Calcitonin

Calcitonin is indicated in Active Paget's disease in patients who do not respond to alternative treatments or for whom such treatments are not suitable; Hypercalcaemia.

Intravenous (Adult)-

Emergency treatment of hypercalcaemia

: Up to 10 u/kg in 500 mL of sodium chloride 0.9% by slow IV infusion over at least 6 hr.

Parenteral (Adult)-

Adjunct in hypercalcaemia

SC/IM: 4 u/kg 12 hrly, may increase after 1-2 days to 8 u/kg 12 hrly to max 8 u/kg 6 hrly after 2 days. Alternatively, 100 u every 6-8 hr, increased after 1-2 days to max 400 u every 6-8 hr.

Paget's disease of bone

SC/IM: 50 u 3 times wkly to 100 u/day.

Nasal (Adult)-

Nasal postmenopausal osteoporosis

200 u/day, alternation nostrils everyday.

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.

GI disturbances, dizziness, flushing, tingling of the hands, unpleasant taste, skin rash, abdominal pain, urinary frequency, tremor, inj site inflammation. Rarely, diabetogenic effect.

Hypersensitivity. Patients with hypocalcaemia.

Skin test should be done before initiating therapy. Heart failure; renal impairment. Pregnancy, lactation, childn.

Renal Impairment

Dosage adjustment needed.

Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Symptoms

: Flushing, nausea, vomiting and dizziness.

Management

: Symptomatic and supportive treatment.

Concurrent use wth cardiac glycosides (e.g. digitalis) or Ca-channel blockers requires dosage adjustments of these drugs. May decrease serum concentration of lithium.

Store between 2-8° C.