HomeFactsCalcitonin Nasal Spray For Pain

Calcitonin Nasal Spray For Pain

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How Does This Medication Work What Will It Do For Me

Calcitonin for bone disorders || Osteoporosis & Paget’s disease

Calcitonin salmon nasal spray is no longer being manufactured for sale in Canada. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

Calcitonin salmon nasal spray belongs to the group of medications called bone metabolism regulators. It is used to treat osteoporosis for women who are more than 5 years past menopause.

Calcitonin is a hormone that occurs naturally in the human body. Calcitonin salmon is similar to human calcitonin hormone in many ways, but is longer-acting and more potent than human calcitonin. Calcitonin salmon is not derived from salmon, but is a man-made version of calcitonin produced by salmon. Calcitonin salmon nasal spray works by reducing the rate of bone breakdown caused by cells in the bone called osteoclasts and may encourage cells called osteoblasts to build up the bones. This increases the density of bone in the lower spine.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

What Should I Watch For While Using This Medicine

Visit your doctor or health care professional for regular checks on your progress. Your doctor will need to exam the inside of your nose before you start using the medicine and periodically during use.

Talk to your doctor about your risk of cancer. You may be more at risk for certain types of cancers if you take this medicine.

Be sure that you get at least 1000 mg of calcium and 400 I.U. of vitamin D while you are taking this medicine. This will help the medicine work better. Ask your doctor or health care provider for good nutrition advice.

What Form Does This Medication Come In

Apo-Calcitonin is no longer being manufactured for sale in Canada. For brands that may still be available, search under calcitonin salmon nasal spray. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

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What Should I Discuss With My Healthcare Provider Before Using Calcitonin Nasal

You should not use this medicine if you are allergic to salmon calcitonin.

To make sure calcitonin nasal is safe for you, tell your doctor if you have:

  • high levels of calcium in your blood or
  • any nasal or sinus problems such as nasal deformities, a chronic infection, or nasal pain.

Using calcitonin nasal may increase your risk of developing certain types of cancer. Ask your doctor about your specific risk.

FDA pregnancy category C. It is not known whether calcitonin nasal will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

It is not known whether calcitonin nasal passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

What Are Some Side Effects That I Need To Call My Doctor About Right Away

Calcitonin Nasal Spray For Pain

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash hives itching red, swollen, blistered, or peeling skin with or without fever wheezing tightness in the chest or throat trouble breathing, swallowing, or talking unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of low calcium levels like muscle cramps or spasms, numbness and tingling, or seizures.
  • Chest pain or pressure or a fast heartbeat.
  • Dizziness or passing out.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

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How Should I Use This Medicine

This medicine is only for use in the nose. Do not take by mouth. Follow the directions on your prescription label. Alternate nostrils daily. Do not use more often than directed. Make sure that you are using your nasal spray correctly. Ask you doctor or health care provider if you have any questions.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

Efficacy Of Calcitonin For Treating Acute Pain Associated With Osteoporotic Vertebral Compression Fracture: An Updated Systematic Review

Published online by Cambridge University Press: 19 March 2020

Cumming School of Medicine, University of Calgary, Alberta, Canada
Brianna Rosgen
Cumming School of Medicine, University of Calgary, Alberta, Canada
Eddy Lang*
Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada
*
Correspondence to: Dr. Eddy Lang, Department of Emergency Medicine RGH, Holy Cross Ambulatory Care Centre, 7007 14th Street SW, Room 5A105, Calgary, Alberta, CanadaT2V 1P0 Email:

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What Side Effects May I Notice From Receiving This Medicine

Side effects that you should report to your doctor or health care professional as soon as possible:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • breathing problems
  • runny, stuffy, or irritated nose

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What Should I Know About Storage And Disposal Of This Medication

Pharmacology- Calcitonin MADE EASY!

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store unopened calcitonin salmon nasal spray in the refrigerator do not freeze. Store opened bottles at room temperature in an upright position. Replace the plastic cover to keep the nozzle clean. Opened calcitonin salmon stored at room temperature should be disposed of after 35 days.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.

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Carcinogenesis Mutagenesis Impairment Of Fertility

CarcinogenicityThe incidence of pituitary adenomas was increased in rats after one and two years of subcutaneous exposure to synthetic calcitonin salmon. The significance of this finding to humans is unknown because pituitary adenomas are very common in rats as they age, the pituitary adenomas did not transform into metastatic tumors, there were no other clear treatment-related neoplasms, and synthetic calcitonin salmon related neoplasms were not observed in mice after two years of dosing.

Mouse findingsNo carcinogenicity potential was evident in male or female mice dosed subcutaneously for two years with synthetic calcitonin salmon at doses up to 800 International Units/kg/day. The 800 International Units/kg/day dose is approximately 390 times the maximum recommended intranasal dose in humans based on scaling for body surface area and a 20-fold conversion factor to account for low clinical exposure via the intranasal route.

MutagenesisSynthetic calcitonin salmon tested negative for mutagenicity using Salmonella typhimurium and Escherichia coli , with and without rat liver metabolic activation, and was not clastogenic in a chromosome aberration test in Chinese Hamster V79 cells. There was no evidence that calcitonin salmon was clastogenic in the in vivo mouse micronucleus test.

FertilityEffects of calcitonin salmon on fertility have not been assessed in animals.

How Supplied/storage And Handling

How SuppliedCalcitonin Salmon Nasal Spray is available as a metered dose clear solution in a 2 mL or 3.7 mL fill clear glass bottle that contains 2,200 USP Calcitonin Salmon Units calcitonin salmon per mL. A pump is attached to the bottle. After priming, the pump will deliver 200 USP Calcitonin Salmon Units per activation .

