Calcitonin

Calcitonin

Brand Name: Cibacalcin, calcitonin, salmon, Calcimar, Caltine (CAN), Miacalcin, Miacalcin Nasal Spray, Osteocalcin, Salmonine

Pregnancy Category C (human), Pregnancy Category B (salmon)

Drug classes: Hormonal agent, Calcium regulator

Therapeutic actions
The calcitonins are polypeptide hormones secreted by the thyroid; human calcitonin is a synthetic product classified as an orphan drug; salmon calcitonin appears to be a chemically identical polypeptide but with greater potency per milligram and longer duration; inhibits bone resorption; lowers elevated serum calcium in children and patients with Paget's disease; increases the excretion of filtered phosphate, calcium, and sodium by the kidney.

Indications
• Paget's disease (human and salmon calcitonin)
• Postmenopausal osteoporosis in conjunction with adequate calcium and vitamin D intake to prevent loss of bone mass (salmon calcitonin)
• Hypercalcemia, emergency treatment (salmon calcitonin)

Contraindications
• Contraindicated with allergy to salmon calcitonin or fish products, lactation.
Adverse effects
Flushing of face or hands, rash, Nausea, vomiting, Urinary frequency (calcitonin-human), Local inflammatory reactions at injection site (salmon), nasal irritation (nasal spray)

Nursing considerations
• Give skin test to patients with any history of allergies; salmon calcitonin is a protein, and risk of allergy is significant. Observe after 15 min; the presence of a wheal or more than mild erythema indicates a positive response.
• Use reconstituted human calcitonin within 6 hr.
• Maintain parenteral calcium on standby in case of development of hypocalcemic tetany.
• Monitor serum alkaline phosphatase and urinary hydroxyproline excretion prior to therapy and during first 3 mo and q 3–6 mo during long-term therapy.
• Inject doses of more than 2 mL IM, not SC; use multiple injection sites.
• Refrigerate nasal spray until activated, then store at room temperature.