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Calcitonin Side Effects

In Summary

Commonly reported side effects of calcitonin include: nausea, vomiting, and inflammation at injection site. Other side effects include: diarrhea, flushing of face and/or neck, flushing of hands and feet, gastrointestinal signs and symptoms, stomach pain, flushing, irritation at injection site, pain at injection site, and swelling at injection site. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to calcitonin: 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

  • Blurred vision
  • chills or fever
  • cough
  • difficulty with breathing
  • difficulty with swallowing
  • dizziness
  • frequent urination
  • headache
  • joint pain
  • muscle aches and pains
  • muscle cramps in the hands, arms, feet, legs, or face
  • nausea or vomiting
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • seizures
  • skin rash or itching
  • slow or fast heartbeat
  • sweating
  • swelling of the hands, ankles, feet, or lower legs
  • tightness in the chest
  • tingling of the hands or feet
  • trembling or shaking of the legs, arms, hands or feet
  • trouble sleeping
  • unusual tiredness or weakness
  • 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

Less Common

  • Feeling of warmth
  • redness of the face, neck, arms, and occasionally, upper chest

Incidence Not Known

  • Abdominal or stomach pain
  • changes in vision
  • diarrhea
  • pain in the eyes
  • poor appetite
  • 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.[Ref]


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.[Ref]

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.[Ref]


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.[Ref]

Nervous system

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.[Ref]

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.[Ref]


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.[Ref]


Respiratory side effects of shortness of breath and nasal congestion occur infrequently. Rhinorrhea, mild nose bleeds, and nasal dryness may occur with nasal administration.[Ref]


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.[Ref]


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.[Ref]

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.[Ref]


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.[Ref]


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.[Ref]

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.[Ref]


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.[Ref]

Musculoskeletal side effects including a bilateral deformation of the alar nasal cartilages have been rarely reported after intranasal use. Musculoskeletal weakness may occur.[Ref]


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.


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3. Wuster C, Schurr W, Scharla S, Raue F, Minne HW, Ziegler R "Superior local tolerability of human versus salmon calcitonin preparations in young healthy volunteers." Eur J Clin Pharmacol 41 (1991): 211-5

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15. Nagant de Deuxchaisnes C, Devogelaer JP, Huaux JP, Dufour JP, Esselinckx W, Engelbeen JP, Stasse P, Hermans P, de Buisseret JP "New modes of administration of salmon calcitonin in Paget's disease. Nasal spray and suppository." Clin Orthop 217 (1987): 56-71

16. "Product Information. Miacalcin Nasal Spray (calcitonin nasal)." Novartis Pharmaceuticals, East Hanover, NJ.

17. Evans IM, Joplin GF, MacIntyre I "Hyperglycaemic effect of synthetic salmon calcitonin." Lancet 1 (1978): 280

18. Thomas DW, Frewin DB, Jolley PT "Deterioration in diabetic control during calcitonin therapy." Med J Aust 2 (1979): 699-70

19. Escanero JF, Elosegui LM, Cordova A, Pecondon A, Asin JJ, Beltran J, Otero W "Calcitonin and metabolic alkalosis." Biomed Pharmacother 45 (1991): 307-9

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21. Hantman DA, Donaldson CL, Hulley SB "Abnormal urinary sediment during therapy with synthetic salmon calcitonin." J Clin Endocrinol Metab 33 (1971): 564-6

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23. Goihman-Yahr M "Disseminated granuloma annulare and intranasal calcitonin." Int J Dermatol 32 (1993): 150

24. Strumia R, Mantovani L "May calcitonin spray cause nasal deformation?." Dermatology 185 (1992): 72

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.