An increased incidence of pituitary adenomas has been reported in rats given synthetic salmon calcitonin for 1 year. The addition of 10 mM sodium phosphate buffer . Reduction in serum calcium concentration in patients with hypercalcemia persists for about 68 hours after single injection. 8 0 obj 1 0 obj Calcitonin salmon helps treat osteoporosis and Paget's disease of bone but does not cure them. 10 0 obj Of the 189 medications listed in AHFS Drug Information 2006 for storage in a . Has been used in the treatment of glucocorticoid-induced osteoporosis [off-label]; however, other therapies (e.g., oral bisphosphonates) are preferred. /Pattern << Use multiple sites of injection when volume >2 mL. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. endstream endobj 129 0 obj <>stream Off-label: Use is not currently included in the labeling approved by the US Food and Drug Administration. The effect of calcitonin may be monitored by measurement of suitable markers of bone remodelling, such as serum alkaline phosphatase or urinary hydroxyproline or deoxypyridinoline. endstream endobj startxref Catecholamines, glucagon, gastrin, or cholecystokinin may stimulate calcitonin secretion. The frequencies of the above listed undesirable effects are partly based on results from clinical trials with calcitonin nasal spray. Intranasal spray pumps deliver 0.09 mL of solution per actuation; each 0.09-mL spray delivers 200-unit dose. \Mu}I'wP{|vq wW7_=0Z&F0P13Mhx.='rU 8OIm0Kl{xA#{(/GOh\k j)/^z0r[q kSY+LOuC0 | Salmon calcitonin may be administered at bedtime to reduce the incidence of nausea or vomiting which may occur, especially at the initiation of therapy. Calcitonin-salmon injection is administered intramuscularly or subcutaneously. Type I, clear glass ampoule containing 1 ml of solution. 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. Nasal effects described as mild. Calcium salts, including calcium carbonate, can elevate serum calcium concentrations and antagonize the effects of the calcitonin for this condition. CAS number: 47931-85-1. Remove the unopened bottle from the refrigerator and allow the spray to reach room temperature.Remove the protective cap.To prime the pump bottle, the bottle should be held upright and the 2 side arms of the pump depressed toward the bottle until a full spray is produced. For patients using calcitonin nasal spray, provide careful instruction on storage, pump assembly, priming of pump, and administration. For the treatment of hypercalcemia, calcium supplements should be avoided. Solution for injection/infusion (injection/infusion). S . Peak effects are observed within 4 hours after parenteral administration. Calcitonin acts primarily on bone, but direct renal effects and actions on the gastrointestinal tract are also recognized. Such reactions should be differentiated from generalised or local flushing, which are common non-allergic effects of calcitonin (see section 4.8). Use of salmon calcitonin in children 0 to 18 years is therefore not recommended. Calcitonin injection is used to treat Paget's disease of the bone. Am J Health Syst Pharm. Calcitonin receptor down-regulation may also result in a reduced clinical response in a small percentage of patients following long-term therapy. We offer this Site AS IS and without any warranties. Serious allergic-type reactions such as bronchospasm, swelling of the tongue and throat, anaphylactic shock. endobj For the treatment of hypercalcemia, calcium supplements should be avoided. However, care should be exercised in patients receiving concurrent treatment with cardiac glycosides or calcium channel blocking agents. For the treatment of hypercalcemia, calcium supplements should be avoided. To comment please, Comments on Medscape are moderated and should be professional in tone and on topic. Qf Ml@DEHb!(`HPb0dFJ|yygs{. /Type /Page [27980][52559] [57624], Calcitonin-salmon should be used during pregnancy only if the potential benefit justifies the use versus potential risks to the patient or fetus. Lithium: (Moderate) Reduced serum lithium concentrations have been observed in previously stabilized patients who initiated daily calcitonin salmon subcutaneous injections for osteoporosis. Calcifediol: (Moderate) Calcitonin is given to hypercalcemic patients to reduce serum calcium concentrations. >> This has the potential to reduce the total dose delivered to the patient. Glass or hard plastic IV containers should not be used. - Treatment of hypercalcemia of malignancy. If the volume of the injection exceeds 2 mL, intramuscular injection is preferable and multiple injection sites should be used.Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit.With chronic use, ensure adequate intake of calcium and vitamin D to reduce the risk of treatment-related hypocalcemia. Treatment of Paget disease of bone. Your doctor may do a skin test before you start calcitonin salmon to make sure you do not have an allergic reaction to it. 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. endobj /F7 7 0 R Do not freeze this medicine or shake the vials. [/Pattern /DeviceRGB] Calcitonin salmon injection is also used sometimes to treat osteogenesis imperfecta. