Miacalcic - Calcitonin
Calcitonin has been used in Osteoporosis for some time
now and it is also used in Pagets disease of the bone.
It inhibits osteoclastic bone
resorption.
It has direct effects on osteoclasts, reducing the osteoclast’s ability to resorb
bone.
It also has the effect of reducing plasma calcium by increasing renal calcium excretion.
It is well reported that it has an analgesic effect which I use most effectively -
especially in the context of spinal fractures from osteoporosis.
Calcitonin is currently available as synthetic salmon, human,
porcine or eel Calcitonin. It can be administered intramuscularly or subcutaneously and
has a rapid onset of action within 30 minutes.
Recently intranasal aerosol spray preparations have been marketed with fewer side effects.
I find it especially useful in :-
Osteoporosis - particularly
in patients with evidence of high bone turnover and patients with immobilization
osteoporosis and spinal fractures.
I use it also if a patient cannot tolerate Estrogen.
Paget’s disease of bone.
Hypercalcemia of malignancy
Reflex Sympathetic dystrophy
Side Effects....
I find side effects are unusual and usually mild.
Flushing
Nausea
Skin Rash or allergy may be seen
Systemic allergic reactions are very rare.
The results of research show that if used for
osteoporosis, an increase in bone mass in approximately 4 -5% per year may obtained,
although the improvement in the hip is not as great. As mentioned Calcitonin is also
extremely effective in reducing the bone pain.
In the treatment of Paget’s disease of bone I find it also useful for pain
relief.
However the problem in my country is cost of the
medication and non-availability of the nasal form which was recently marketed by Sandoz as
Miacalcic in the USA.
I personally however was involved in use of the nasal form at an early stage prior to
release and found it EXTREMELY good for Osteoporotic fracture...but unfortunately do not
have it available here in South Africa.
Currently I use the ampoules - Injectable form.
Calcitonin should be given in doses of 50–100 MRC units once a day for the first 1-2
weeks and then I reduce the dose to 3 times per week thereafter.
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