Used for treating established postmenopausal osteoporosis as well as hypercalcemia secondary to hyperparathyroidism, and pagets disease
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Prototye Med
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calcitonin-salmon (Miacalcin, Calcimar)
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Treatment of postmenopausal osteoporosis
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Hypercalcemia secondary to hyperparathyroidism
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Paget’s disease
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Nasal dryness and irritation with intranasal calcitonin
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Hypersensitivity reactions/ anaphylaxis
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Hypocalcemia
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Decrease in therapeutic effects over time
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Nasal form of calcitonin may cause nasal dryness and irritation as well as headaches and epistaxis
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Injectable form may cause injection site reaction, nausea and vomiting and polyuria.
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When administering intranasal calcitonin
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Alternate nostril used daily.
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Assess prior to administration for irritation/ulceration.
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Prior to beginning therapy
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Perform intradermal allergy test.
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Development of erythema within 15 minutes indicates sensitivity.
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Have epinephrine 1:1000, antihistamines, and oxygen available during early therapy
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Monitor for hypocalcemia (serum calcium level, muscle spasms, tingling of fingers and toes).
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Provide diet high in calcium and vitamin D.
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Intranasal spray
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Hold nasal pump upright.
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If using pump for the first time, prime pump according to manufacturer’s instructions.
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Spray once in nostril opposite of previous instillation
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Intramuscular/Subcutaneous
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Rotate injection sites.
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Subcutaneous is preferred route - Administer IM if dose more than 2 ml
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Protect from light.
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Keep calcitonin salmon refrigerated.
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For intranasal calcitonin, instruct clients to
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Alternate nostril used daily.
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Report nasal irritation or bleeding.
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Instruct clients to immediately notify provider if rash or itching occurs.
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Instruct clients to do the following for 30 minutes after taking drug: report changes in swallowing or vision to provider
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Notify provider of muscle spasms, tingling of fingers and toes.
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Eat a diet high in calcium and vitamin D.
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Monitor for loss of effect after a year or more of use through regular bone density studies
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Allergy to salmon
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Prior treatment with bisphosphonates
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Pregnancy and lactation
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Safety not established in pediatric clients
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May decrease serum lithium levels.
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Previous treatment with bisphosphonates may decrease the response to calcitonin.
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