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. /CSp /DeviceRGB In severe or emergency cases, intravenous infusion with up to 10 IU/kg body weight in 500 ml 0.9% w/v sodium chloride solution may be administered over a period of at least 6 hours. Pyridoxine, Vitamin B6: (Moderate) Calcitonin is given to hypercalcemic patients to reduce serum calcium concentrations. Remaining contents should be discarded. Monitor by periodic determinations of serum alkaline phosphatase and urinary hydroxyproline excretion as well as evaluation of symptoms. A p p r o v a l : 1 9 7 5) Calcitonin salmon has same pharmacologic activity as calcitonin human, but calcitonin salmon is more potent and has longer duration of action. /CSpg /DeviceGray It may be also be taken as a subcutaneous injection. Duration of treatment should not normally exceed 3 months due to evidence of an increased risk of malignancies with long term calcitonin use. << Reporting suspected adverse reactions after authorisation of the medicinal product is important. Irrigant Sterile (Monarch Pharmaceuticals), Peg-interferon alfa-2a vial prefilled syringe, Penicillin G benzathine injection suspension, Penicillin G benzathine and penicillin G procaine injection suspension, Pneumococcal 7-valent conjugate vaccine (diphtheria CRM, Proparacaine hydrochloride ophthalmic solution, Rabies immune globulin (human) solvent/detergent treated, Tetanus immune globulin human solvent/detergent treated. Alternate nostrils daily. Miacalcin Injection is indicated for the treatment of postmenopausal osteoporosis in females greater than 5 years postmenopause with low bone mass relative to healthy premenopausal females. CONTRAINDICATIONS: Hypersensitivity to calcitonin salmon or any of the excipients. AHFS DI Essentials. There is a relationship between the subcutaneous dose of calcitonin and peak plasma concentrations. redness, swelling, or irritation at the site of injection, flushing (feeling of warmth) of the face or hands. Appropriate medical support and monitoring measures should be readily available when Miacalcin injection is administered. Miacalcin injection is indicated for the early treatment of hypercalcemic emergencies, along with other appropriate agents, when a rapid decrease in serum calcium is required, until more specific treatment of the underlying disease can be accomplished. If the solution is discolored or contains particles, do not use it, and call your pharmacist. 20 0 obj For the treatment of hypercalcemia, vitamin D preparations should be avoided. Influenza-like symptoms, oedema (facial, peripheral and generalised), injection site reaction. For the treatment of hypercalcemia, calcium supplements should be avoided. was insufficient regarding room- temperature stability and pharma- . The U.S. Pharmacopeia's definition of room temperature (20-25 C [68-77 F]) was used for this review. 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. 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. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. Early treatment of hypercalcemic emergencies (with other appropriate agents) when a rapid decrease in serum calcium concentration is required. [24558] [24298]. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Results: Of the 189 medications listed in AHFS Drug Information 2006 for storage in a. For additional instructions see sections 6.3 and 6.6. Before priming the pump and using a new bottle, allow it to reach room temperature. H\@=OQEn$dy ! .|1=( |nr]zMtxXk!:?^rt:wn/6]rO6go'c?[\B_k}.t/i-P7qSEVH*}WecH^,T\er1],9 +"2"u6-N}}\ /#ay. 150 0 obj <>stream Do not let anyone else use your medication. The dose of lithium may require adjustment. This website also contains material copyrighted by 3rd parties. 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. If the response is not satisfactory after 1 to 2 days, increase the dose to 8 International Units/kg IM or subcutaneously every 12 hours. /Parent 2 0 R Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. 2007American Society of Health-System Pharmacists. Single doses (up to 10,000 IU) of injectable salmon calcitonin have been administered without adverse reactions, other than nausea and vomiting, and exacerbation of pharmacological effects. Calcitonin has not been studied in pregnant women. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. 16 0 obj Skin Testing prior to treatment:In patients with a suspected sensitivity to salmon calcitonin, a skin test using a diluted injection concentration should be performed.A detailed skin testing protocol is available from the manufacturer's product safety department. The result is a decrease in urinary calcium. Correct hypocalcemia and any other disorders affecting mineral metabolism (e.g., vitamin D deficiency) before administration of calcitonin. Calcium salts, including calcium carbonate, can elevate serum calcium concentrations and antagonize the effects of the calcitonin for this condition. It is not known if the substance is excreted in human milk. 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. Does not create a doctor / patient relationship the tongue and throat anaphylactic..., swelling of the 189 medications listed in AHFS Drug Information 2006 storage... Priming the pump and using a new bottle, allow it to room. 150 0 obj < > stream do not have an allergic reaction it. Be exercised in patients receiving concurrent treatment with cardiac glycosides or calcium channel blocking.... 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