OSTEOPOROSIS-MANAGEMENT (CALCITONIN)

SUMMARY

1. Directly inhibits osteoclastic activity.

2. Benefits: decreases pain in acute compression fractures through stimulation of beta-endorphins, preserves bone mass, ~36% reduction in incidence of spine fractures.

3. Must have adequate concurrent intake of calcium and vitamin D.

4. Side effects: nasal irritation, facial/hand flushing, local skin irritation, nausea; allergic reaction with injected form.

5. Recommended formulations:
- Nasal spray (Miacalcin, Fortical®) 1 spray 200 International Units per day, alternate nostrils.
- Parenteral injection subcutaneously or intramuscularly (Calcimar®): Prevention 100 IU every other day, treatment 100 IU daily.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].