Applies to the following strengths: 200 intl units/mL; 200 intl units/inh
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Usual Adult Dose for:
Usual Pediatric Dose for:
Additional dosage 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.
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.
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:
Children over 6 months of age: 2 international units/kg IM or SQ 3 times/week.
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Liver metabolism is important in porcine but not synthetic salmon or synthetic human calcitonin. Dosage reductions may be considered in patients with liver disease if porcine calcitonin is used, however, dosage reductions are generally not necessary as plasma levels 20,000 times the physiologic are tolerated without hypocalcemia or other obvious illness.
Data not available
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- Drug class: calcitonin
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