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Bone Health
Clinical

Calcitonin (Salmon)

Also known as: Miacalcin, Fortical, Salcatonin, Calcitonin-salmon

A 32-amino-acid hormone that slows bone breakdown, FDA-approved as Miacalcin for Paget's disease, hypercalcemia and osteoporosis. Prescription.

Last updated

Mechanism of Action

Calcitonin-salmon is a synthetic or recombinant form of the 32-amino-acid hormone made by salmon, which is more potent and longer-acting at the human calcitonin receptor than human calcitonin. Binding to calcitonin receptors on osteoclasts rapidly inhibits their bone-resorbing activity. It also increases urinary calcium excretion, which lowers serum calcium.

Half-life
~1 hour (subcutaneous); shorter after nasal use
Administration Routes
Subcutaneous, Intramuscular, Intranasal
Research Status
Clinical

Reported Benefits

  • Treats symptomatic Paget's disease of bone (injection)
  • Lowers serum calcium in hypercalcemia (injection)
  • Treats postmenopausal osteoporosis when other treatments are not suitable
  • Reduced new vertebral fractures in the PROOF nasal spray trial

Potential Side Effects

  • Nausea, with or without vomiting
  • Flushing of the face or hands and injection-site reactions
  • Nasal irritation, rhinitis or nosebleeds (nasal spray)
  • Hypocalcemia and serious hypersensitivity reactions
  • Small increase in malignancy rates seen in pooled trial data

Common Dosing

The injection is given subcutaneously or intramuscularly, with dose and frequency set by indication (Paget's disease, hypercalcemia or osteoporosis); hypercalcemia dosing is weight-based. Because of the malignancy signal, labeling recommends periodically reassessing the need for continued therapy. Dosing is set and supervised by the prescribing clinician.

The dosing information above is aggregated from research literature and anecdotal community reports for educational purposes only. It is not a recommendation, prescription, or medical advice. Peptides are sold as research chemicals only and are not intended for human use.

Contraindications

  • Hypersensitivity to calcitonin-salmon or any product component
  • Not a first-line osteoporosis treatment when other options are suitable

No documented stacking partners for Calcitonin (Salmon) yet.

  • A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. PROOF Study Group

    2000

    View

  • Does salmon calcitonin cause cancer? A review and meta-analysis

    2016

    View

Yes. Calcitonin-salmon injection (Miacalcin) has been FDA-approved for decades for Paget's disease of bone, hypercalcemia and postmenopausal osteoporosis, and a nasal spray was approved for osteoporosis in 1995. Nasal spray products have since been withdrawn in some markets, including the European Union in 2013, after a malignancy signal, so availability varies; it is a prescription medication used under medical supervision.

Pooled analyses of randomized trials found slightly higher rates of malignancy in people taking calcitonin than placebo, without a clear single cancer type or proven causation. Regulators responded by restricting long-term use and advising that ongoing need be reassessed.

Salmon calcitonin binds the human calcitonin receptor more strongly and is cleared more slowly than the human hormone, so it is more potent clinically.

PeptideChat is for educational and research purposes only. Nothing on this site constitutes medical advice. Peptides are sold as research chemicals only and are not intended for human use. These statements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. PeptideChat is an independent educational resource — not a pharmacy, compounding, or 503A/503B outsourcing facility — and does not sell products or provide medical advice.