Calcitonin nasal spray

B) Begin calcitonin nasal spray to prevent further bone resorption and help with the pain. 

Adachi JD, Bensen WG, Bell MJ, Bianchi FA, Cividino AA, Craig GL, Sturtridge WC, Sebaldt RJ, Steele M, Gordon M, Themeles E, Tugwell P, Roberts R, Gent M. Salmon calcitonin nasal spray in the prevention of corticosteroid-induced osteoporosis. Br J Rheumatol 1997 36(2) 255-9. 

Salmon calcitonin nasal spray prevented bone loss in the lumbar spine of 31 patients treated with prednisone for polymyalgia rheumatica (SEDA-22, 448) (9). They were randomized to salmon calcitonin nasal spray 200 IU/day or matched placebo for 1 year. Both groups were treated with calcium supplements if their dietary intake was below 800 mg/day. With calcitonin the mean bone mineral density in the lumbar spine fell by 1.3% and with placebo by 5% after 1 year. There were no differences in the hip, including the femoral neck and trochanter, or in total body bone density. 

Peichl P, Griesmacher A, Kumpan W, et al. Clinical outcome of salmon calcitonin nasal spray treatment in postmenopausal women after total hip arthroplasty. Gerontology. 2005 51 242-252. 

On February 17,2004, Nastech Pharmaceutical Company announced its filing of an ANDA for a salmon calcitonin nasal spray drug product for the treatment of postmenopausal osteoporosis. As with Fortical, Novartis s Miacalcin was cited as the reference listed drug however, Nastech chose to submit an ANDA via the 505(j)(l) route, rather than a 505(b)(2) application. 

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. 

However, salmon calcitonin nasal spray prevented bone loss in the lumbar spine of 31 patients treated with prednisone for polymyalgia rheumatica (SEDA-22, 448)... 

Treatment of osteoporosis depends on the cause. In secondary osteoporosis, treatment is directed at the underlying condition. Most therapies for the treatment of postmenopausal osteoporosis are directed at decreasing osteoclastic bone resorption. Antiresorptive therapies include bisphosphoiiates (alendronate and risedronate), estrogen replacement, selective estrogen receptor modulators (raloxifene), and calcitonin (nasal spray or injection). The FDA has recently approved recombinant hPTH(l-34) (injection), the first approved therapy for stimulating bone formation. 

Yes, so far it appears that it is an improvement over the other two treatments, calcitonin nasal spray and fluoride. 

The adverse effects of salmon calcitonin have again been reviewed [1 ]. Salmon calcitonin nasal spray is thought to be safe. Hypersensitivity is the only contraindication. The systemic adverse reactions of flushing and nausea that occur with injections are rare. Loccd reactions due to nasal irritation are the most common adverse reactions. 

Vik A, Ravindran A, Shiah 1, Wong H, Walji N, Lam RW, et al. A double-blind, placebo-controUed study of adjimctive calcitonin nasal spray in acute refractory mania. Bipolar Disord 2013 15(4) 359-64. 

Calcitonin Calcitonin 200 IU/0.9 mL, Nasal spray 200 IU daily Nasal spray Alternate nostrils on a 93 per 3.75-mL... 

Chesnut III CH, Silverman S, Andriano K, Genant H, Gimona A, Harris S, Kiel D (2000) A randomised trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis the prevent recurrence of osteoporotic fractures study. Am J Med 109 267-276... 

Caldtonin (p. 264) inhibits osteoclast activity, hence bone resorption. As a peptide it needs to be given by injection (or, alternatively, as a nasal spray). Salmonid is more potent than human calcitonin because of its slower elimination. 

Calcitonin (Miacalcin, Miacalcin Nasal Spray) is a synthetic 32-amino acid polypeptide that is identical to salmon calcitonin. Salmon calcitonin is more potent than human calcitonin because of its higher affinity for the human calcitonin receptor and its slower metabolic clearance. Administration is by subcutaneous or intramuscular injection or by nasal spray. The absorption of the nasal form is slower than that of the parenteral routes. 

Nasal Spray (Fortical, Miacalcin Nasal) 200 international units/activation (calcitonin-salmon). 

Torring, O., et al. 1991. Salmon calcitonin treatment by nasal spray in primary hyperparathyroidism. Bone 12 311. 

In the past, calcitonin was administered by injection (intramuscular or subcutaneous), but aerosolized versions of calcitonin are now available that allow delivery in the form of nasal sprays.51,68 Oral delivery of calcitonin is difficult because this hormone is absorbed poorly from the gastrointestinal (GI) tract and because calcitonin is degraded by proteolytic enzymes in the stomach.57 Nonetheless, efforts are being made to overcome these limitations, and an oral form of calcitonin may be available someday.62... 

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. 

Calcitonin - available as a nasal spray, but requires dietary calcium intake. 

The salmon form of this 32-amino acid non-glycosy-lated polypeptide is available as a nasal spray with a biovailability in humans of -3%.[ °] Mackay et al. reported that the absolute bioavailabilities of human calcitonin across the colon of rat and man, and the lung (via intratracheal instillation) of rat, were 0.9, 0.15 and 36%. 

Nishi Y, Hamamoto K, Kajiyama M, Ono H, Kihara M, Jinno K. Effect of long-term calcitonin therapy by injection and nasal spray on the incidence of fractures in osteogenesis imperfecta. J Pediatr 1992 121(3) 477-80. 

Administration. The intranasal dose of calcitonin is sprayed in alternating nares every other day (see Table 88-6). Other than minor nasal adverse effects, calcitonin is well tolerated. Subcutaneous administration at 100 units daily is available but rarely used. 

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