How does this medication work? What will it do for me?

Calcitonin is a medication that is also known as a calcium regulator. It is used to treat hypercalcemia (too much calcium in the blood) by working in the kidney to remove the calcium from the body. Calcitonin also works by slowing down the rate of bone breakdown.

Calcitonin is also used to treat symptoms of Paget's disease when other treatments have not been successful. Paget’s disease causes inflammation of the bones, in turn causing pain and changes to the breakdown and formation of bones. Calcitonin is used by itself or in combination with other medications when it is necessary to quickly remove excess amounts of calcium from the blood.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each mL of sterile solution contains 200 International Units (IU) of calcitonin salmon. Nonmedicinal ingredients: acetic acid, phenol, sodium acetate, sodium chloride, and sterile water for injection.

How should I use this medication?

The recommended starting dose of calcitonin for treating Paget's disease is 100 IU (international units) once daily, given by subcutaneous (under the skin) or intramuscular (into a muscle) injection.

Calcitonin is used with the guidance and supervision of a doctor. Your doctor or nurse may ask you to inject the medication at home once they have instructed you and are certain that you won't have any problems with doing it at home. Do not attempt to prepare or inject this medication on your own until you completely understand how to prepare and inject a dose.

When used to treat hypercalcemia, the dose of calcitonin is based on body weight (4 IU per kilogram of body weight) and injected every 12 hours by subcutaneous or intramuscular injection. This should be done by a nurse or doctor in the hospital. Depending on the reduction in calcium in the body, your doctor may increase this dose to a maximum of 8 IU per kilogram of body weight, injected 4 times a day.

Calcitonin should be used for the shortest time possible.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not inject a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication in the refrigerator between 2°C to 8°C. Protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use calcitonin salmon injection if you are allergic to calcitonin salmon or any ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • decreased appetite
  • facial flushing (feeling of warmth)
  • injection site reactions, e.g.:
    • bleeding
    • bruising
    • itching
    • pain
    • skin irritation
    • swelling
  • metallic taste in the mouth
  • nausea
  • tingling of the hands
  • vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Stop using the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction, e.g.:
    • difficulty breathing
    • hives
    • swelling of the face, tongue, or throat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Cancer: There is evidence that calcitonin salmon injection may increase the risk of developing certain types of cancer when used for a long time. Calcitonin salmon injection should be used for the shortest time possible. Speak to your doctor if you have concerns.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication may decrease milk production. It is not known if calcitonin passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

What other drugs could interact with this medication?

There may be an interaction between calcitonin salmon injection and any of the following:

  • lithium
  • zoledronic acid

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.