Calcitonin intranasal

Calcitonin (Miacalcin) Teriparatide (1-34 units, Forteo) 200 units intranasal daily, alternating nares every other day 20 meg subcutaneously daily for up to 2 years... 

Only vertebral fractures have been documented to decrease with intranasal calcitonin therapy. Calcitonin does not consistently affect hip BMD and does not decrease hip fracture risk. 

Intranasal Solutions Calcitonin for Paget s disease gonadotropin-releasing hormone (GnRH) agonist for management of endometriosis... 

Parenteral calcitonin (32 aa) formulations are used to regulate calcemia. Intranasal delivery of calcitonin, a potentially convenient alternative, produces low bioavailability and is not useful as such. Permeation enhancers, including mixed micelle formulations composed of either... 

Lee, W.A., R.D. Ennis, J.P Longenecker, and P. Bengtsson, The bioavailability of intranasal salmon calcitonin in healthy volunteers with and without a permeation enhancer. Pharm Res, 1994. 11(5) 747-50. 

Salmon- and eel-derived calcitonins are more potent than the human and porcine forms. Intranasal calcitonin has a systemic availability of only 3% of the subcutaneous form but is associated with fewer adverse effects, probably because of lower systemic availability. Antibodies against calcitonin are often found after prolonged treatment, more commonly with salmon (30-69%) or eel calcitonin than with human calcitonin. Antibodies do not usually affect the clinical effect of calcitonin and have not been reported to cause any harm to the patient. Antibody-mediated resistance is exceptional. 

The usefulness of intranasally administered salmon calcitonin for 2 years has been evaluated in 44 glucocorticoid-dependent asthmatics (SEDA-19, 378 7). All were taking calcium supplements (1000 mg/day), but one group also took calcitonin 100 IU every other day. Calcitonin increased spinal bone mass during the first year of... 

A 60-year-old woman tolerated daily intranasal calcitonin for 6 months of the year for 4 years (19). She developed nasal watering, nasal and ocular pruritus, and sweating immediately after the administration of nasal calcitonin when she restarted after a 6-month break. These symptoms recurred 2 years later, with abdominal pain and hypotension, after 10 months of... 

Intranasal calcitonin is associated with fewer adverse effects than parenteral formulations, probably because of low systemic availability. However, a meta-analysis has confirmed that adverse events are poorly reported in clinical trials (21). The pooled relative risk for rhinitis from four trials (n = 1663) was 1.72, but this did not reach statistical significance. 

The adverse effects of parenteral and intranasal calcitonin have been compared (22). Parenteral salmon calcitonin is commonly associated with flushing of the face, ears, hands, and feet within minutes of the injection. Nausea and vomiting can occur within 30 minutes. The flushing needs to be distinguished from the less common but serious and potentially fatal hypersensitivity reactions that have been reported. The nausea, which is mild, usually abates with continued therapy. Intranasal calcitonin is better tolerated rhinitis of mild or moderate severity is the most frequent adverse effect. 

Hinchcliffe, M., I. Jabbal-Gill, and A. Smith. 2005. Effect of chitosan on the intranasal absorption of salmon calcitonin in sheep. J Pharm Pharmacol 57 681. 

Kaskani E, Lyritis GP, Kosmidis C, et al. Effect of intermittent administration of 200 IU intranasal salmon calcitonin and low doses of 1 alpha(OH) vitamin D3 on bone mineral density of the lumbar spine and hip region and biochemical bone markers in women with postmenopausal osteoporosis a pilot study. Clin Rheumatol. 2005 24 232-238. 

Considerable research in recent years has successfully yielded drug preparations that can also be given intranasally (e.g., calcitonin for osteoporosis) or by inhalation (e.g., bronchodilators for asthmatics). A more complete list of possible routes of drug... 

Intranasal Desmopressin is administered intranasally in the treatment of diabetes insipidus salmon calcitonin, a peptide hormone used in the treatment of of osteoporosis, is available as a nasal spray. The abused drug, cocaine, is generally taken by sniffing. 

