0 Victor Cohen,1,2 Samantha P. Jellinek,1 Leftherios Teperikidis,1 Elliot Berkovits,1 William M. Goldman 1,2 1Maimonides Medical Center, Brooklyn, NY 2Long Island University, Brooklyn, NY. . Although smaller ulcers often heal without withdrawal of calcitonin nasal spray, the medication should be discontinued temporarily until healing occurs. Treatment of postmenopausal osteoporosis in women >5 years postmenopause. Experience with calcitonin in children with juvenile Paget disease is very limited; the relationship between this disorder and adult Paget disease is not established. Appropriate agents for treatment of hypersensitivity reactions should be readily available. Data are inadequate to support use of calcitonin in children. Store calcitonin salmon injection in its original container in the refrigerator. Results: Of the 189 medications listed in AHFS Drug Information 2006 for storage in a. Pyridoxine, Vitamin B6: (Moderate) Calcitonin is given to hypercalcemic patients to reduce serum calcium concentrations. Calcium salts, including calcium carbonate, can elevate serum calcium concentrations and antagonize the effects of the calcitonin for this condition. 285.599999 0] Following IM administration, calcitonin is absorbed directly into the systemic circulation and the onset of action begins within 15 minutes. Known hypersensitivity to calcitonin salmon. Calcitonin should be used during pregnancy only if treatment is considered absolutely essential by the physician. Copyright, 2023. redness, swelling, or irritation at the site of injection, flushing (feeling of warmth) of the face or hands. It is best to change which nostril you use each day. 100 International Units IM or subcutaneously once daily. For the treatment of osteoporosis adequate intake of calcium salts are necessary in conjunction with calcitonin. Use multiple sites of injection when volume >2 mL. Resume the regular dosing schedule at the beginning of the next week. What special precautions should I follow? Discard the bottle after 30 doses. The reported overall incidence of new primary malignancy was higher among calcitonin-salmon-treated patients (4.1%) compared with placebo-treated patients (2.9%) in a meta-analysis of 21 randomized, controlled clinical trials with calcitonin-salmon (nasal spray or investigational oral formulations). Do not use more or less of it or use it more often than prescribed by your doctor. Allergic-type reactions also reported in patients receiving calcitonin nasal spray. When studied in rabbits, salmon calcitonin-salmon decreased fetal birth weights when given by subcutaneous injection in doses 4 to 18 times the recommended human parenteral dose and 70 to 278 times the recommended human intranasal dose (based on body surface area). 14 0 obj low levels of calcium in your blood--numbness or tingly feeling around your mouth, fast or slow heart rate, muscle tightness or contraction, overactive reflexes. Although calcitonin may help relieve acute back pain associated with a recent osteoporotic vertebral compression fracture, one metanalysis found that there is no sufficient data for effectiveness against chronic pain associated with older vertebral fracture. Prepared synthetically or using recombinant DNA technology; contains the 32 amino acids in the same linear sequence as occurs in natural calcitonin of salmon origin. The information for 34 of these medications (38%) was obtained from the official prescribing information. The U.S. Pharmacopeia's definition of room temperature (20-25 C [68-77 F]) was used for this review. - Prevention of acute bone loss due to sudden immobilisation such as in patients with recent osteoporotic fractures. In the kidney, calcitonin increases the excretion of filtered phosphate, calcium, and sodium by decreasing their tubular reabsorption. new primary malignancy / Delayed / 4.1-4.1bronchospasm / Rapid / 1.0-3.0stroke / Early / 0-1.0myocardial infarction / Delayed / 0-1.0hearing loss / Delayed / 0-1.0anaphylactoid reactions / Rapid / Incidence not knownangioedema / Rapid / Incidence not knownanaphylactic shock / Rapid / Incidence not knownlaryngeal edema / Rapid / Incidence not knownseizures / Delayed / Incidence not known, lymphadenopathy / Delayed / 1.0-3.0constipation / Delayed / 1.0-3.0depression / Delayed / 1.0-3.0hypertension / Early / 1.0-3.0angina / Early / 1.0-3.0cystitis / Delayed / 0-3.0conjunctivitis / Delayed / 1.0-3.0skin ulcer / Delayed / 0-1.0anemia / Delayed / 0-1.0dyspnea / Early / 0-1.0gastritis / Delayed / 0-1.0migraine / Early / 0-1.0palpitations / Early / 0-1.0sinus tachycardia / Rapid / 0-1.0bundle-branch block / Early / 0-1.0phlebitis / Rapid / 0-1.0cholelithiasis / Delayed / 0-1.0hepatitis / Delayed / 0-1.0hyperthyroidism / Delayed / 0-1.0goiter / Delayed / 0-1.0nephrolithiasis / Delayed / 0-1.0hematuria / Delayed / 0-1.0peripheral edema / Delayed / 0-1.0edema / Delayed / 0-1.0blurred vision / Early / 0-1.0antibody formation / Delayed / 10.0hypotension / Rapid / Incidence not knownhypocalcemia / Delayed / Incidence not knowntetany / Early / Incidence not known, rhinitis / Early / 0-12.0injection site reaction / Rapid / 10.0-10.0vomiting / Early / 1.8-10.0nausea / Early / 1.8-10.0flushing / Rapid / 0-5.0back pain / Delayed / 5.0-5.0arthralgia / Delayed / 3.8-3.8epistaxis / Delayed / 3.5-3.5headache / Early / 3.2-3.2rash / Early / 1.0-3.0infection / Delayed / 1.0-3.0sinusitis / Delayed / 1.0-3.0diarrhea / Early / 1.0-3.0abdominal pain / Early / 1.0-3.0dyspepsia / Early / 1.0-3.0dizziness / Early / 1.0-3.0paresthesias / Delayed / 1.0-3.0myalgia / Early / 1.0-3.0fatigue / Early / 1.0-3.0lacrimation / Early / 1.0-3.0alopecia / Delayed / 0-1.0pruritus / Rapid / 0-1.0parosmia / Delayed / 0-1.0nasal congestion / Early / 0-1.0sneezing / Early / 0-1.0cough / Delayed / 0-1.0pharyngitis / Delayed / 0-1.0appetite stimulation / Delayed / 0-1.0flatulence / Early / 0-1.0dysgeusia / Early / 0-1.0xerostomia / Early / 0-1.0weight gain / Delayed / 0-1.0agitation / Early / 0-1.0insomnia / Early / 0-1.0anorexia / Delayed / 0-1.0anxiety / Delayed / 0-1.0vertigo / Early / 0-1.0tremor / Early / 0-1.0diaphoresis / Early / 0-1.0fever / Early / 0-1.0tinnitus / Delayed / 0-1.0otalgia / Early / 0-1.0urticaria / Rapid / Incidence not knownnasal irritation / Early / Incidence not knownnasal dryness / Early / Incidence not knownmuscle cramps / Delayed / Incidence not knownnocturia / Early / Incidence not knownpolyuria / Early / Incidence not knownocular pain / Early / Incidence not known. 610.079999 0] This has the potential to reduce the total dose delivered to the patient. Store in a refrigerator (2C-8C). Brand names: Fortical, Miacalcin For the treatment of osteoporosis adequate intake of vitamin D is necessary in conjunction with calcitonin. The recommended dosage is 100 IU per day administered subcutaneously or intramuscularly, however, a minimum dosage regimen of 50 IU three times a week has achieved clinical and biochemical improvement. Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed. You've successfully added to your alerts. The evidence of efficacy for calcitonin salmon injection is based on increases in total body calcium observed in clinical trials. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. H\@=OQEn$dy ! .|1=( |nr]zMtxXk!:?^rt:wn/6]rO6go'c?[\B_k}.t/i-P7qSEVH*}WecH^,T\er1],9 +"2"u6-N}}\ /#ay. [62369] The developmental and health benefits of breast-feeding should be considered along with the mother's clinical need for calcitonin and any potential adverse effects on the breast-fed infant from calcitonin or the underlying maternal condition. Calcitonin markedly reduces bone turnover in conditions with an increased rate of bone resorption such as Paget's disease and acute bone loss due to sudden immobilisation. 9 0 obj /PCSp 4 0 R For the treatment of hypercalcemia, calcium supplements should be avoided. Salmon calcitonin is rapidly absorbed. Calcium Carbonate: (Moderate) Calcitonin is given to hypercalcemic patients to reduce serum calcium concentrations. Calcium: (Moderate) Calcitonin is given to hypercalcemic patients to reduce serum calcium concentrations. For the treatment of hypercalcemia, calcium supplements should be avoided. \Mu}I'wP{|vq wW7_=0Z&F0P13Mhx.='rU 8OIm0Kl{xA#{(/GOh\k j)/^z0r[q kSY+LOuC0 | An increase in serum calcium concentrations helps to reduce bone resorption and loss of bone mass, and offsets the effect of calcitonin in lowering serum calcium levels. Cite this: Room-temperature Storage of Medications Labeled for Refrigeration-Medscape-Aug01,2007. For the treatment of hypercalcemia, calcium supplements should be avoided. Miacalcin Injection should be reserved for patients who refuse or cannot tolerate estrogens or in whom estrogens are contraindicated. 