MIACALCIC
SALCATONIN (CALCITONIN) · by NOVARTIS
Composition
Inj 50 IU/100 IU: Per ml: Salcatonin 50 IU/100 IU; 1 ml amp.Nasal Spray 200 IU: Per actuation: Salcatonin 200 IU; metered spray, approx 14 metered spray.
Indications & Dosage
Hypercalcaemia of malignancy: BY SC INJ, OR BY IM INJ: Adult: 100 units every 6-8 hours (max. per dose 400 units every 6-8 hours), adjusted according to response. BY IV INF: Adult: Up to 10 units/kg, in severe or emergency cases,to be administered by slow intravenous INF over atleast 6 hours. Pagets disease of bone: BY SC INJ, OR BY IM INJ: Adult: 100 units daily, adjusted according to response for max. 3 months (6 months in exceptional circumstances). Prevention of acute bone loss due to sudden immobility: BY SC INJ, OR BY IM INJ: Adult: Initially 100 units daily in 1-2 divided doses, then reduced to 50 units daily at the start of mobilisation, usual duration of treatment is 2 weeks;max. 4 weeks. Post-menopausal Osteoporosis: BY SC INJ, OR BY IM INJ: Adult: 100 IU daily. Patients should also receive 600 mg elemental calcium and if necessary 400 units vit D daily. NASAL SPRAY: Adult: 200 IU (1 spray) into one nostril daily, with dietary calcium and vit D supplements.
Administration
IM route is preferred if volume exceeds 2 ml. Taking medication in the evening minimizes the problems of flushing, nausea and vomiting.
Stability
Store under refrigeration at 2C-6C, stable for up to 2 weeks at room temperature.
Contraindications
Hypocalcaemia, hypersensitivity to Salcatonin.
Precautions
Heart failure, history of allergy (skin test advised) , risk of malignancy; avoid prolonged use (use lowest effective dose for shortest possible time), renal impairment, caution when driving or operating machinery. For nasal spray; regular monitoring of patients with chronic rhinitis. Monitor serum alkaline phosphatases and urinary hydroxyproline excretion levels; if rise after initial fall, modify treatment accordingly.
Interactions
Cardiac glycosides, hypoglycaemics.
Pregnancy
Avoid unless potential benefit outweighs risk
Lactation
Contraindicated
Side Effects
Nausea, vomiting, flushing, tingling hands, unpleasant taste. Anaphylaxis