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calcitonin injection

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, or high levels of calcium in the blood (hypercalcemia). Calcitonin injection is also used to treat osteoporosis in postmenopausal women.

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

Important Information

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use this medicine if you are allergic to salmon calcitonin.

To make sure calcitonin is safe for you, tell your doctor if you have:

  • low levels of calcium in your blood (hypocalcemia).

Using calcitonin may increase your risk of developing certain types of cancer. Ask your doctor about your specific risk.

FDA pregnancy category C. It is not known whether calcitonin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

It is not known whether calcitonin passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use calcitonin injection?

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

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Calcitonin is injected under the skin or into a muscle. You may be shown how to use injections at home. Do not self-inject this medicine if you do not understand how to give the injection and properly dispose of used needles and syringes.

Use a disposable needle only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Use calcitonin regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Calcitonin injection is not a cure for Paget's disease. You may have a relapse, especially if your body forms antibodies and you become immune to calcitonin.

Call your doctor if your symptoms do not improve, or if they get worse while using calcitonin.

Your doctor may want you to take extra calcium and vitamin D while you are using calcitonin. Take only the amounts of calcium and vitamin D your doctor has prescribed.

Store in the refrigerator, do not freeze.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using calcitonin injection?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be 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; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out; or

  • low levels of calcium in your blood--numbness or tingly feeling around your mouth, fast or slow heart rate, muscle tightness or contraction, overactive reflexes.

Common side effects may include:

  • flushing (warmth, redness, or tingly feeling);

  • nausea;

  • vomiting; or

  • swelling where the injection was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects (complete list)

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.


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:
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?

Other drugs may interact with calcitonin, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or 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: 3.01.

Date modified: January 03, 2018
Last reviewed: July 04, 2014