Calcitonin
- Atc Codes:H05BA
- CAS Codes:47931-85-1#21215-62-3#9007-12-9
- PHARMGKB ID:47931-85-1#21215-62-3#9007-12-9
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Calcitonin, Ucecal; Belgium: Miacalcic, Steocalcin; Bulgaria: Miacalcic, Neocalcin; Cyprus: Calciphar, Calcitonin, Calsynar, Miacalcic; Czech Republic: Calcitonin, Miacalcic, Osteodon, Tonocalcin; Denmark: Miacalcic; Finland: Miacalcic; France: Cadens, Calcitonine, Calsyn, Cibacalcine, Miacalcic; Germany: Calcihexal, Calcitonin, Karil, Miacalcic, Osteos, Ostostabil; Greece: Alciton, Alfaton, Alicitonin, Arsipor, Assocals, Aurocalcin, Brosidon, Calcicontrol, Calcideron, Calciphar, Calcispren, Calcitonin, Calco, Calcytonil, Caloston, Calsal, Calsaton, Calsynar, Crocalcin, Doctadryle, Farmicalcine, Galcin, Genecalcin, Iamacalcin, Iricalcin, Latonina, Miacalcic, Miadenil, Mioser, Neostensin, Norcalcin, Nylex, Osanit, Osivan, Ostifix, Ostoplus, Pluston, Procalcic, Rafacalcin, Redicalcin, Rothrin, Salmocalcin, Steocin, Tendolon, Tonocalcin, Tosicalcin, Velkacalcin, Zyoston; Hungary: Calco, Calsynar, Miacalcic; Ireland: Miacalcic, Miakaril, Ostulex; Italy: Calcitonina; Luxembourg: Calsynar, Cibacalcine, Karil, Ucecal; Malta: Miacalcic; Netherlands: Calcitonine; Poland: Calcihexal, Calcitonin, Calsynar, Cibacalcin, Miacalcic, Osteotropin, Ostostabil, Tonocalcin; Portugal: Calcitar, Calcitonina, Calsyn, Miacalcic, Osseocalcina, Osteodon, Salcat, Tonocaltin; Romania: Miacalcic, Nylex, Tonocalcin; Slovakia: Calcitonin, Miacalcic, Osteodon, Tonocalcin; Spain: Calcitonina, Calogen, Calsynar, Miacalcic, Oseototal, Ospor, Osteobion, Ostetan, Tonocaltin; Sweden: Miacalcic; UK: Miacalcic.
North America
Canada: Calcimar, Calcitonin, Caltine, Miacalcin; USA: Fortical, Miacalcin.
Latin America
Argentina: Calcitonina; Brazil: Acticalcin, Calsynar, Miacalcic, Seacalcit, Serocalcin; Mexico: Miacalcic, Oseum.
Asia
Japan: Calcitonin Salmon, Calcitoran, Leton, Marincatonil, Sakecalton, Sakecitonin, Salmostone, Salmotonin, Samocalton, Sarcalnin.
Drug combinations
Chemistry
Calcitonin: C~145~H~240~N~44~O~48~S~2~ (salmon); C~151~H~226~N~40~O~45~S~3~ (human). Mw: 3432.01. A polypeptide hormone that lowers the calcium concentration in the plasma of mammals; or the same substance obtained by synthesis. The source of the product must be indicated in the labeling. Thyrocalcitonin (source). CAS-47931-85-1 (salmon); CAS-21215-62-3 (human); CAS-9007-12-9 (1967).
Pharmacologic Category
Hormones and Synthetic Substitutes; Parathyroid. Bone Resorption Inhibitors. (ATC-Code: H05BA (calcitonin preparations); H05BA03 (human synthetic); H05BA02 (pork natural); H05BA01 (salmon synthetic)).
Mechanism of action
Functionally antagonizes the effects of parathyroid hormone (PTH). Directly inhibits osteoclastic bone resorption. Promotes renal excretion of calcium, phosphate, sodium, magnesium, and potassium by decreasing tubular reabsorption. Increases jejunal secretion of water, sodium, potassium and chloride. The pharmacologic activity of calcitonin salmon and calcitonins of mammalian origin is the same, but calcitonin salmon is substantially more potent on a weight basis and has a longer duration of action. Calcitonin may act as an emergency hormone lowering serum calcium in patients with acute hypercalcemia. It is believed that calcitonin, through its action on bone plays a role, along with PTH, in calcium homeostasis. Gastrointestinal hormones, particularly gastrin, can also stimulate calcitonin secretion and calcitonin may have a regulatory function in the release or catabolism of gastrin. Presumably, calcitonin interacts with a specific receptor site on the plasma membrane of the osteoclast resulting in intracellular accumulation of cyclic adenosine monophosphate (cAMP) and altering calcium and/or phosphate transport across the plasma membrane. It also appears that calcitonin inhibits osteocytic osteolysis. The inhibition of bone resorption by calcitonin decreases both mineral release and matrix or collagen breakdown.
Therapeutic use
Treatment of Paget’s disease of bone (osteitis deformans). Adjunctive therapy for hypercalcemia (carcinoma, multiple myeloma, or primary hyperparathyroidism). Osteoporosis in women >5 years postmenopause.
Pregnancy and lactiation implications
Decreased birth weight observed in animal studies. Calcitonin does not cross the placental barrier. There are no adequate studies in pregnant women. Calcitonin salmon nasal spray should not be used in pregnant women. Not recommended during lactation.
Unlabeled use
Contraindications
Hypersensitivity to calcitonin salmon or any component of the formulation.
Warnings and precautions
May cause hypersensitivity reactions (salmon-derived products). May cause hypocalcemic tetany following parenteral administration. Frequency of osteogenic sarcoma is increased in pagetic lesions. Patients >65 years of age may experience a higher incidence of nasal adverse events with calcitonin nasal spray. The frequency of common adverse effects is higher after treatment with parenteral calcitonin salmon than with calcitonin salmon nasal spray. An increased incidence of pituitary adenomas has been observed in rats given calcitonin salmon subcutaneously.