FDA Approved Healing & Recovery

Calcitonin

also known as: Miacalcin, Fortical, Salmon Calcitonin, Calcitonin-Salmon

The bone-protective thyroid hormone — a 32-amino-acid peptide that directly inhibits osteoclasts, used as a nasal spray or injection for osteoporosis and hypercalcemia.

A 32-amino-acid peptide hormone secreted by parafollicular C-cells of the thyroid, binding the calcitonin receptor (CTR) on osteoclasts to directly inhibit bone resorption, with additional analgesic effects on vertebral fracture pain.

Mechanism of action

Binds the calcitonin receptor (CTR, a class B GPCR) on osteoclasts, activating Gs → cAMP and causing rapid cytoskeletal disruption, loss of ruffled border, and cessation of bone resorption. Also has analgesic effects in acute vertebral fractures, possibly via central serotonergic and endorphinergic pathways. The CTR in complex with RAMPs forms amylin receptors (AMY1–3), relevant to metabolic pharmacology.

Primary uses

Postmenopausal osteoporosis (second-line)
Hypercalcemia of malignancy
Paget's disease of bone
Acute vertebral fracture pain (analgesic effect)

Typical dosing

200 IU once daily (nasal) or 100 IU SC/IM every other day (intranasal or subcutaneous)

Nasal spray is most common. Alternate nostrils daily. Long-term use limited by tachyphylaxis and cancer signal.

Regulatory status

FDA-approved as Miacalcin (injection/nasal spray, Novartis) and Fortical (nasal spray) for postmenopausal osteoporosis and hypercalcemia of malignancy. Use has declined due to concerns about cancer signal in long-term studies.

References

[clinical-trial] Chesnut CH, et al. "A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis (PROOF study)." Am J Med, 2000;109:267-276.
[fda-pi] Miacalcin (calcitonin-salmon) Prescribing Information. Novartis.

Related peptides

Teriparatide

The FDA-approved anabolic osteoporosis drug (Forteo, 2002; Bonsity biosimilar 2019) — the recombinant N-terminal PTH fragment (PTH 1-34) that builds bone rather than slowing resorption. Daily subcutaneous injection; 2-year lifetime-exposure limit.

Amylin

Insulin's co-secreted partner — the native satiety hormone behind pramlintide (Symlin) and the amylin component of CagriSema.

Disclaimer

This entry is for educational purposes only and does not constitute medical advice. Dosing information reflects published regulatory or research data and is not a recommendation. Many compounds described here are not approved for human use in the United States. Consult a licensed medical professional before considering any peptide therapy.