Type of medicine: bone resorption inhibitor
Generic and brand names: calcitonin-salmon, injection; calcitonin-salmon, nasal; Fortical; Miacalcin
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:
It may be used for other conditions as determined by your healthcare provider.
Before taking this medicine, tell your healthcare provider if you have ever had an allergic reaction to any medicine or to fish. Before using the nasal spray, tell your provider if you have any nasal or sinus problems.
Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.
Follow the diet your healthcare 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.
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 side arms of the pump 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.
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.
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 injections and how much is to be given each time. If you are not sure of how to give yourself the shots, ask your healthcare provider or pharmacist for help.
If using the spray and you miss a dose, use it as soon as you remember. If you do not remember until the next day, skip the missed dose and use the next one as directed. Do not use double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.
If you are using the injections and miss a dose, contact your healthcare provider.
If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.
Symptoms of an acute overdose may include: nausea, vomiting.
If you are using the spray form of this medicine, do not use other nasal sprays without your healthcare provider's approval.
Do not use the injection if it looks discolored, or if you see particles in the liquid.
If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are using this medicine.
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 healthcare provider if you have any side effects that continue or get worse.
Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).
Serious (report these to your healthcare provider right away): Tingling in the hands or feet; severe irritation of the nose if you are using the spray form.
Other: Headache, runny nose, nosebleed, or nasal irritation if you use the nasal spray; irritation where the injection is given, nausea, vomiting, loss of appetite if you use the shots.
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 healthcare provider if you are taking:
If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.
Refrigerate the medicine for injection. Do not freeze the medicine. Warm the vial to room temperature before using but do not store it at room temperature. Do not shake the vial.
Put the unopened nasal spray in the refrigerator, but do not let it freeze. When you use the medicine the first time, warm the spray 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.
This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare 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.
