nurse, or pharmacist about whether some foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

When treating hypercalcemia, calcitonin is given as an injection. This may be either under the skin (subcutaneous, or SubQ) or into a muscle (intramuscular, or IM). It may be given in a hospital or doctor’s office, or you or a family member can be taught how to give the medicine under the skin at home.

Injections are often given every 12 hours to start, but the time between doses may need to be changed depending on how you respond. The dose is based on your body weight.

If you are taking it at home, the medicine should be kept in its original container in the refrigerator. Store the syringes, needles, and supplies in a safe place, away from children and pets. Keep the used syringes and needles in a special sharps container. Ask your nurse or doctor about this, and when you should bring the filled container back to the office.

Calcitonin is also available as a nasal spray. This form is usually used to help treat osteoporosis.

Precautions

Your doctor may ask you to have a skin test before you take this drug to see if you have allergies. This drug can cause allergic reactions in some people when it is given. Mild reactions usually consist of fever and chills. More serious reactions happen rarely, but can be dangerous. Symptoms can include feeling lightheaded or dizzy (due to low blood pressure), fever or chills, hives, nausea, itching, headache, coughing, shortness of breath, or swelling of the face, tongue, or throat. Tell your doctor or nurse right away if you notice any of these symptoms during or after being given the drug.

In rare cases, taking this drug could lead to low blood calcium levels (hypocalcemia). Possible symptoms could include muscle spasms or cramps, muscle or joint pains, changes in sensations in the face, hands, or feet, confusion, or seizures. Tell your doctor right away if you notice any of these symptoms.

Your doctor will test your blood often throughout your treatment, looking for possible effects of the drug on blood chemistry levels (especially calcium levels). Based on the test results, your doctor may need to change your next dose of this drug.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

• mild nausea
• reaction at injection site

Less common

• vomiting
• flushing of the face or hands
• itching of the ear lobes
• feeling feverish
• eye pain
• loss of appetite
• stomach pain
• swelling of the feet
• salty taste in the mouth
• having to urinate at night

Rare

• muscle pain, cramps, or spasms*
• abnormal sensations in the hands or feet*
• allergic reactions*

*See "Precautions" section for more detailed information.

There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved before 1984 (FDA cannot verify dates of drugs approved before 1984).

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.