Calcitonin Salmon (Miacalcin, Fortical)
Calcitonin Salmon (Synthetic), also known as Salmon Calcitonin (sCT); USP designation: Calcitonin-salmon
Approved status applies to specific products, routes, and indications, not every use context discussed online.
An FDA-approved medication (Miacalcin, Fortical) that helps regulate calcium and strengthen bones, used for postmenopausal osteoporosis, Paget's bone disease, and dangerously high blood calcium. It can also relieve pain from spine fractures caused by osteoporosis. Newer bone-strengthening medications are generally preferred today.
Safety Summary
Most common adverse reactions: nausea with or without vomiting (~10%), injection site inflammation (~10%), and facial/hand flushing (2-5%) (FDA Label, Section 6.1). Nausea is most evident at treatment initiation and tends to decrease with continued use. Other reported reactions: skin rashes, pruritus of ear lobes, nocturia, feverish sensation, pain in eyes, poor appetite, abdominal pain, pedal edema, salty taste (FDA Label, Section 6.1). Post-marketing reports include urticaria, arthralgia, musculoskeletal pain, hypertension, diarrhea, polyuria, dizziness, headache, paresthesia, tremor, visual disturbance (FDA Label, Section 6.2). In the Phase 2 oral formulation trial (NCT01292187), abdominal discomfort (10.5% vs 2.3% placebo) and arthralgia (11.6% vs 2.3% placebo) were more common with active treatment. The FDA label contains a cancer risk warning based on a meta-analysis of 21 RCTs showing malignancy rates of 4.1% (sCT) vs 2.9% (placebo), risk difference 1.0% (95% CI 0.3-1.6%) (FDA Label, Section 6.1). Serious hypersensitivity reactions including fatal anaphylaxis have been reported; skin testing should be considered before treatment (FDA Label, Section 5.1). Hypocalcemia with tetany and seizures has been reported; correct hypocalcemia before initiating therapy (FDA Label, Section 5.2). Circulating antibodies develop in approximately 50% of Paget's disease patients after 2-18 months, sometimes leading to loss of response (FDA Label, Section 6.3). Urine sediment abnormalities (coarse granular casts) were observed in young adult volunteers at bed rest receiving injectable sCT (FDA Label, Section 5.5).
Clinical check-in
If real-world use or exposure is being considered, review potential interactions, contraindications, and monitoring needs with a licensed clinician rather than relying on summary copy alone.
Sources: [1-15]