Calcitonin (Nasal-Systemic)
   
Calcitonin (Nasal-Systemic)
US Brand Names
• Miacalcin
Description
Calcitonin (kal-si-TOE-nin) is used to treat women with postmenopausal osteoporosis (bone loss). It is used together with calcium and vitamin D.
This medicine is available only with your doctor's prescription, in the following dosage form:
Nasal
• Nasal solution (U.S.)
Special Considerations
In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For calcitonin, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to calcitonin or to proteins. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy
Calcitonin has not been studied in pregnant women. However, in animal studies, calcitonin has been shown to lower the birth weight of the baby when the mother was given a dose of calcitonin many times the human dose. Calcitonin nasal solution should not be used by women during pregnancy.
Breast-feeding
It is not known whether calcitonin passes into breast milk. However, studies in animals have shown that calcitonin may decrease the flow of milk.
Children
There is no specific information comparing the use of calcitonin in children with use in older age groups.
Older adults
Calcitonin nasal solution has been tested in elderly patients and has not been found to cause different side effects or problems in older people than it does in younger adults.
Other medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking calcitonin, it is especially important that your health care professional know if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Administration
This medicine usually comes with patient directions. Read them carefully Special Considerations. If you have any questions about using the pump spray, ask your doctor, nurse, or pharmacist.
Use this medicine only as directed by your doctor. Do not use more of it and do not use it more often or for a longer time than directed.
To assemble the pump:
• If your medicine and its pump were not already assembled by the pharmacist, carefully follow the instructions provided:
• Remove the bottle of solution from the refrigerator and let it sit until it warms to room temperature (less than 77 °F).
• Lift the blue plastic tab and pull the metal safety seal off the bottle.
• Hold the bottle upright and carefully pull the rubber stopper out of the bottle.
• Hold the spray pump unit and remove the plastic cap from the bottom of the unit.
• Hold the bottle upright and place the spray pump unit into the bottle.
• Turn the spray pump unit clockwise and tighten it until it is securely fastened.
To prepare this medicine:
• Before you use a new bottle of calcitonin spray, the spray pump will need to be primed (started). If your pharmacist assembled the unit for you, check to see if it has already been primed by pumping the unit once. If a full spray comes out, the unit has already been primed; if not, you must prime the pump.
• To prime, hold the bottle upright and away from you, then pump it several times until you see a faint spray.
• Do not prime the pump again before each daily use.
To use the nose spray:
• Before using the spray, blow your nose gently.
• Keeping your head in an upright position, carefully place the nozzle into one nostril.
• Press the pump toward the bottle one time. Do not spray more than once.
• Do not inhale while spraying.
• To keep the nosepiece clean, wipe it with a clean tissue and replace the dust cap after use.
Dosing
The dose of calcitonin will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of calcitonin. If your dose is different, do not change it unless your doctor tells you to do so.
• For nasal dosage form (nose spray):
o For treatment of women with osteoporosis after menopause:
§ Adults-One spray into one nostril once a day. It is best to spray into the nostril on one side one day and the other side the next day.
Missed dose
If you miss a dose of this medicine, use it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage
To store this medicine:
• Keep out of the reach of children.
• Store in the refrigerator until it is opened for the first time. However, keep the medicine from freezing.
• After the bottle is opened, it may be kept at room temperature (no more than 77 °F) until the medicine is gone (2 weeks). Opened or unopened bottles left at room temperature for more than 30 days must be discarded.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
More common
Crusting, patches, or sores inside the nose; dryness, itching, redness, swelling, tenderness, or other signs of nasal irritation not present before use of this medicine; headaches (severe or continuing); nosebleeds; runny nose.
Less common
Bloody or cloudy urine; breathing difficulty or wheezing (severe); difficult, burning, or painful urination; dizziness; frequent urge to urinate; loss of sense of smell; swollen glands; upper respiratory infection, with chest pain, chills, cough, ear congestion or pain, fever, head congestion, hoarseness or other voice changes, nasal congestion, runny nose, sneezing, or sore throat.
Rare
Hair loss; hives, itching, or skin rash; increased thirst; taste disturbances.
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
More common
Back pain; joint pain.
Less common or rare
Abdominal pain; burning, dry, or itching eyes; constipation; diarrhea; flu-like symptoms (fever with or without chills, headache, body ache); flushing; mental depression; muscle pain; nausea; unusual tearing of eyes; unusual tiredness or weakness; upset stomach.
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
March 23, 1998 
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