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Calcitonin

Calcitonin is a hormone that occurs naturally in your body. It is secreted by the thyroid gland, and helps regulate your bone metabolism and the calcium levels in your body.

If you are at least five years past menopause, calcitonin medication:

  • may prevent bone loss in the hip
  • may maintain or increase bone mass in the spine
  • can decrease the risk of fractures to the spine
  • can provide some pain relief from bone pain, especially acute pain from a spinal fracture, for some people

Calcitonin medication is derived from salmon. It is available in Canada in two forms: as a nasal spray and as an injection.

Calcitonin nasal spray
Calcitonin nasal spray, available in Canada as Miacalcin®, is approved for the treatment of osteoporosis in women who have been post-menopausal for at least five years.

The dose of Miacalcin® is usually one spray (200 IUs) into one nostril per day. Women are advised to alternate nostrils from one day to the next (you might choose to spray your LEFT nostril on EVEN days of the month, and your RIGHT nostril on ODD days).

Side-effects
Possible side-effects of the nasal spray include:

  • local irritation, dryness or inflammation in the nose
  • runny nose
  • nose bleeds

Other side-effects, such as facial flushing, nausea, vomiting, chills, or skin and other allergic reactions, are rare.

How to use it
Bottles of calcitonin nasal spray should be stored in the fridge before use. Women should 'prime' the pump before the first squirt is used. Each bottle contains 14 doses. It can be kept at room temperature for one month.

If you are pregnant or breastfeeding, you should not use calcitonin.

Cost
Coverage of calcitonin varies from province to province. To find out if this medication is covered in your province, click here.

Calcitonin injection
Calcitonin injection is currently not approved for the treatment of osteoporosis but is sometimes prescribed for people who have fractures of the vertebrae, mainly to relieve pain.

If your doctor recommends an injection, he or she will give you a test dose first to check for an allergic reaction to the medication.

Treatment usually includes injections for three to five days in a row, initially, followed by maintenance therapy three times a week, for up to about six months. Long-term use may decrease the medication’s effectiveness.

Side-effects
Possible side-effects of the injection include:

  • local pain or irritation at the site of the injection
  • flushing of the face and hands
  • nausea and/or vomiting
  • chills
  • frequent urination or increased number of bowel movements
  • skin rash and allergic reactions (rare)

These side-effects are temporary and may decrease with a lower dose.

 

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Treatment

Bisphosphonates (BPs)

Selective estrogen receptor modulators (SERMs)

Hormone therapy (HT)

Calcitonin

Parathyroid hormone

Other medications

Monitoring treatment response

  • A publication of:
  • Women's College Hospital