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Used for treating established postmenopausal osteoporosis as well as hypercalcemia secondary to hyperparathyroidism, and pagets disease
Medication NamesPrototye Med | calcitonin-salmon (Miacalcin, Calcimar) |
Drug Class: Hypocalcemic
Action: decrease bone resorption, inhibits the action of osteoclasts and increases excretion of calcium Therapeutic UseTreatment of postmenopausal osteoporosis | Hypercalcemia secondary to hyperparathyroidism | Paget’s disease |
Adverse EffectsNasal dryness and irritation with intranasal calcitonin | Hypersensitivity reactions/ anaphylaxis | Hypocalcemia | Decrease in therapeutic effects over time | Nasal form of calcitonin may cause nasal dryness and irritation as well as headaches and epistaxis | Injectable form may cause injection site reaction, nausea and vomiting and polyuria. |
Nursing InterventionsWhen administering intranasal calcitonin | Alternate nostril used daily. | | | Assess prior to administration for irritation/ulceration. | Prior to beginning therapy | Perform intradermal allergy test. | | | Development of erythema within 15 minutes indicates sensitivity. | Have epinephrine 1:1000, antihistamines, and oxygen available during early therapy | Monitor for hypocalcemia (serum calcium level, muscle spasms, tingling of fingers and toes). | Provide diet high in calcium and vitamin D. |
AdministrationIntranasal spray | Hold nasal pump upright. | | | If using pump for the first time, prime pump according to manufacturer’s instructions. | | | Spray once in nostril opposite of previous instillation | Intramuscular/Subcutaneous | Rotate injection sites. | | | Subcutaneous is preferred route - Administer IM if dose more than 2 ml | | | Protect from light. | | | Keep calcitonin salmon refrigerated. |
| | Patient EducationFor intranasal calcitonin, instruct clients to | Alternate nostril used daily. | | | Report nasal irritation or bleeding. | Instruct clients to immediately notify provider if rash or itching occurs. | Instruct clients to do the following for 30 minutes after taking drug: report changes in swallowing or vision to provider | Notify provider of muscle spasms, tingling of fingers and toes. | | | Eat a diet high in calcium and vitamin D. | Monitor for loss of effect after a year or more of use through regular bone density studies |
ContraindicationsdicationsAllergy to salmon | Prior treatment with bisphosphonates | Pregnancy and lactation |
PrecautionsSafety not established in pediatric clients |
InteractionsMay decrease serum lithium levels. | Previous treatment with bisphosphonates may decrease the response to calcitonin. |
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