calcitonin injection

Pronunciation

Generic Name: calcitonin injection (kal si TOE nin)
Brand Name: Miacalcin

What is calcitonin injection?

Calcitonin is a man-made form of a hormone that occurs naturally in the thyroid gland.

Calcitonin injection is used to treat Paget's disease of bone, postmenopausal osteoporosis, or high levels of calcium in the blood (hypercalcemia).

Calcitonin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about calcitonin injection?

Do not use this medication if you are allergic to salmon calcitonin.

To make sure you are not allergic to this medication, your doctor may perform an allergy skin test before your first dose of calcitonin injection.

Calcitonin injection is not a cure for Paget's disease and you may have a relapse, especially if your body forms antibodies and you become immune to calcitonin. Talk with your doctor at any time if you think the medication is not working as well as it did before.

Slideshow: Flashback: FDA Drug Approvals 2013

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your urine may also need to be tested. Do not miss any scheduled appointments.

Calcitonin injection can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

It is important to use calcitonin injection regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

What should I discuss with my health care provider before using calcitonin injection?

Do not use this medication if you are allergic to salmon calcitonin.

Before using calcitonin injection, tell your doctor if you are allergic to any food or drugs. You may need a dose adjustment or special tests to safely use this medication.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether calcitonin passes into breast milk or if it could harm a nursing baby. Calcitonin may slow breast milk production. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use calcitonin injection?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.

To make sure you are not allergic to this medication, your doctor may perform an allergy skin test before your first dose of calcitonin injection.

This medication is given as an injection under the skin. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Calcitonin injection is not a cure for Paget's disease and you may have a relapse, especially if your body forms antibodies and you become immune to calcitonin. Talk with your doctor at any time if you think the medication is not working as well as it did before.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your urine may also need to be tested. Do not miss any scheduled visits to your doctor.

It is important to use calcitonin injection regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store this medication in the refrigerator and do not allow it to freeze.

What happens if I miss a dose?

Use the medication as soon as you remember the missed dose. If it is almost time for your next dose, skip the missed dose and use the medicine at your next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include nausea or vomiting.

What should I avoid while using calcitonin injection?

Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are using calcitonin injection.

Calcitonin injection can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Calcitonin injection side effects

You may have increased bone pain during the first few months of treatment with calcitonin injection. This is not a sign that the medication isn't working properly.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • feeling light-headed, fainting; or

  • muscle stiffness.

Less serious side effects may include:

  • warmth, redness, itching, or tingly feeling under your skin;

  • nausea, loss of appetite, stomach pain;

  • vomiting;

  • skin rash or itching;

  • increased urination, especially at night;

  • eye pain;

  • swelling in your feet; or

  • swelling or irritation of the skin where an injection was given.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Calcitonin injection dosing information

Usual Adult Dose for Paget's Disease:

50 to 100 intl units given subcutaneously or intramuscularly once a day. The dosage may be reduced to 50 to 100 intl units subcutaneously or intramuscularly three times a week when improvement (clinical or biochemical) occurs. Calcitonin is usually not given for more than 6 months unless there are neurological symptoms or extensive lytic lesions in the weight-bearing bones. Biochemical remissions of the illness generally last for under six months. If retreatment is necessary, the same initial and maintenance dosage schedules generally are repeated. Human calcitonin is an orphan drug that may be used in patients that develop resistance or an allergic reaction to calcitionin-salmon.

-or-

200 to 400 intl units by intranasal administration once a day may also be used with a slight loss in efficacy (400 intl units nasal dose compared to 100 intl units intramuscular dose) but a decrease in systemic side effects. Studies have demonstrated that intranasal preparations reduced bone turnover by 30% to 40%, compared to the 50% seen with subcutaneous or intramuscular preparations.

Usual Adult Dose for Hypercalcemia:

4 intl units/kg (rounded to the next higher 5 intl units) subcutaneously or intramuscularly every 12 hours. The maximum dosage should not exceed 545 intl units per dose. If a response to the 4 intl units/kg dose is not observed in 1 to 2 days, 8 intl units/kg (rounded to the next higher 5 intl units) may be given subcutaneously or intramuscularly every 12 hours. The dosing frequency may be increased to every 6 hours, if needed. The maximum dosage should not exceed 1090 intl units per dose. Therapy is generally 5 days or fewer. A 2 mg/dl reduction in plasma calcium level is usually noted and maintained for 2 to 4 days. Thereafter, the effect diminishes.

Usual Adult Dose for Osteoporosis:

100 intl units given every other day or 50 intl units given once a day either subcutaneously or intramuscularly. Injectable doses may be increased to 200 or 400 intl units once per day, as required.

-or-

200 intl units may be given intranasally once a day, alternating nostrils daily.

Therapy is generally long-term, lasting months or years.

Usual Adult Dose for Osteogenesis Imperfecta Tarda:

50 intl units given subcutaneously three times a week. Dosages may be increased to 100 intl units depending on tolerance of side effects and efficacy of the 50 intl units dose therapy.

Usual Pediatric Dose for Osteogenesis Imperfecta Tarda:

Not a FDA approved indication:
Osteogenesis imperfecta
Children over 6 months of age: 2 international units/kg IM or SQ 3 times/week.

What other drugs will affect calcitonin injection?

There may be other drugs that can affect calcitonin injection. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about calcitonin injection.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.03. Revision Date: 2010-12-15, 5:01:39 PM.

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