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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 ?
A: Miacalcin is a form of salmon calcitonin (calcium).
Furthermore, a single administration of ViaDerm-Calcitonin resulted in a statistically significant reduction of bone resorption and cartilage degradation biomarkers, CTX-I and CTX-II, similar to the reduction obtained with daily injections of 100 IU Miacalcin.
The market will witness generic erosion owing to the patent expiry of products such as Actonel (risedronate sodium), Reclast (zoledronic acid) and Miacalcin (salmon calcitonin).
nasal calcitonin prescriptions, similar to the 60% November market share achieved prior to the early December launch of two products generic to Miacalcin, but not to Fortical.
Table 7: Global Osteoporosis Drug Market (2006): Breakdown of Value Sales of Leading Drug Brands - Fosamax, Evista, Boniva, Forteo, Actonel and Miacalcin (In US$ Million) (includes corresponding Graph/Chart) II-51 Osteoporosis Therapeutics: A Peek into the Major Brands II-52 Arthritis II-52 Cataract II-53 Glaucoma II-53 Anti- Glaucoma Ophthalmic Drugs II-53 Beta-Adrenergic Blockers or "Beta Blockers" II-54 Timolol II-54 Levobunolol II-54 Carteolol II-54 Metipranolol II-55 Betaxolol II-55 Carbonic Anhydrase Inhibitors II-55 Prostaglandins II-55 Miotics II-55 Other Treatments II-55
Diovan, Diovan/HCT, Lotrel, Zelnorm, Tekturna, Famvir, Miacalcin, and Exforge are registered trademarks of Novartis AG Corporation or its affiliate.