Salmon calcitonin
Also known as: Calcimar, Calsynar, Fortical, Miacalcin, Salcatonin, Salmon calcitonin, sCT
Source Salmon calcitonin at Peptiology
Save 10% with code PEPTI-BOSSRABBIT-10
Affiliate link: we earn a commission on purchases made through this link, at no extra cost to you.
Tapping Shop Now & Save 10% copies your 10% off code PEPTI-BOSSRABBIT-10 to your clipboard. Paste it at the Peptiology checkout to claim the discount.
Summary
Salmon calcitonin (sCT) is a peptide hormone belonging to the calcitonin family, approved for prescription use. It is administered by injection (intramuscular, subcutaneous, intravenous) or as a nasal spray. Clinically it is employed to inhibit bone resorption in osteoporosis, particularly glucocorticoid‑induced forms, and to provide analgesic relief in bone‑related pain.
Mechanism of Action
sCT binds the calcitonin receptor (CTR), a G‑protein‑coupled receptor that activates adenylate cyclase and raises intracellular cAMP. This signaling suppresses osteoclast activity, reducing bone resorption and calcium release. sCT also interacts with renal tubular receptors, decreasing reabsorption of sodium, phosphate and calcium. By binding CTR alone, sCT can activate amylin receptors (CTR‑RAMP complexes) in the area postrema and brainstem, influencing appetite, energy expenditure and glucose homeostasis.
What the Research Shows
A 1989 randomized trial in patients with glucocorticoid‑induced osteoporosis reported that subcutaneous 100 U sCT every other day reduced bone‑pain and increased distal‑radius mineral content by 2.7 % over six months, whereas controls lost 3.5 % (p < 0.001). Reviews highlight the challenge of oral delivery for peptides like sCT, noting various formulation strategies under clinical investigation. Receptor pharmacology studies describe sCT as a potent agonist of both calcitonin and amylin‑type receptors, elucidating its ability to activate CTR alone. Kidney studies demonstrate sCT‑mediated inhibition of tubular sodium, phosphate and calcium reabsorption via cAMP signaling, while brain circuitry work maps amylin‑receptor pathways that sCT can engage, suggesting broader metabolic effects.
Reported Benefits
Evidence from the osteoporosis trial indicates sCT can modestly increase bone mineral density and alleviate bone‑related pain in glucocorticoid‑treated patients. Its activation of calcitonin receptors reduces osteoclast‑mediated bone loss, supporting its use in osteoporosis management. Renal receptor activation may promote excretion of sodium and phosphate, offering a potential diuretic effect. Activation of amylin‑type pathways in the brain suggests possible influence on appetite and energy balance, although clinical relevance remains to be established.
Limitations of the Evidence
Clinical data are limited to small, older studies; no large modern randomized trials are cited for osteoporosis or metabolic indications. The metabolic and renal effects are primarily described in animal or in‑vitro work, leaving their significance in humans uncertain. Oral delivery of sCT remains experimental, with no approved formulations. Potential variability in response due to receptor subtype distribution is not fully understood, and broader safety and efficacy profiles are lacking in the cited literature.
Safety Considerations
The cited abstracts do not detail adverse events; safety information is therefore limited. sCT is generally considered well tolerated in the contexts studied, but caution may be warranted in patients with chronic renal failure, where endogenous calcitonin levels are already elevated. Monitoring for possible nausea, hypocalcemia, or allergic reactions is prudent, although such effects were not reported in the referenced trials.
How It Is Administered
Salmon calcitonin is delivered by injection (intramuscular, subcutaneous, intravenous) or as a nasal spray. Injectable forms are typically supplied as lyophilized powder for reconstitution or ready‑to‑use solutions, while nasal preparations are formulated as sprays. No oral formulations are currently approved.
