Fortical Disease Interactions

Calcitonin inhibits bone resorption, which results in decreased serum calcium levels. Following single IV doses, a marked transient inhibition of the ongoing bone resorptive process occurs, while continuous use leads to a persistent, smaller decrease in rate of bone resorption. Because of the drug's acute hypocalcemic effects, patients administered calcitonin may, theoretically, experience tetany under certain circumstances. Calcitonin should be administered cautiously to patients with preexisting hypocalcemia, since they may be particularly sensitive to these effects. Hypocalcemia should preferably be corrected prior to initiation of therapy. If calcitonin is used to increase bone mineral density, such as in osteoporosis, an adequate intake of calcium and vitamin D should be ensured throughout the course of treatment.

When calcitonin is used for the treatment of osteoporosis, hypocalcemia and other disturbances of mineral metabolism such as vitamin D deficiency should be treated prior to initiation of therapy. The desired increase in bone mineral density requires an adequate supply of calcium and vitamin D in the body. In patients with these conditions, serum calcium and symptoms of hypocalcemia should be monitored during therapy with calcitonin salmon nasal spray. Appropriate intake of calcium and vitamin D should be ensured throughout the course of treatment.