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Related to Miacalcin: Miacalcin Nasal Spray

calcitonin (salmon)

APO-Calcitonin, Calcimar, Caltine, Fortical, Miacalcic (UK), Miacalcin, Miacalcin Nasal Spray, Sandoz Calcitonin

Pharmacologic class: Hormone (calcium-lowering)

Therapeutic class: Hypocalcemic

Pregnancy risk category C


Directly affects bone, kidney, and GI tract. Decreases osteoclastic osteolysis in bone; also reduces mineral release and collagen breakdown in bone and promotes renal excretion of calcium. In pain relief, acts through prostaglandin inhibition, pain threshold modification, or beta-endorphin stimulation.


Injection: 0.5 mg/ml (human), 1 mg/ml (human), 200 international units/ml in 2-ml vials (salmon)

Nasal spray (salmon): 200 international units/actuation, metered nasal spray in 3.7 ml-bottle

Indications and dosages

Postmenopausal osteoporosis

Adults:Calcitonin (salmon)-100 international units/day I.M. or subcutaneously, or 200 international units/day intranasally with concurrent supplemental calcium and vitamin D

Paget's disease of bone (osteitis deformans)

Adults:Calcitonin (salmon)-Initially, 100 international units/day I.M. or subcutaneously; after titration, maintenance dosage is 50 to 100 international units daily or every other day (three times weekly). Calcitonin (human)-0.5 mg I.M. or subcutaneously daily, reduced to 0.25 mg daily.


Adults:Calcitonin (salmon)-4 international units/kg I.M. or subcutaneously q 12 hours; after 1 or 2 days, may increase to 8 international units/kg q 12 hours; after 2 more days, may increase further, if needed, to 8 international units q 6 hours.


• Hypersensitivity to drug or salmon
• Pregnancy or breastfeeding


Use cautiously in:
• renal insufficiency, pernicious anemia
• children.


Before salmon calcitonin therapy begins, perform skin test, if prescribed. Don't give drug if patient has positive reaction. Have epinephrine available.
• Bring nasal spray to room temperature before using.
• Give intranasal dose as one spray in one nostril daily; alternate nostrils every day.
• To minimize adverse effects, give at bedtime.
• Rotate injection sites to decrease inflammatory reactions.

Adverse reactions

CNS: headache, weakness, dizziness, paresthesia

CV: chest pain

EENT: epistaxis, nasal irritation, rhinitis

GI: nausea, vomiting, diarrhea, epigastric pain or discomfort

GU: urinary frequency

Musculoskeletal: arthralgia, back pain

Respiratory: dyspnea

Skin: rash

Other: altered taste, allergic reactions including facial flushing, swelling, and anaphylaxis


Drug-drug.Previous use of bisphosphonates (alendronate, etidronate, pamidronate, risedronate): decreased response to calcitonin

Patient monitoring

• Monitor for adverse reactions during first few days of therapy.
• Assess alkaline phosphatase level and 24-hour urinary excretion of hydroxyproline.
• Check urine for casts.
• Monitor serum electrolyte and calcium levels.

Patient teaching

• Instruct patient to take drug before bedtime to lessen GI upset. Tell him to call prescriber if he can't maintain his usual diet because of GI upset.
• Inform patient using nasal spray that runny nose, sneezing, and nasal irritation may occur during first several days as he adjusts to spray.
• Instruct patient to bring nasal spray to room temperature before using.
• Advise patient to blow nose before using spray, to take intranasal dose as one spray in one nostril daily, and to alternate nostrils with each dose.
• Tell patient to discard unrefrigerated bottles of calcitonin (salmon) nasal spray after 30 days.
• Encourage patient to consume a diet rich in calcium and vitamin D.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.


Calcitonin-salmon, see there.
References in periodicals archive ?
By the way, it sounds like Miacalcin is made from salmon.
What was accomplished by the Actonel, Miacalcin, Evista and calcium citrate with vitamin D was not possible as recently as 15 years ago.
Diovan, Diovan/HCT, Lotrel, Zelnorm, Tekturna, Famvir, Miacalcin, and Exforge are registered trademarks of Novartis AG Corporation or its affiliate.
Several key products - including Lescol, LoTensin, Lamisil and Miacalcin - have generated impressive sales increases in 1996.
TOP Rx/OTC PRODUCTS PURCHASED BY CONSUMERS TO TREAT OSTEOPOROSIS RANK # PRODUCT RX/OTC #1 Fosamax Rx #2 Miacalcin Rx #3 Evista Rx #4 Premarin Rx #5 Prempro Rx #6 Calcium supplements OTC #7 Citracal OTC #8 Caltrate OTC #9 Oscal OTC
Miacalcin Nasal Spray has been on the market since November 1995 and is the only nasal spray approved for the treatment of postmenopausal osteoporosis.
This analysis showed that patients taking Miacalcin Nasal Spray (200 IU per day) had 37 percent fewer new spinal fractures than those taking placebo.
In addition, the sales of Miacalcin continue to grow, with Miacalcin having gained over 32% share of the new prescription market for treatment of postmenopausal osteoporosis in its first year.
Demand in the United States has been growing since the 1995 introductions of Merck's Fosamax and Sandoz's Miacalcin nasal spray, two new osteoporosis therapies.