Routes of Administration
Goals & Uses
- Postmenopausal osteoporosisBone MetabolismModerate
- Osteoporosis treatmentBone MetabolismHigh
- Analgesia in bone painPain ManagementModerate
- Paget disease of boneBone RemodelingModerate
- Treatment of Paget's disease of boneBone MetabolismHigh
- Treatment of hypercalcemiaMineral HomeostasisHigh
- Hypercalcemia of malignancyCalcium RegulationHigh
- Prevention of immobilization hypercalcemiaMineral HomeostasisModerate
Contraindications
- Severe hypocalcemiaElectrolyte DisorderModerate
- PregnancyPopulationModeratePotential fetal risk or insufficient safety data
- Hypersensitivity to salmon calcitoninAllergy/ImmunologyHigh
- HypocalcemiaElectrolyte DisorderHigh
- Hypersensitivity to salmon calcitonin or formulation excipientsAllergyHigh
Adverse Effects
- Nasal irritationLocal/NasalCommon
- Facial flushingCardiovascular/DermatologicCommon
- Injection site painLocalCommonPain at the injection site
- FlushingVascularCommonWarmth and redness of the skin
- Rhinitis and nasal symptomsENTCommon
- Nausea and vomitingGastrointestinalCommon
- NauseaGastrointestinalCommonFeeling of sickness or urge to vomit
- HypocalcemiaMetabolicUncommon
- Malignancy (long-term use)OncologyRare
- VomitingGastrointestinalCommonForceful expulsion of stomach contents
- TachyphylaxisPharmacodynamicCommon
Drug Interactions
- BisphosphonatesModerate
- Calcium supplements / Vitamin DLow
- Calcium supplementsLow
- LithiumModerate
Population Constraints
- PregnancyReproductive SafetyRelative
- Renal impairmentOrgan ImpairmentRelative
- Pediatric patientsAgeAbsolute
- Long‑term therapy (>2 years)DurationRelative
- Lactating womenReproductiveRelative
- Patients with History of MalignancyOncologyRelative
Regulatory Status
- European UnionApprovedApproved: osteoporosis, hypercalcemia, Paget diseaseAvailable as nasal spray (Calcimar) and injection.
- United StatesApprovedApproved: osteoporosis, hypercalcemia of malignancy, Paget disease of bonePrescription injectable (Miacalcin) and nasal spray.
- United KingdomApprovedApproved: osteoporosis, hypercalcemia, Paget diseasePrescription use; same formulations as EU.
Approved in the US, EU and UK for osteoporosis, hypercalcemia, and Paget disease. Available as injectable (e.g., Miacalcin) and nasal spray formulations.
Evidence & Sources
- Journal ArticleModerateZhu Q, et al.2021-01-01T00:00:00.000000Z
- Journal ArticleModerateYoung A2005-01-01T00:00:00.000000Z
- Journal ArticleModerateRinge JD1989-01-01T00:00:00.000000Z
- Journal ArticleModerateBoccia L, et al.2020-01-01T00:00:00.000000Z
- Journal ArticleModerateArdaillou R1975-01-01T00:00:00.000000Z
Frequently Asked Questions
What condition is salmon calcitonin primarily prescribed for?
It is approved for the treatment of osteoporosis, especially forms linked to long‑term glucocorticoid therapy, where it helps reduce bone loss and relieve bone‑related pain.
How does salmon calcitonin differ from human calcitonin?
Salmon calcitonin has a higher affinity for the calcitonin receptor and can also activate amylin receptors, giving it greater potency in inhibiting osteoclast activity and influencing metabolic pathways.
Can salmon calcitonin be taken orally?
Oral delivery of peptide drugs like salmon calcitonin is challenging due to degradation in the gastrointestinal tract. Current research explores protective formulations, but no oral product is approved.
Are there any known risks for patients with kidney disease?
Calcitonin receptors are present in the kidney and calcitonin is degraded there. While the abstracts do not report specific adverse events, elevated endogenous calcitonin in chronic renal failure suggests careful monitoring is advisable.
What routes are available for administering salmon calcitonin?
It can be given by subcutaneous, intramuscular, or intravenous injection, and as a nasal spray; the choice depends on the clinical setting and patient preference.
What is Salmon calcitonin?
Salmon calcitonin (sCT) is a peptide hormone belonging to the calcitonin family, approved for prescription use. It is administered by injection (intramuscular, subcutaneous, intravenous) or as a nasal spray. Clinically it is employed to inhibit bone resorption in osteoporosis, particularly glucocorticoid‑induced forms, and to provide analgesic relief in bone‑related pain.
What is Salmon calcitonin used for?
Salmon calcitonin is educationally associated with: Postmenopausal osteoporosis, Osteoporosis treatment, Analgesia in bone pain, Paget disease of bone, Treatment of Paget's disease of bone, Treatment of hypercalcemia, Hypercalcemia of malignancy, Prevention of immobilization hypercalcemia. Educational only — not medical advice.
How is Salmon calcitonin administered?
Recorded routes of administration: Intramuscular, Intranasal, Intravenous, Nasal, Subcutaneous.
What are the potential side effects of Salmon calcitonin?
Reported adverse effects include: Nasal irritation, Facial flushing, Injection site pain, Flushing, Rhinitis and nasal symptoms, Nausea and vomiting, Nausea, Hypocalcemia, Malignancy (long-term use), Vomiting, Tachyphylaxis. This list is not exhaustive — consult a qualified clinician.
Who should avoid Salmon calcitonin?
Recorded contraindications: Severe hypocalcemia, Pregnancy, Hypersensitivity to salmon calcitonin, Hypocalcemia, Hypersensitivity to salmon calcitonin or formulation excipients. Consult a qualified clinician before use.