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Calcitonin Cheat Sheet by

Used for treating established postmenopausal osteoporosis as well as hypercalcemia secondary to hyperparathyroidism, and pagets disease

Medication Names

Prototye Med
calcit­oni­n-s­almon (Miaca­lcin, Calcimar)
Drug Class: Hypoca­lcemic
Action: decrease bone resorp­tion, inhibits the action of osteoc­lasts and increases excretion of calcium

Therap­eutic Use

Treatment of postme­nop­ausal osteop­orosis
Hyperc­alcemia secondary to hyperp­ara­thy­roidism
Paget’s disease

Adverse Effects

Nasal dryness and irritation with intranasal calcitonin
Hypers­ens­itivity reactions/ anaphy­laxis
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 Interv­entions

When 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.


Intranasal 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
Rotate injection sites.
Subcut­aneous is preferred route - Administer IM if dose more than 2 ml
Protect from light.
Keep calcitonin salmon refrig­erated.

Patient Education

For 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


Allergy to salmon
Prior treatment with bispho­sph­onates
Pregnancy and lactation


Safety not establ­ished in pediatric clients


May decrease serum lithium levels.
Previous treatment with bispho­sph­onates may decrease the response to calcit­onin.


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