Calcitonin


Generic Medicine Info
Indications and Dosage
Intravenous
Emergency treatment of hypercalcaemia
Adult: Up to 10 u/kg in 500 mL of sodium chloride 0.9% by slow IV infusion over at least 6 hours.

Parenteral
Adjunct in hypercalcaemia
Adult: SC/IM: 4 u/kg 12 hourly, may increase after 1-2 days to 8 u/kg 12 hourly max 8 u/kg 6 hourly after 2 days. Alternatively, 100 u every 6-8 hours, increased after 1-2 days to max 400 u every 6-8 hours.

Parenteral
Paget's disease of bone
Adult: SC/IM: 50 u 3 times weekly to 100 u/day.

Parenteral
Prophylaxis of acute bone loss due to sudden immobilisation
Adult: SC/IM: 100 u/day or 50 u bid for 2-4 weeks.

Rectal
Emergency treatment of hypercalcaemia
Adult: 1 supp tid. Total daily dose: 900 u.
Renal Impairment
Dosage adjustment needed.
Contraindications
Hypersensitivity. Patients with hypocalcaemia.
Special Precautions
Skin test should be done before initiating therapy. Heart failure. Renal impairment. Pregnancy and lactation. Children.
Adverse Reactions
Endocrine disorders: Diabetogenic effect.
Gastrointestinal disorders: GI disturbances, abdominal pain.
General disorders and administration site conditions: Inj site inflammation.
Nervous system disorders: Dizziness, tingling of the hands, unpleasant taste, tremor.
Renal and urinary disorders: Urinary frequency.
Skin and subcutaneous tissue disorders: Skin rash.
Vascular disorders: Flushing.
Potentially Fatal: Anaphylactic shock.
IM/IV/Nasal/Parenteral/SC: C
Monitoring Parameters
Serum electrolytes and Ca.
Overdosage
Symptoms: Flushing, nausea, vomiting and dizziness. Management: Symptomatic and supportive treatment.
Drug Interactions
Concurrent use with cardiac glycosides (e.g. digitalis) or Ca-channel blockers requires dosage adjustments of these drugs. May decrease serum concentration of lithium.
Action
Description: Calcitonin is a polypeptide hormone produced by the ultimobranchial gland in non-mammalian vertebrates or by the mammalian thyroid parafollicular cells. It inhibits osteoclastic bone resorption and reduces bone turnover. It decreases tubular reabsorption and promotes renal excretion of Ca, Cl, Na, Mg, K and phosphate.
Pharmacokinetics:
Absorption: Rapidly inactivated (oral). Bioavailability: Approx 70% (IM/SC). Time to peak plasma concentration: 30-40 min (nasal); 15-25 min (IM).
Distribution: Volume of distribution: 0.15-0.3 L/kg. Plasma protein binding: Approx 30-40%.
Metabolism: Rapidly in the kidneys, blood and peripheral tissues.
Excretion: Urine (as inactive metabolites, and small amounts of unchanged drug). Elimination half-life: IV: Approx 70-90 min.
Chemical Structure

Chemical Structure Image
Calcitonin

Source: National Center for Biotechnology Information. PubChem Database. Calcitonin, CID=16220016, https://pubchem.ncbi.nlm.nih.gov/compound/Calcitonin (accessed on Jan. 21, 2020)

Storage
Store between 2-8°C.
ATC Classification
H05BA - Calcitonin preparations ; Used in the management of calcium homeostasis.
References
Anon. Calcitonin. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 12/08/2013.

Anon. Calcitonin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 12/08/2013.

Background Document for Meeting of Advisory Committee for Reproductive Health Drugs and Drug Safety and Risk Management Advisory Committee. U.S. FDA. https://www.fda.gov/. Accessed 05/03/2013 .

Buckingham R (ed). Calcitonins. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 12/08/2013.

Direct Healthcare Professional Communication on Calcitonin (Miacalcic) Associated with Malignancy – New Restrictions on Use and Withdrawal of the Nasal Spray from the Market.. Medicines & Healthcare products Regulatory Agency. https://www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency. Accessed 08/2012.

Disclaimer: This information is independently developed by MIMS based on Calcitonin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
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