Calcitonin-Salmon, Injection/Nasal

What are other names for this medicine?

Type of medicine: bone resorption inhibitor

Generic and brand names: calcitonin-salmon, injection; calcitonin-salmon, nasal; Calcimar; Miacalcin; Osteocalcin; Salmonine

What is this medicine used for?

This medicine comes in two forms: a nose spray and injections (shots). The nose spray is used to prevent bone loss due to osteoporosis (thinning of the bones) in women who have not had monthly periods for at least 5 years.

The shots are used to treat:

• Paget's disease
• hypercalcemia (too much calcium in the blood)
• osteoporosis.

What should my health care provider know before I take this medicine?

Before taking this medicine, tell your health care provider if you have ever had an allergic reaction to any medicine.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your health care provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your health care provider right away. Do not breast-feed while you are receiving this medicine.

How should I use it?

Use the nose spray once a day. Gently blow your nose before using the medicine. Spray the medicine into only one nostril. The next day, spray it into the other nostril. After that, spray the medicine in alternating nostrils every other day.

The nose spray comes in a bottle with a pump that must be primed the first time you use it. To prime the pump, hold the bottle upright and press down on the two white sides 6 times until a faint spray comes out. The pump is now primed and ready for use. It does not need to be primed again. Instructions for the assembly of the pump and priming are included with the medicine. You may want to have your pharmacist assemble your pump.

If you are taking the injections, you may be able to give them to yourself or have a family member give them to you. Be sure you know how to give the daily injections and how much is to be given each time. Use an alcohol swab to clean the skin of your upper arm or thigh. Gently pinch up the skin and insert the needle into the skin at a 45° angle. After you insert the needle completely, release your grasp of the skin. After you have given yourself the shot, withdraw the needle and syringe and press an alcohol swab on the spot where the shot was given. Use the syringes and needles ONLY ONCE. Throw them away after use. Put used needles in rigid puncture-resistant containers with lids or caps, such as heavy plastic bleach bottles with screw caps. DO NOT throw needles directly into garbage cans or dumpsters. If you are not sure of how to give yourself the shots, ask your health care provider or pharmacist for help.

Follow the diet your health care provider recommends. If you are using this medicine to treat osteoporosis, your provider may prescribe vitamin D and calcium supplements or a high-calcium diet. However, if you have hypercalcemia, your provider may prescribe a low-calcium diet.

What should I watch out for?

If you are using the spray form of this medicine, contact your health care provider if you have severe irritation of the nose.

Do not use the injection if it looks discolored, or if you see particles in the liquid.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your health care provider if you have any side effects that continue or get worse.

Serious (report these to your health care provider right away): Severe irritation of the nose if you are using the spray form, chest pain, rapid heart beat, shortness of breath, rash.

Other: Runny nose, nosebleed, headache, back pain, nausea, vomiting, diarrhea, loss of appetite, salty taste, dry mouth, irritation where the injection is given, fever, muscle aches and pains, tiredness, cough, trouble sleeping, dizziness, anxiety, flushing of face or hands, trouble hearing.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your health care provider if you are taking:

• lithium.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all health care providers who treat you about all the products you are taking.

How should I store this medicine?

Refrigerate the medicine for injection.

Put the unopened nasal spray in the refrigerator, but do not let it freeze. When you take the nasal spray out of the refrigerator for your first use, allow the spray to come to room temperature. After the pump is primed and you have used the spray once, store it at room temperature in an upright position. After 30 days, discard any medicine you have left. Each bottle should provide 14 doses.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your health care provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.