Calcitonin analogue
Calcitonin (salmon)
Brand names: Miacalcic
Adult dose
Dose: Hypercalcaemia of malignancy: 100 units IM/SC q6–8h; Paget's: 50–100 units OD/3× weekly
Route: SC / IM (intranasal withdrawn)
Frequency: q6–8h or 3× weekly
Clinical pearls
- MHRA Drug Safety Update 2012: long-term use restricted due to malignancy signal — only for short-term treatment of hypercalcaemia of malignancy and Paget's disease; intranasal withdrawn
- Bisphosphonates / denosumab generally preferred for hypercalcaemia
Contraindications
- Hypocalcaemia
- Hypersensitivity
Side effects
- Nausea
- Flushing
- Local reactions
- Allergic reactions
- Increased malignancy risk with long-term use (MHRA — restricted indications)
Interactions
- Lithium
Monitoring
- Calcium
- Symptoms
- Duration of use
Reference: BNF; MHRA Drug Safety Update; SmPC; https://bnf.nice.org.uk/drugs/calcitonin-salmon/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016