Calcitonin (Systemic)
   
Calcitonin (Systemic)
US Brand Names
• Calcimar
• Cibacalcin
• Miacalcin
Canadian Brand Names
• Calcimar
Description
Calcitonin (kal-si-TOE-nin) is used to treat Paget's disease of bone. It also may be used to prevent continuing bone loss in women with postmenopausal osteoporosis and to treat hypercalcemia (too much calcium in the blood). This medicine may be used to treat other conditions as determined by your doctor.
Calcitonin is available only with your doctor's prescription, in the following dosage forms:
Special Considerations
In deciding to use a medicine, the risks of taking 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 other proteins. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Diet
Make certain your health care professional knows if your diet includes large amounts of calcium-containing foods and/or vitamin D-containing foods, such as milk or other dairy products. Calcium and vitamin D may cause the calcitonin to be less effective in treating a high blood calcium. Also let your health care professional know if you are on any special diet, such as low-sodium or low-sugar diet.
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.
Breast-feeding
Calcitonin has not been reported to cause problems in nursing babies. However, studies in animals have shown that calcitonin may decrease the flow of breast milk.
Children
Studies on this medicine have been done only in adult patients, and there is no specific information comparing the use of calcitonin in children with use in other age groups. Therefore, be sure to discuss with your doctor the use of this medicine in children.
Older adults
Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing the use of calcitonin in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults. Calcitonin is often used in elderly patients.
Other medicines
Other medicine
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. Tell your health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Administration
This medicine is for injection only. If you will be giving yourself the injections, make sure you understand exactly how to give them, including how to fill the syringe before injection. If you have any questions about this, check with your doctor.
Use the calcitonin only when the contents of the syringe are clear and colorless. Do not use it if it looks grainy or discolored.
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.
The number of doses you receive, the time allowed between doses, and the length of time you receive the medicine depends on the medical problem for which you are receiving calcitonin .
For calcitonin-human
• For injection dosage form:
o For Paget's disease of bone:
§ Adults-To start, 500 micrograms (mcg) injected under the skin once a day. Your doctor may reduce your dose or increase the time between doses. Or, your doctor may give you a smaller dose to start and increase your dose over two weeks.
§ Children-Dose must be determined by your doctor.
For calcitonin-salmon
• For injection dosage form:
o For Paget's disease of bone:
§ Adults-To start, 100 Units injected into a muscle or under the skin once a day, once every other day, or three times a week. Your doctor may reduce your dose or increase the time between doses.
§ Children-Dose must be determined by your doctor.
o For hypercalcemia (too much calcium in the blood):
§ Adults-To start, 4 Units per kilogram (kg) (1.8 Units per pound) of body weight injected into a muscle or under the skin every twelve hours. Your doctor may increase your dose or increase the time between doses.
§ Children-Dose must be determined by your doctor.
o For postmenopausal osteoporosis:
§ Adults-100 Units injected into a muscle or under the skin once a day, once every other day, or three times a week. Or, your doctor may give you a smaller dose to start and increase your dose over two weeks.
§ Children-Dose must be determined by your doctor.
Missed dose
If you miss a dose of this medicine and your dosing schedule is:
• Two doses a day-If you remember within 2 hours of the missed dose, give it right away. Then go back to your regular dosing schedule. But if you do not remember the missed dose until later, skip it and go back to your regular dosing schedule. Do not double doses.
• One dose a day-Give the missed dose as soon as possible. Then go back to your regular dosing schedule. If you do not remember the missed dose until the next day, skip it and go back to your regular dosing schedule. Do not double doses.
• One dose every other day-Give the missed dose as soon as possible if you remember it on the day it should be given. Then go back to your regular dosing schedule. If you do not remember the missed dose until the next day, give it at that time. Then skip a day and start your dosing schedule again.
• One dose three times a week-Give the missed dose the next day. Then set each injection back a day for the rest of the week. Go back to your regular Monday-Wednesday-Friday schedule the following week. Do not double doses.
If you have any questions about this, check with your doctor.
Storage
To store this medicine:
• Keep out of the reach of children.
• Store away from heat and direct light.
• Store calcitonin-human at a temperature below 77 °F. Do not refrigerate. Use prepared solution within 6 hours.
• Store calcitonin-salmon in the refrigerator. However, keep it from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.
Precautions
Your doctor should check your progress at regular visits to make sure that this medicine does not cause unwanted effects.
If you are using this medicine for hypercalcemia (too much calcium in the blood), your doctor may want you to follow a low-calcium diet. If you have any questions about this, check with your doctor.
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 either of the following side effects occurs:
Rare
Skin rash or hives.
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
Diarrhea; flushing or redness of face, ears, hands, or feet; loss of appetite; nausea or vomiting; pain, redness, soreness, or swelling at place of injection; stomach pain.
Less common
Increased frequency of urination.
Rare
Chills; dizziness; headache; pressure in chest; stuffy nose; tenderness or tingling of hands or feet; trouble in breathing; weakness.
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
Additional Information
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, calcitonin is used in certain patients with the following medical condition:
• Osteoporosis caused by hormone problems, certain drugs, and other causes
Other than the above information, there is no additional information relating to proper use, precautions, or side effects for this use.
Notes
This information applies to the following medicines:
1. Calcitonin-Human (kal-si-TOE-nin HYOO-man)
2. Calcitonin-Salmon (kal-si-TOE-nin SAM-en)
June 27, 1994 
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