Calcitonin (Cibacalcin) is an hormonal agent indicated for patients with Paget’s disease.
(kal si toe’ nin)
calcitonin, human
Cibacalcin
calcitonin, salmon
Calcimar, Caltine (CAN), Miacalcin, Miacalcin Nasal Spray, Osteocalcin
Pregnancy Category C (human)
Pregnancy Category B (salmon)
Metabolism: Renal; T1/2: 43 min (salmon), 1 hr (human)
Distribution: May enter breast milk
Excretion: Urine
Generic Names & Brand Names
calcitonin(kal si toe’ nin)
calcitonin, human
Cibacalcin
calcitonin, salmon
Calcimar, Caltine (CAN), Miacalcin, Miacalcin Nasal Spray, Osteocalcin
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
- Human and salmon calcitonin: Paget’s disease
- Salmon calcitonin: Postmenopausal osteoporosis in conjunction with adequate calcium and vitamin D intake to prevent loss of bone mass
- Salmon calcitonin: Hypercalcemia, emergency treatment
Contraindications and cautions
- Contraindicated with allergy to salmon calcitonin or fish products, lactation.
- Use cautiously with renal insufficiency, osteoporosis, pernicious anemia.
Available forms
Injection (human)—1 mg/mL; injection (salmon)—200 IU/mL; nasal spray (salmon)—200 IU/actuationDosages
ADULTS
Calcitonin, human- Paget’s disease: Starting dose of 0.5 mg/day subcutaneously; some patients may respond to 0.5 mg two to three times per week or 0.25 mg/day. Severe cases may require up to 1 mg/day for 6 mo. Discontinue therapy when symptoms are relieved.
- Skin testing: 0.1 mL of a 10 IU/mL solution injected subcutaneously.
- Paget’s disease: Initial dose 100 IU/day IM or subcutaneously. For maintenance dose, 50 IU/day or every other day. Actual dose should be determined by patient response.
- Postmenopausal osteoporosis: 100 IU/day IM or subcutaneously, with supplemental calcium (calcium carbonate, 1.5 g/day) and vitamin D (400 units/day) or 200 IU intranasally daily.
- Hypercalcemia: Initial dose, 4 IU/kg q 12 hr IM or subcutaneously. If response is not satisfactory after 1–2 days, increase to 8 IU/kg q 12 hr; if response remains unsatisfactory after 2 more days, increase to 8 IU/kg q 6 hr.
PEDIATRIC PATIENTS
Safety and efficacy not established.Pharmacokinetics
Route | Onset | Peak | Duration |
IM, SC | 15 min | 16–25 min | 8–24 hr |
Nasal | Rapid | 31–39 min | 8–24 hr |
Distribution: May enter breast milk
Excretion: Urine
3 comments:
Calcitonin (salmon) is a 32-amino acid polypeptide hormone that is produced in humans primarily by the parafollicular cells (also known as C-cells) of the thyroid, Calcitonin
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