Calcitonin for Paget's disease of bone

Examples

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Brand Name	Chemical Name
Cibacalcin	calcitonin-human

Brand Name	Chemical Name
Miacalcin	calcitonin-salmon

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 the Food and Drug Administration (FDA) for the treatment of Paget's disease.

How It Works

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

Why It Is Used

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People use calcitonin to control symptoms of Paget's disease and to slow the process of bone tissue breaking down and rebuilding too quickly. It helps manage bone pain, may relieve some symptoms of nerve problems such as ringing in the ears, and may slow the progress of hearing loss.¹ 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

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Calcitonin can cause a decrease in symptoms such as bone pain. It can reduce the chances of permanent injury to nerves that are causing ringing in the ears or dizziness.

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

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You may feel sick to your stomach (nausea) after you receive a shot of calcitonin. However, 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

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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.

About 20% of people develop a resistance to calcitonin.^{1, 3} 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. However, 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

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Citations

1. Kanis JA (2004). Paget's disease of bone (osteitis deformans). In L Goldman, D Ausiello, eds., Cecil Textbook of Medicine, 22nd ed., vol. 2, pp. 1579–1582. Philadelphia: Saunders.

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.

3. Favus MJ, Vokes TJ (2005). Paget disease and other dysplasias of bone. In DL Kasper et al., eds., Harrison's Principles of Internal Medicine, 16th ed., vol. 2, pp. 2279–2286. New York: McGraw-Hill.

Credits

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Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Michele Cronen
Primary Medical Reviewer	Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer	Hanan Bassyouni, MD - Endocrinology and Metabolism
Last Updated	September 30, 2005