Calcitonin
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 supplementsPrevention 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 :3431.9 %Protein binding :30–40 %Excreted unchanged in urine : Minimal Volume of distribution (L/kg) :9.9 litreshalf-life – normal/ESRD (hrs) :50–90 minutes (parenteral); 16–43 minutes (intranasal)/Increased DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50 : Dose as in normal renal function 10 to 20 : Dose as in normal renal function <10 : Dose as in normal renal function DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD :Unlikely to be dialysed. Dose as in normal renal function HD :Unlikely to be dialysed. Dose as in normal renal functionHDF/high flux :Unlikely to be dialysed. Dose as in normal renal functionCAV/VVHD :Unlikely to be dialysed. Dose as in normal renal function IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsNone 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
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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