Bone & endocrine
Salmon calcitonin
A fish-derived hormone that slows bone breakdown, still used for Paget's disease and cancer-related high calcium. Its osteoporosis use was withdrawn in Europe over a cancer signal.
What it is
Salmon calcitonin is a synthetic 32-amino-acid version of the hormone calcitonin from salmon, which is far more potent in humans than the human hormone. It is available as a nasal spray and an injection. European regulators concluded in 2012 that long-term use in osteoporosis raised cancer risk and recommended removing that indication, so its remaining uses are narrow.
How it works
- 1
Binds calcitonin receptors on osteoclasts, the cells that dissolve bone.
- 2
Inhibits osteoclast activity, so bone resorption falls within hours of a dose.
- 3
Lowers serum calcium by reducing release from bone and increasing kidney calcium excretion.
- 4
Also appears to have analgesic effects on bone pain through mechanisms that are not fully explained.
What it's studied for
Reported and studied effects
- 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
Research protocol notes
Research context onlyResearch 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.
These figures are described so you can understand what researchers did. They are not a dose, a schedule, or a suggestion — and they are not a substitute for a doctor.
Possible side effects and contraindications
Safety profile
Possible side effects
- 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
Contraindications and cautions
- Preexisting hypocalcaemia
- Hypersensitivity to salmon calcitonin or its excipients
- Pregnancy and breastfeeding
- Long-term use in osteoporosis is no longer recommended in the EU
A side-effect list is never complete, and these are not the only situations that warrant caution. Anything unexpected, or anything you are unsure about, should be discussed with a doctor before use.
Evidence assessment
Multiple randomised trials and decades of use support the bone-density and calcium-lowering effects, but fracture data are limited and regulators restricted the main indication over long-term safety.
References
- 01European Medicines Agency — Calcitonin-containing medicines: referral and restrictions
- 02Salmon calcitonin clinical studies — PubMed literature search
References link to published literature, regulator pages or literature indexes. Where a link points to a search, it collects the peer-reviewed work on that molecule rather than a single study.
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