Calcitonin Salmon: Uses and Adverse Reactions

• Calcitonin salmon is a medication

Therapeutic Uses

• Used in the treatment of postmenopausal osteoporosis
• Used in the treatment of hypercalcemia secondary to hyperparathyroidism
• Used in the treatment of Paget's disease

Adverse Drug Reactions

• Nasal dryness and irritation may occur with intranasal calcitonin
• Hypersensitivity reactions/anaphylaxis are possible
• Hypocalcemia may occur
• The therapeutic effects may decrease over time
• Nasal calcitonin can cause nasal dryness, irritation, headaches, and epistaxis
• Injectable calcitonin may cause injection site reactions, nausea, vomiting, and polyuria

Interventions

• When administering intranasal calcitonin alternate the nostril used daily.
• Assess the nostrils prior to administration for irritation/ulceration.
• Before starting therapy, perform an intradermal allergy test
• Development of discoloration within 15 minutes indicates sensitivity
• Have epinephrine 1:1000, antihistamines, and oxygen available during early therapy
• Monitor for hypocalcemia: check serum calcium level, muscle spasms, tingling of fingers and toes
• A diet high in calcium and vitamin D is encouraged

Administration

• Options include intranasal spray, intramuscular, or subcutaneous injections
• Hold the nasal pump upright.
• If using the pump for the first time, prime pump according to manufacturer's instructions
• Spray in the nostril opposite of previous instillation.
• Rotate injection sites.
• Subcutaneous route is preferred
• If administering IM route, administer if dose is more than 2 mL
• Protect from light
• Keep calcitonin salmon refrigerated

Client Instructions

• For intranasal calcitonin, alternate nostril used daily
• Report nasal irritation or bleeding
• Instruct clients to immediately notify provider if rash or itching occurs
• Notify provider of muscle spasms, tingling of fingers and toes
• Eat a diet high in calcium and vitamin D
• Monitor for loss of effect after a year or more of use through regular bone density studies

Contraindications

• Allergy to salmon is a contraindication
• Prior treatment with bisphosphonates is a contraindication
• Pregnancy and lactation are contraindications

Precautions

• Safety not established in pediatric clients

Interactions

• May decrease serum lithium levels
• Previous treatment with bisphosphonates may decrease the response to calcitonin

Calcitonin salmon is a medication used for postmenopausal osteoporosis, hypercalcemia, and Paget's disease. Adverse effects include nasal dryness, hypersensitivity, and hypocalcemia. Nursing interventions include alternating nostrils for intranasal use and monitoring for allergic reactions.