Salmon Calcitonin
Indications
Salmon Calcitonin is used for:
Hypercalcaemia, Paget's disease of bone, Postmenopausal osteoporosis.
Adult Dose
Parenteral
Hypercalcemia
Initial dose: 4 IU/kg SC/IM q12hr May increase to 8 IU/kg SC/IM q12hr; may increase up to a maximum 8 IU/kg q6hr if unresponsive
Paget Disease
Initial dose: 100 IU SC/IM qDay
Maintenance: 50 IU/day or 50-100 IU every 1-3 days
Osteoporosis, Postmenopausal
Indicated for the treatment of postmenopausal osteoporosis in women greater than 5 yr postmenopause
100 IU SC/IM every other day with calcium and vitamin D
Nasal Spray:
1 spray (200 IU) qDay, alternate nostrils daily
Child Dose
Safety and efficacy not established
Renal Dose
Administration
Contra Indications
Hypersensitivity.
Precautions
Children <18 yr, renal impairment. Pregnancy, lactation. Serious hypersensitivity reactions, including fatal anaphylaxis, reported; consider skin testing prior to treatment. Hypocalcemia associated with tetany has been reported; ensure adequate intake of calcium and vitamin D
Lactation: excretion in milk unknown/not recommended
Pregnancy-Lactation
Interactions
Concurrent use w/ cardiac glycosides (e.g. digitalis) or Ca-channel blockers requires dosage adjustments of these drugs. May decrease serum concentration of lithium.
Adverse Effects
Side effects of Salmon Calcitonin :
>10%
Rhinitis (12%)
1-10%
Arthralgia (4%),Back pain (5%),Expistaxis (4%),Injection site reactions (10%),Nausea (10%),Headache (3%),Flushing of face or hands (2-5%)
<1%
Abdominal pain,Possible allergic reactions,Appetite decreased,Edema of feet,Eye pain,Feverish sensation,Nausea,Nocturia,Possible local irritative effects in the respiratory tract,Salty taste
Frequency Not Defined
Tremors
Potentially Fatal: Anaphylactic shock.
Mechanism of Action
It inhibits osteoclastic bone resorption and reduces bone turnover. It decreases tubular reabsorption and promotes renal excretion of Ca, Cl, Na, Mg, K and phosphate.