Calcitonin for Paget's disease of bone

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Calcitonin for Paget's disease of bone

Examples

Generic NameBrand Name
calcitonin-salmon Miacalcin

Calcitonin is available for injection either under the skin (subcutaneous or subQ injection) or into the muscle (intramuscular or IM injection). Miacalcin is available in a nasal spray, but it is not approved by Health Canada for the treatment of Paget's disease.

How It Works

Calcitonin slows bone breakdown and rebuilding. It is injected under the skin for the treatment of Paget's disease.

Why It Is Used

People use calcitonin to control symptoms of Paget's disease and to slow the process of bone tissue breaking down and rebuilding too quickly. Doctors also may prescribe it to help prevent complications in people with Paget's disease who do not yet have symptoms.

How Well It Works

Calcitonin helps manage bone pain1.

Calcitonin may prevent future hearing loss, but it will not repair hearing loss that has already occurred.

The benefits of calcitonin may take many weeks to notice, and they often go away soon after the person stops taking the medicine. Calcitonin does not slow or eliminate disease activity as well as bisphosphonates do.2

Side Effects

You may feel sick to your stomach (nausea) after you receive a shot of calcitonin. But nausea usually gets better over time. Less common side effects of calcitonin include:

  • Suddenly feeling very hot (flushed).
  • Vomiting.
  • Diarrhea.
  • Abdominal pain.

Taking the medicine in the evening after dinner can reduce side effects.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

You must take the injection form of calcitonin daily or at least several times a week. You or a family member can usually learn how to give the shot properly. It is important not to give the shot in the same place twice in a row. Changing places where the shots are given prevents damage to muscle tissue.

Some people develop a resistance to calcitonin. The medicine then stops working, and the disease becomes active again. Bisphosphonates appear to keep Paget's disease in an inactive state longer than calcitonin does.

The effects of calcitonin go away within a few months after you stop taking the medicine.

Miacalcin is available in a nasal spray. But this form has not been well-tested for Paget's disease.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations

  1. Shoback D, et al. (2007). Paget's disease of bone (osteitis deformans) section of Metabolic bone disease. In DG Gardner, D Shoback, eds., Greenspan's Basic and Clinical Endocrinology, 8th ed., pp. 337–341. New York: McGraw-Hill.
  2. Altman RD (2005). Paget's disease of bone. In WJ Koopman, LW Moreland, eds., Arthritis and Allied Conditions: A Textbook of Rheumatology, 15th ed., vol. 2, pp. 2543–2557. Philadelphia: Lippincott Williams and Wilkins.

Credits

By Healthwise Staff
Primary Medical Reviewer Caroline S. Rhoads, MD - Internal Medicine
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Matthew I. Kim, MD - Endocrinology
Specialist Medical Reviewer Donald Sproule, MD, CM, CCFP, FCFP - Family Medicine
Last Revised November 6, 2009

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