Storage and HandlingStore unopened bottle in refrigerator between 2°C to 8°C . Protect from freezing.

Store bottle in use at room temperature between 20°C to 25°C in an upright position, for up to 30 days or 35 days . Each bottle contains at least 14 doses or 30 doses .

Discard bottle after 14 doses or 30 doses .

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Before Taking This Medicine

You should not use calcitonin nasal if you are allergic to salmon calcitonin.

To make sure calcitonin nasal is safe for you, tell your doctor if you have:

  • high levels of calcium in your blood or

  • any nasal or sinus problems such as nasal deformities, a chronic infection, or nasal pain.

Using calcitonin nasal may increase your risk of developing certain types of cancer. Ask your doctor about your specific risk.

FDA pregnancy category C. It is not known whether calcitonin nasal will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

It is not known whether calcitonin nasal passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Why Is This Medication Prescribed

Calcode Calcitonin Salmon Nasal Spray, For Intranasal, Medicine Grade ...

Calcitonin salmon is used to treat osteoporosis in women who are at least 5 years past menopause and cannot or do not want to take estrogen products. Osteoporosis is a disease that causes bones to weaken and break more easily. Calcitonin is a human hormone that is also found in salmon. It works by preventing bone breakdown and increasing bone density .

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Pain Killing With Calcitonin Nasal Spray In Patients With Malignant Tumors

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Usual Adult Dose For Hypercalcemia

Initial dose: 4 International Units/kg subcutaneously or IM every 12 hours

  • For unsatisfactory response after 1 or 2 days, increase to 8 International Units/kg subcutaneously or IM every 12 hours
  • For unsatisfactory response after 2 or more days, may increase to 8 International Units/kg subcutaneously or IM every 6 hours

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What Are Some Things I Need To Know Or Do While I Take Calcitonin Nasal Spray

  • Tell all of your health care providers that you take calcitonin nasal spray. This includes your doctors, nurses, pharmacists, and dentists.
  • Very bad and sometimes deadly allergic side effects have rarely happened. Talk with your doctor.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • Have your urine checked as you have been told by your doctor.
  • Take calcium and vitamin D as you were told by your doctor.
  • This medicine may add to the chance of getting some types of cancer. Talk with the doctor.
  • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.
  • If you are 65 or older, use calcitonin nasal spray with care. You could have more side effects.

Calcitonin Used To Treat Metastatic Bone Pain

Board-Osteoporosis 6: Calcitonin-Salmon ( Miacalcic) & Raloxifene ( Evista )

People who have cancer which has spread to their bones and the nerves adjacent to the bones often suffer severe pain. There are several treatments to help relieve this pain: radiotherapy, analgesic drugs such as opioids, and bone-modulating drugs such as bisphosphonates and calcitonin. Calcitonin has the potential to relieve pain and maintain bone strength, thus reducing the risk of broken bones. This review looked at the effectiveness of calcitonin for controlling pain from bone metastases. However, only two studies were found with very low quality evidence to support the use of calcitonin for patients suffering from bone pain. We updated the review in 2015 and did not find any more studies. There were slightly more side effects for the patients given calcitonin. Unless new studies provide additional relevant information about this treatment, other therapeutic approaches should be considered.

Current available research evidence is of very low quality and there is a lack of evidence to support the use of calcitonin for managing bone pain from bone metastases. Since the last version of this review, we did not identify any additional studies.

We updated the electronic searches in the Cochrane Central Register of Controlled Trials , MEDLINE and EMBASE up to February 2015. We also searched registers of clinical trials in progress up to February 2015.

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Precautions While Using Calcitonin

It is very important that your doctor check your progress at regular visits to make sure that calcitonin is working properly. Blood and urine tests may be needed to check for unwanted effects. Your doctor may also want to check your nose before and during treatment with calcitonin.

Your doctor might give you an allergy skin test to see if you are allergic to calcitonin before using calcitonin.

Calcitonin may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. The most serious signs of this reaction are rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using calcitonin. If these side effects occur, get emergency help at once.

Calcitonin can lower your calcium levels in the blood . Check with your doctor right away if you have abdominal or stomach cramps, confusion, convulsions, difficulty breathing, mood or mental changes, muscle cramps in hands, arms, feet, legs, or face, or numbness and tingling around the mouth, fingertips, or feet.

Calcitonin may cause irritation in the nose that can be painful and serious. Check with your doctor right away if you have more than one of the following symptoms: sneezing, runny or stuffy nose, shortness of breath, troubled breathing, or heavy nosebleeds.

Calcitonin may increase your risk of having cancer. Talk to your doctor if you have concerns about this risk.

What May Interact With This Medicine

  • prior bone scan with diphosphonate in patient with Paget’s disease

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

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How Should I Use Calcitonin Nasal

To make sure you are not allergic to calcitonin, your doctor may perform an allergy skin test before your first dose of this medicine.

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Calcitonin nasal comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Store unopened calcitonin nasal in the refrigerator but do not allow it to freeze.

Once you put the bottle and pump assembly together, you may keep the medicine at room temperature, away from light and heat. Store the bottle upright with the pump attached.

Before your first use of the assembled bottle and pump, you must prime the spray. Allow the medicine to reach room temperature before priming.

To prime calcitonin nasal, press the pump at least 5 times until a fine mist appears. Prime the spray only before your first use of the newly assembled bottle.

To use the nasal spray:

Calcitonin nasal is usually given as one spray per day into only one of your nostrils. Use the other nostril the next day and continue alternating back and forth for each daily dose.

Calcitonin nasal spray delivers a fine mist into the nose. Even if you do not feel the spray while using it, the medication is still being absorbed by your nasal passages.

Report Problems To The Food And Drug Administration

Calcitonin Nasal Spray, Packaging Size: 1 Ml, 200 I.u

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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