Calcitonin Side Effects
Some side effects of calcitonin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to calcitonin: injection injectable, injection solution
Other dosage forms:
Along with its needed effects, calcitonin 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 immediately if any of the following side effects occur while taking calcitonin:Incidence not known
- Bloating or swelling of the face, arms, hands, lower legs, or feet
- difficulty with breathing
- difficulty with swallowing
- joint pain
- muscle aches and pains
- nausea or vomiting
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- skin rash
- tightness in the chest
- tingling of the hands or feet
- trembling or shaking of the legs, arms, hands or feet
- trouble sleeping
- unusual weight gain or loss
Some side effects of calcitonin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Red streaks on the skin
- swelling, tenderness, or pain at the injection site
- Feeling of warmth
- redness of the face, neck, arms, and occasionally, upper chest
- Abdominal or stomach pain
- blurred or loss of vision
- disturbed color perception
- double vision
- halos around lights
- increased urge to urinate during the night
- itching of the ear lobes
- night blindness
- overbright appearance of lights
- pain in the eyes
- poor appetite
- salty taste
- tunnel vision
- waking to urinate at night
For Healthcare Professionals
Applies to calcitonin: injectable solution, nasal spray
Side effects are often mild, but commonly occur in about 10% of patients and may occur in up to 30%. About one third of treated patients discontinue the drug due to side effects. Diminished adverse effects occur with the subcutaneous route versus the intramuscular route. After injection, side effects generally occur within an hour.
Calcitonin is a large, manufactured peptide. A certain percentage of what is produced during manufacturing may be "error peptides" which may increase or change the side effects.
Nausea is the most common symptom and occurs in about 10% to 21% of patients. Vomiting, diarrhea, anorexia, and abdominal discomfort are also common effects of calcitonin. A metallic taste is reported.
A 71-year-old with Paget's disease was treated with 100 intl units of synthetic salmon calcitonin five times a week. After each injection she experienced nausea, vomiting, and severe shivering. Administration of the 5HT antagonist pizotifen eliminated the side effects.
Cardiovascular side effects including tingling of the hands and flushing of the palms, soles, face, or ears are common. A feeling of pressure in the chest may occur.
Within 90 minutes of a subcutaneous injection of 100 intl units of synthetic salmon calcitonin, a 35-year-old woman developed widespread fine tremor which lasted an hour. The reaction could be repeated with a different batch of the drug but not with placebo.
Central nervous system side effects of shivering, chills, paresthesias, dizziness, headache, vertigo, migraine, neuralgia, agitation and tremor have been reported. Tetany has been reported rarely.
Local side effects including pain, wheals, and erythema at the injection site have been reported. Local reactions are less likely after injection of synthetic human calcitonin than with the synthetic salmon preparation.
Respiratory side effects of shortness of breath and nasal congestion occur infrequently. Rhinorrhea, mild nose bleeds, and nasal dryness may occur with nasal administration.
Antibodies may develop to extracted or synthetic calcitonin products after chronic use. The time to antibody development is variable and patient dependent. Antibodies have been reported with the salmon preparation, and rarely to the human product. Antibody development will render a patient resistant to therapy.
Hyperglycemia has been reported as a metabolic side effect in patients with Paget's disease. Impaired glucose tolerance may occur in healthy volunteers. Diabetics may lose control of blood sugar.
Metabolic acidosis and hypocalcemia may occur. Transient increases in water and sodium excretion may occur.
A study of 20 postmenopausal women on calcitonin for osteoporosis for 6 months showed that about seven hours after administration of 100 intl units (intramuscularly) of synthetic salmon calcitonin a mild metabolic acidosis developed.
Renal side effects including polyuria and urinary frequency may occur in 5% to 10% of patients. Abnormal urinary sediment (but not proteinuria or reduced creatinine clearance) is a rare side effect.
A 66-year-old woman received a total of 5600 intl units of intranasal synthetic salmon calcitonin for treatment of osteoporosis. Within one month she developed disseminated granuloma annulare (DGA). The calcitonin was continued for one month after symptoms of DGA were recognized. Lesions did not disappear immediately but continued for 10 months. The relationship was temporal but could not be proved as causal.
Dermatologic side effects including various rashes, urticaria, and flushing and itching of the palmar and plantar surfaces have been reported. Flushing is a common effect. A single case of disseminated granuloma annulare was temporarily related to synthetic salmon calcitonin use. It is a rare effect.
Musculoskeletal side effects including a bilateral deformation of the alar nasal cartilages have been rarely reported after intranasal use. Musculoskeletal weakness may occur.
A 58-year-old woman being treated for osteoporosis with 100 intl units of salmon calcitonin spray per nostril per day developed a progressive bilateral deformation of the alar nasal cartilages. Two depresses, symmetric areas appeared after 4 months. There was nasal septum deformation. The relationship was temporal but could not be proven as causal.
Hypersensitivity side effects have included a few cases of serious allergic-type reactions (e.g., bronchospasm, swelling of the tongue or throat, anaphylactic shock), including very rare reports of death attributed to anaphylaxis.
More calcitonin resources
- calcitonin Injection Advanced Consumer (Micromedex) - Includes Dosage Information
- Calcitonin Monograph (AHFS DI)
- Fortical Prescribing Information (FDA)
- Fortical Nasal Advanced Consumer (Micromedex) - Includes Dosage Information
- Fortical Consumer Overview
- Fortical spray MedFacts Consumer Leaflet (Wolters Kluwer)
- Miacalcin Prescribing Information (FDA)
- Miacalcin MedFacts Consumer Leaflet (Wolters Kluwer)
- Miacalcin Consumer Overview
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