Miacalcin


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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

Action

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.

Availability

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.

Hypercalcemia

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.

Contraindications

• Hypersensitivity to drug or salmon

• Pregnancy or breastfeeding

Precautions

Use cautiously in:

• renal insufficiency, pernicious anemia

• children.

Administration

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

Interactions

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.

Miacalcin®

Calcitonin-salmon, see there.
References in periodicals archive ?
A: Miacalcin is a form of salmon calcitonin (calcium).
You may have heard of calcitonin (Fortical or Miacalcin).
Calcitonin (brand names: Fortical or Miacalcin) can be administered as a nasal spray or as a skin injection; side effects may include nasal congestion and nausea.
Covered drugs will include anakinra (Kineret), adalimumab (Humira), etanercept (Enbrel), and calcitonin-salmon (Miacalcin nasal spray).
Nonoperative management with bracing, nasal miacalcin, opioids, relative rest, and physical therapy fail to control pain.
To rebuild bone density she was put on a regimen of 30 mg of Actonel once weekly, Miacalcin nasal spray daily and 1,500 mg of calcium citrate with vitamin D daily, morning and evening.
Novartis AG markets the brand product, indicated for treating post-menopausal osteoporosis, under the Miacalcin name.
The reduced price program will cover Diovan, a high blood pressure medication, as well as a number of other other key Novartis prescription products, including Exelon (Alzheimer's disease), Lamisil Oral (fungal infections), Lescol (high cholesterol), Miacalcin nasal spray (osteoporosis) and Lotensin and Lotril (both high blood pressure).
Several key products - including Lescol, LoTensin, Lamisil and Miacalcin - have generated impressive sales increases in 1996.
The drugs alendronate sodium (Fosamax) and calcitonin-salmon nasal spray (Miacalcin Nasal Spray) have recently been approved for the treatment of osteoporosis.