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Calcitonin (Into the nose)

Calcitonin (kal-si-TOE-nin)

Treats osteoporosis in women who are past menopause.

Brand Name(s):

Fortical, Miacalcin

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

Do not use this medicine if you have had an allergic reaction to calcitonin.

How to Use This Medicine:


  • Take your medicine as directed.
  • This medicine is for use only in the nose. Do not get any of it in your eyes or on your skin. If it does get on these areas, rinse it off right away.
  • Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
  • Before you use a new bottle of medicine, take the bottle out of the refrigerator and let it slowly warm up to room temperature.
  • If you are using the nasal spray for the first time, you will need to prime the spray. To do this, pump or squeeze the bottle until some of the medicine sprays out. Now it is ready to use. Prime the spray after each time you clean the pump, or if you have not used the medicine for 5 days or longer.
  • This medicine is used in only 1 nostril each day. It is best to change which nostril you use each day.
  • Before using the medicine, gently blow your nose to clear the nostrils.
  • After using the nasal spray, wipe the tip of the bottle with a clean tissue and put the cap back on.
  • Each spray bottle contains 30 doses of the medicine. Keep track of the doses you use and throw away any medicine you do not use after 30 doses, even if the bottle is not completely empty.
  • You may also need to take calcium and vitamin D supplements while you use this medicine.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

  • Store the unopened bottle in the refrigerator. Do not freeze. Store the opened bottle in an upright position at room temperature, away from heat and direct light. Throw away any medicine you do not use after 30 days.
  • Keep the bottle tightly closed when you are not using it.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you use lithium (Eskalith®, Lithobid®) or other medicines for osteoporosis (such as etidronate, risedronate, Actonel®, or Didronel®).

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breastfeeding or if you have Paget disease.
  • Your doctor might give you an allergy skin test to see if you are allergic to calcitonin before you use this medicine.
  • This medicine may cause irritation in the nose that can be painful and serious. Check with your doctor right away if you have sores in your nose, sneezing, runny or stuffy nose, trouble breathing, or heavy nosebleeds.
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.Your doctor may also want to check your nose before and during treatment with this medicine.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Heavy or ongoing bleeding from your nose
  • Runny or stuffy nose
  • Severe sores, crusting, redness, or irritation in your nose

If you notice these less serious side effects, talk with your doctor:

  • Light bleeding from your nose
  • Mild itching, dryness, or tenderness in your nose

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 4/4/2014

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