In clinical trials, salmon calcitonin, administered intranasally, has been effective and well tolerated in postmenopausal women at risk of developing osteoporosis. In trials lasting several years the drug reduced bone resorption and improved bone architecture, relieved pain, and increased function. 

Calcitonin is also another option that may be used if a patient cannot take bisphosphonates. It is administered intranasally or via subcutaneous or intramuscular injection. It is usually only prescribed in specialist clinics. 

Intranasal calcitonin (salmon calcitonin) reduces the incidence of vertebral fractures, but evidence is lacking on whether it reduces the incidence of non-vertebral fractures. 

On July 10, 2006, Nastech was notified by the FDA that its ANDA for intranasal calcitonin salmon was not approvable at present based on concerns relating to the potential for immunogenicity that might result from a possible interaction between calcitonin salmon and chlorobutanol, the preservative in the formulation. 

Pontiroli et al. [76] looked at the intranasal absorption of calcitonin in normal subjects. Their study included six healthy volunteers who had no family history of endocrine or metabolic diseases. Human calcitonin (Cibacalcin Ciba-Geigy) was administered intravenously or mixed with sodium glycocholate, a surfactant, in distilled water and instilled as nose drops. Plasma concentrations of calcitonin were found to be consistently higher when compared with intranasal administration of... 

Polyacrylic acid aqueous gel enhances the absorption of calcitonin after nasal as well as rectal administration. When [Asul,7]-eel calcitonin (lOU/kg) was administered nasally in polyacrylic acid gel at a concentration of 0.1% w/v, a prominent hypocalcemic effect was seen in the first 30min. Nasal administration of [Asul,7]-eel calcitonin in saline had no hypocalcemic effect at the same dose when given by the nasal route. In addition to this, the effect of [Asul,7]-eel calcitonin in the dose range of 1-10 U/kg has also been studied. The resulting data showed that a rapid reduction in plasma calcium concentrations can be achieved at doses of 5 and 10 U/kg however, at doses of 1 U/kg only a small reduction in the plasma calcium concentration was observed, suggesting that polyacrylic acid gel can be used for the intranasal administration of peptides such as calcitonin. The possible side effects, however, were not known at the time the study was performed [76-78],... 

Calcitonin is a peptide hormone produced by the C cells of the thyroid gland (in mammals). It acts on bone (inhibiting osteoclasis) to reduce the rate of bone turnover, and on the kidney to reduce reabsorption of calcium and phosphorus. It is obtained from natural sources (pork, salmon, eel), or S3mthesised. The t/ varies according to source t/ human is 10 min. Antibodies develop particularly to pork calcitonin and neutralise its effect synthetic salmon calcitonin (salcatonin) is therefore preferred for prolonged use loss of effect may also be due to down-regulation of receptors. Calcitonin is used (s.c., i.m. or intranasally) to control hypercalcaemia (rapid effect), Paget s disease of bone (relief of pain, and to relieve compression of nerves, e.g. auditory cranial), metastatic bone cancer pain, and postmenopausal osteoporosis. 

Fig. 7 Mean plasma concentration-time curves of intact [ H]-(Asu )-eel calcitonin after intravenous (0.68 pg open triangle), intranasal liquid (1.68 pg open circle), and intranasal powder (1.54pg closed circle) administration in rats. The mean SEM (n = 3). (Reprinted from Ref. with permission from Elsevier.)...

A 65-year-old woman, who had previously tolerated calcitonin nasal spray, developed eye and nose congestion, an itchy nose, and sneezing minutes after using intranasal salmon calcitonin (17). She was later given intramuscular salmon calcitonin and developed generalized urticaria and nasal itching within minutes. Skin testing was positive with eel and salmon calcitonins but not human calcitonin, and she was treated with human calcitonin without adverse effects. 

---