Calcitonin (Injection)

Although manufactured in the body by the thyroid gland, there is sometimes a deficiency of natural calcitonin in the body, and that makes it beneficial to ingest additional calcitonin.

Overview

The main area of focus for calcitonin is in the bones of the body, which should be strengthened by the drug. It accomplishes this strengthening by lowering the levels of calcium and phosphate in the bloodstream, so that more of those two minerals eventually get deposited in the bones. In medical terms, it binds to a specific receptor on certain osteoclasts, thereby inhibiting their actions, and also inhibiting calcium resorption. It also decreases resorption of calcium and phosphate in the kidneys, so that its overall effect is to decrease the concentration level of plasma calcium.

When manufactured calcitonin (as opposed to the naturally-produced calcitonin in the body), is used in the treatment of medical conditions, it must be injected into the muscles of the body, so that it can work to decrease the level of calcium in the blood. Some good examples of medical conditions which are treatable with calcitonin are Paget's disease of the bones, hypercalcemia (a condition characterized by dangerously high levels of calcium in the blood), and osteoporosis, most commonly occurring in postmenopausal women.

Condition Treated

  • Bone cancer, Osteoporosis, Paget's Disease, Hypercalcemia

Type of Medicine

  • Polypeptide hormone naturally-occurring in the body, also manufactured as a medication

Side Effects

While there are many desirable effects that calcitonin (brand name Miacalcin) brings about in the body, there is also a possibility that some unwanted side effects could accompany these benefits. One fairly common side effect reported by patients using calcitonin is an increased incidence of pain in the bones during the initial months of treatment with the medication. This should not be considered a sign that the medication is not working properly, but is instead simply a by-product of its activity within the body.

One of the most dangerous potential side effects of using calcitonin is when someone has an allergic reaction to it. As with any other kind of allergic reaction, for instance those involving pets, foods, or other substances, the side effects of an allergic reaction can be very dangerous for an individual who doesn't immediately receive treatment. Some of the most common side effects of an allergic reaction are swelling in the area around the face, tongue, throat, or lips. Some people also break out in hives, or suddenly develop extreme difficulty with breathing – if any of these symptoms occur after ingesting calcitonin, you should immediately seek medical attention, because the potential exists for them to worsen.

There are several other side effects which are considered moderately serious, and for which you should immediately contact your doctor if they should be manifested in your own case. These more serious side effects include the following:

  • irregular heartbeat which may be considerably faster or slower than normal
  • muscle tightness or contraction
  • hypersensitivity in the reflexes
  • tingly sensation in the area around the mouth
  • numbness in the facial area.

Some other fairly common side effects which might occur when taking calcitonin, but which are not considered to be serious in nature are:

  • swelling at the site of injection
  • nausea or vomiting
  • becoming flushed and exhibiting redness, experiencing tingly sensations around the body, or unusual warmth around the body.

Dosage

One of the primary methods by which calcitonin is introduced into the body is by injection. When it is injected, calcitonin must be delivered subcutaneously, or directly into a major muscle group, where it can be easily absorbed.

Patients who are being treated for Paget's disease or postmenopausal osteoporosis should generally receive 100 units per day, which would be injected into muscle, or at a location under the skin. For patients being treated for hypercalcemia, between four and eight units per kilogram of injectable calcitonin should be administered at 6 to 12-hour intervals, in accordance with your doctor's instructions.

In some cases, patients will be recommended to self-administer the injectable form of calcitonin at home. If this is true in your case, your physician will thoroughly instruct you about how to self-administer the medication, and you should be sure that you thoroughly understand everything about the process before attempting it at home.

You should also have an understanding of how to properly dispose of needles and syringes which have been previously used. Disposable needles are intended for single usage, and should be discarded immediately afterward. Most states or local governments have laws dictating how used needles and syringes are to be handled, so you should educate yourself about this process as well.

It's advisable to procure a ‘sharps' disposal container, which is puncture-proof and is considered a safe repository for used needles and syringes. If you're unsure about where to get these and how to use them, consult your pharmacist for information. Obviously, your ‘sharps' container with used needles and syringes should be kept completely away from children and pets, so there is no danger of some kind of accident occurring.

In order to get the greatest benefit from using calcitonin, you should use it regularly at the precise dosage prescribed by your doctor, and the dosage should be administered at the same time every day, so that your body can become acclimated to the routine.

Interactions

It is possible when taking calcitonin to experience a loss of concentration or alertness, and for this reason, you should not drive a motor vehicle, operate heavy machinery, or do other tasks which require alertness on your part. Because the medication affects people differently, it cannot be stated with certainty whether you may experience any such indications as these yourself. If you do observe a loss of focus when taking calcitonin, you should discuss this situation with your doctor, so that adjustments might be made in your dosage schedule, especially when you're working.

