Calcitonin

CLINICAL USE

  • Hypercalcaemia of malignancy
  • Paget’s disease of bone
  • Post-menopausal osteoporosis
  • Prevention of acute bone loss due to sudden immobility

    DOSE IN NORMAL RENAL FUNCTION

  • Hypercalcaemia of malignancy: 100–400 units every 6–8 hours (SC/IM); in severe or emergency situation, up to 10 units/kg by IV infusion
  • Paget’s disease of bone: 50 units 3 times a week to 100 units daily (SC/IM)
  • Post-menopausal osteoporosis: 200 units (1 spray) into 1 nostril daily with calcium and vitamin D supplements
  • Prevention of acute bone loss due to sudden immobility: 100 units daily in 1–2 divided doses for 2–4 weeks then reduce to 50 units daily until fully mobile (SC/IM)

    PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :3431.9
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :30–40
  • %Excreted unchanged in urine &nbsp &nbsp : Minimal

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :9.9 litres

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :50–90 minutes (parenteral); 16–43 minutes (intranasal)/Increased

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unlikely to be dialysed. Dose as in normal renal function
  • HDF/high flux &nbsp :Unlikely to be dialysed. Dose as in normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • None known

    ADMINISTRATION

    Reconstition

    –

    Route

    Intranasal, IM, IV, SC

    Rate of Administration

    Over at least 6 hours

    Comments

    Dilute in 500 ml sodium chloride 0.9% and administer immediately; dilution may result in a loss of potency

    OTHER INFORMATION

  • Peak plasma concentration occurs 30– 40 minutes after intranasal administration, and 15–25 minutes after parenteral administration
  • Mainly GI side effects
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