Calcitonin

Intravenous
Emergency treatment of hypercalcaemia

Parenteral
Adjunct in hypercalcaemia

Parenteral
Paget's disease of bone

Parenteral
Prophylaxis of acute bone loss due to sudden immobilisation

Rectal
Emergency treatment of hypercalcaemia

Dosage adjustment needed.

Hypersensitivity. Patients with hypocalcaemia.

Skin test should be done before initiating therapy. Heart failure. Renal impairment. Pregnancy and lactation. Children.

Endocrine disorders: Diabetogenic effect.
Gastrointestinal disorders: GI disturbances, abdominal pain.
General disorders and administration site conditions: Inj site inflammation.
Nervous system disorders: Dizziness, tingling of the hands, unpleasant taste, tremor.
Renal and urinary disorders: Urinary frequency.
Skin and subcutaneous tissue disorders: Skin rash.
Vascular disorders: Flushing.
Potentially Fatal: Anaphylactic shock.

IM/IV/Nasal/Parenteral/SC: C

Serum electrolytes and Ca.

Symptoms: Flushing, nausea, vomiting and dizziness. Management: Symptomatic and supportive treatment.

Concurrent use with cardiac glycosides (e.g. digitalis) or Ca-channel blockers requires dosage adjustments of these drugs. May decrease serum concentration of lithium.

Description:
Mechanism of Action: Calcitonin is a polypeptide hormone produced by the ultimobranchial gland in non-mammalian vertebrates or by the mammalian thyroid parafollicular cells. 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.
Pharmacokinetics:
Absorption: Rapidly inactivated (oral). Bioavailability: Approx 70% (IM/SC). Time to peak plasma concentration: 30-40 min (nasal); 15-25 min (IM).
Distribution: Volume of distribution: 0.15-0.3 L/kg. Plasma protein binding: Approx 30-40%.
Metabolism: Rapidly in the kidneys, blood and peripheral tissues.
Excretion: Urine (as inactive metabolites, and small amounts of unchanged drug). Elimination half-life: IV: Approx 70-90 min.

Source: National Center for Biotechnology Information. PubChem Database. Calcitonin, CID=16220016, https://pubchem.ncbi.nlm.nih.gov/compound/Calcitonin (accessed on Jan. 21, 2020)

Store between 2-8°C.

Agents Affecting Bone Metabolism

H05BA - Calcitonin preparations ; Used in the management of calcium homeostasis.

Anon. Calcitonin. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 12/08/2013.

Anon. Calcitonin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 12/08/2013.

Background Document for Meeting of Advisory Committee for Reproductive Health Drugs and Drug Safety and Risk Management Advisory Committee. U.S. FDA. https://www.fda.gov/. Accessed 05/03/2013 .

Buckingham R (ed). Calcitonins. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 12/08/2013.

Direct Healthcare Professional Communication on Calcitonin (Miacalcic) Associated with Malignancy – New Restrictions on Use and Withdrawal of the Nasal Spray from the Market.. Medicines & Healthcare products Regulatory Agency. https://www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency. Accessed 08/2012.