Various other drugs may have an interaction with calcitonin, so you should consult with your family doctor to determine if anything you are now taking may be affected. Before starting a program of treatment which includes calcitonin, you should prepare a list of all the over the counter medications you are currently using, as well as all other prescription medications, herbal supplements, and vitamins, as well as the dosage amounts for each one of these.

This list can be very handy to have for other reasons as well. If you should have to make an unplanned visit to a health clinic or an emergency room to deal with some medical condition, the doctor there will need to know about all your other medications, so that safe and adequate treatment may be delivered during your emergency visit.

Combining calcitonin with lithium may reduce the effectiveness of the lithium medication, because the calcitonin may encourage greater passing of the lithium through urination. If you are taking lithium for any medical condition, your doctor may want to increase your dosage to compensate for the amount being lost through urination.

Warnings

One of the most serious warnings that should be observed about using calcitonin is its potential for producing an allergic reaction in patients, and if you should observe any of the traditional symptoms of an allergic reaction (swelling of tongue, throat, lips, or face), you should stop taking the medication immediately and get emergency assistance.

Since calcitonin is often used as an injectable medication, there are cautions to be observed when the medication is self-administered, by a non-professional person. A thorough understanding of the process is necessary, as well as some prior practice on a dummy patient, before attempting this at home. When injections are delivered either subcutaneously or into a major muscle group, the injection site should be carefully monitored over time, to determine whether any adverse reactions are in progress. If so, these should be reported immediately to your doctor.

When calcitonin is being used as part of an overall treatment program for high blood levels of calcium or low bone levels of calcium, your doctor may want to couple your treatment with additional levels of calcium or phosphorus, to increase the effective ness of treatment.

There have not been any major studies conducted about the impact of taking calcitonin during pregnancy, which means it is not known whether or not there are any dangers associated with becoming pregnant while being treated. For this reason, it is best to avoid becoming pregnant while taking calcitonin, or at the very least, the situation should be discussed with your primary care physician so that a determination can be made about the relative benefits to be gained vs. the risks which might be involved.

It is also not known whether or not calcitonin can be passed through breast milk to an infant, nor whether it would have any impact on an infant if it were to be ingested. Therefore, this is another area which should be discussed with your doctor, if you are currently breast-feeding or plan to in the near future.

There have been reports of serious hypersensitivity when using either the injectable form of calcitonin, or the nasal spray. In some of these cases, there have been milder reactions such as swelling in various locations around the body, but there have also been some more severe reactions such as bronchospasms, anaphylaxis, and anaphylactic shock. There have even been some rare reports of fatalities due to anaphylactic shock when taking calcitonin.

Any patients who are considered to be potential candidates for a hypersensitive reaction should be skin-tested prior to embarking on a treatment program which includes calcitonin. By making a tiny, localized introduction of calcitonin into an area of the skin, any reactions can be gauged and assessed prior to recommending any kind of calcitonin treatment.

Storage

Injectable calcitonin must be stored in a refrigerator, which is maintained at between 36 degrees and 46 degrees Fahrenheit, to prevent degradation of the medication. This will generally be done at a doctor's office or at a clinic somewhere, to ensure that proper storage methods are being observed. In some cases however, your doctor may allow you to store your calcitonin at home in a refrigerated environment.

When calcitonin is stored at a patient's home though, it must be kept out of the reach of children who might be curious about it, and accidentally ingest it. There should be some safeguards used to guarantee that children cannot access calcitonin being stored in the family refrigerator, because they might mistake it for a potable fluid which can be ingested by anyone.

If you intend to discard any unused calcitonin, it should be disposed of in a safe and proper manner, according to your physician's instructions, or according to instructions from a pharmacist. Lacking either of these, there is a website maintained by the FDA which details how a great many medications can safely be disposed of. This website should be consulted to determine the safest way to dispose of any unused calcitonin you might have.

Summary

Calcitonin in its man-made state is often referred to as calcitonin-salmon, and is an artificial version of a hormone which is naturally produced in the thyroid gland of the body. When there is hyperactivity of the parathyroid gland and excess parathyroid hormone (PTH) is produced, additional calcitonin is needed to counteract the PTH excess.

The medication is used in the treatment of Paget's bone disease, hypercalcemia, osteoporosis, and sometimes in cancers affecting the bones of the body. Calcitonin works by reducing the level of calcium in the bloodstream, and encouraging greater deposition of calcium in the bones of the body, where it is needed.

It has relatively few side effects and most of these are not considered to be dangerous, unless a patient turns out to be allergic to calcitonin-salmon. The medication is often administered to patients by injection, although the delivery method chosen will generally depend on the specific medical condition being treated.

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Last Reviewed:
December 23, 2017
Last Updated:
April 02, 2018