Calcitonin
Also known as: Miacalcin, Fortical, salmon calcitonin
Calcitonin activates the calcitonin receptor on osteoclasts to inhibit bone resorption and lower blood calcium, with additional actions on the kidney and gastrointestinal tract.
- Drug class
- Calcitonin-receptor agonist (peptide hormone analog)
- Primary targets
- Calcitonin receptor, Osteoclasts
- Dose reference
- Reference label ranges (not recommendations): 100 USP Units/day SC or IM for postmenopausal osteoporosis and symptomatic Paget disease; 4 to 8 USP Units/kg every 6 to 12 hours for hypercalcemia; 200 USP Units/day intranasally for postmenopausal osteoporosis.
- Half-life
- Approximately 1 hour (subcutaneous salmon calcitonin)
- Developer / origin
- Salmon calcitonin originally developed and marketed by Sandoz/Novartis (Miacalcin); recombinant Fortical developed by Unigene/Upsher-Smith
- Reference year
- 1975
- Evidence score
- 3/5 - Moderate, approval-backed but with safety caution
Approved uses
- Postmenopausal osteoporosis (in women >5 years postmenopause)
- Symptomatic Paget disease of bone
- Hypercalcemia
Moderate, approval-backed but with safety caution
Calcitonin is an FDA-approved calcitonin-receptor agonist peptide with label-backed roles in postmenopausal osteoporosis, symptomatic Paget disease and hypercalcemia, but its bone benefit is modest (fracture reduction not demonstrated for the injection) and an FDA meta-analysis identified a malignancy signal that restricted its use.
Limited human pharmacology or small clinical evidence.
Evidence basis
- FDA/DailyMed Miacalcin injection and calcitonin salmon nasal spray prescribing information establish approved indications, routes and reference dosing
- FDA meta-analysis of 21 trials (10,883 patients) found higher overall malignancy rate (4.1% vs 2.9% placebo), prompting label warnings and 2013 advisory-committee rejection for nasal osteoporosis use
- PROOF trial provided limited, dropout-affected evidence for nasal spray vertebral fracture reduction; injection label states fracture reduction not demonstrated
Key references
How to read this entry
Dose references and half-life values are pulled from trial protocols, labels, reviews, or published summaries where available. They are context for research and comparison, not a personal dosing recommendation.
Status matters: approved drugs have regulated indications; investigational compounds are still being studied; research-only peptides do not have established human dosing, safety, or efficacy for consumer use.
Calcitonin guides
Read the matching guide or adjacent research pages for more context.
Peptide calculators
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