Side by side

1. 1.Binds calcitonin receptors on osteoclasts, the cells that dissolve bone.
2. 2.Inhibits osteoclast activity, so bone resorption falls within hours of a dose.
3. 3.Lowers serum calcium by reducing release from bone and increasing kidney calcium excretion.
4. 4.Also appears to have analgesic effects on bone pain through mechanisms that are not fully explained.

• Paget's disease of bone
• Hypercalcaemia caused by cancer
• Postmenopausal osteoporosis (withdrawn in the EU over long-term cancer risk)
• Bone pain from osteoporotic fractures or metastases
• Complex regional pain syndrome (small studies)

• Modest increases in spinal bone mineral density of roughly 1–2%
• Reduced bone pain in some patients with osteoporotic fractures
• Rapid but short-lived lowering of serum calcium
• Fracture reduction data are weak compared with modern treatments
• Antibodies to salmon calcitonin can form with long-term use, reducing effect

• Nasal irritation, rhinitis and nosebleeds with the spray
• Nausea, flushing and vomiting, especially with injections
• Back pain and joint pain
• Hypocalcaemia with repeated dosing
• Possible increased risk of cancer with long-term use
• Antibody formation reducing effectiveness

Research context only — this is a prescription medicine. Common study regimens were 200 IU daily by nasal spray, or 100 IU by injection. Treatment is time-limited and monitored by a doctor because of the cancer signal and hypocalcaemia risk.

Research context only