Calcitonin

Endocrine & Metabolic

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Examples

calcitonin-salmon (Miacalcin, Fortical)

Prefix / Suffix: calci-

Physiology

Calcitonin from thyroid C-cells lowers serum calcium by inhibiting osteoclasts and promoting renal calcium excretion.

Mechanism of Action

Inhibits osteoclast bone resorption and increases urinary calcium excretion, lowering serum calcium and reducing bone breakdown.

Indications

Hypercalcemia (acute)
Paget's disease
Postmenopausal osteoporosis (second-line)

Side Effects / Adverse Effects

Nasal irritation, epistaxis (intranasal form)
Flushing of face/hands
Nausea (with injection)
Possible increased cancer risk with long-term use
Hypocalcemia (rare)

Contraindications

Hypersensitivity to salmon protein

Nursing Considerations

Intranasal: alternate nostrils daily to reduce irritation
Check for nasal ulceration regularly
Ensure adequate calcium and vitamin D intake
Skin test recommended before injection (allergy)
Monitor serum calcium
Less effective than bisphosphonates for osteoporosis — used as alternative

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