310.559999 0] Vitamin D analogs can elevate serum calcium concentrations and antagonize the effects of the calcitonin for this condition. %PDF-1.6 % Generic alternatives may be available. [63474] Calcitonin should be used only in patients who do not respond to alternative treatments or for whom such treatments are not suitable (e.g., patients for whom other therapies are contraindicated or for patients who are intolerant or unwilling to use other therapies).[52559]. Catecholamines, glucagon, gastrin, or cholecystokinin may stimulate calcitonin secretion. To comment please, Comments on Medscape are moderated and should be professional in tone and on topic. endobj Compared to younger adults, the incidence of nasal adverse events (rhinitis, irritation, erythema, and excoriation) was higher in patients over 65 years of age, particularly those over the age of 75 years. 1 0 obj Room-temperature storage of medications labeled for refrigeration | American Journal of Health-System Pharmacy | Oxford Academic Abstract. Because it is a large peptide, any systemic absorption by the infant is unlikely because it is probably destroyed in the infant's gastrointestinal tract. Miacalcinbottle in use: 1530C, in upright position for up to 35 days. Written by ASHP. M I A C A L C I N \( c a l c i t o n i n s a l m o n \) i n j e c t i o n , s y n t h e t i c , f o r s u b c u t a n e o u s o r i n t r a m u s c u l a r u s e I n i t i a l U . /Font << With IM or sub-Q administration, 824 hours. Stability: Salmon calcitonin: Injection: Store under refrigeration at 2C to 6C/36F to 43F; . Directly inhibits osteoclastic bone resorption, altering the function and/or number of osteoclasts. Each bottle contains at least 30 doses. /Filter /FlateDecode Otherwise, skip the missed dose and continue the regular dosing schedule the next day. The usual provisions should be made for emergency treatment if such a reaction occurs. Subcutaneous administration is preferred for outpatient self-administration.If calcitonin is to be self-administered, instruct the patient and/or caregiver on aseptic technique and the proper subcutaneous injection technique.Inject subcutaneously taking care not to inject intradermally.Rotate injection sites.Dispose of the used syringe and needle in an FDA-cleared sharps disposal container after use. Human calcitonin: Store at <25C/77F and protect from light Mechanism of Action: Remaining contents should be discarded. Hypersensitivity to calcitonin salmon or any of the excipients. Calcitonin 50 IU/ml solution for injection and infusion. Am J Health Syst Pharm. For the treatment of osteoporosis adequate intake of calcium salts are necessary in conjunction with calcitonin. MIACALCIN (calcitonin salmon) injection, solution. >> The recommended treatment duration is 2 weeks and should not exceed 4 weeks in any case due to the association of the increased risk of malignancies and long term calcitonin use. Pharmacotherapeutic group: antiparathyroid hormone, ATC code: H05BA01 (calcitonin, salmon, synthetic). Such reactions should be differentiated from generalised or local flushing, which are common non-allergic effects of calcitonin (see section 4.8). Am J Health Syst Pharm. related compound B (calcitonin salmon-glycine) are 110-115 in an air oven. These trials demonstrated an increase in the absolute risk of cancer occurrence for patients treated with calcitonin compared to placebo which varied between 0.7% and 2.4% with long term therapy. AHFS DI Essentials. Vitamin D analogs can elevate serum calcium concentrations and antagonize the effects of the calcitonin for this condition. Conventional long-term toxicity, reproduction, mutagenicity and carcinogenicity studies have been performed in laboratory animals. Safety and efficacy have not been established. This branded product is no longer on the market. Calcitonin has not been studied in pregnant women. /Producer ( w k h t m l t o p d f) Instruct patients to seek medical care if symptoms of hypocalcemia develop. elicited after each injection of calcitonin during chronic therapy has not been investigated. Do not let anyone else use your medication. It works by preventing bone breakdown and increasing bone density (thickness).
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