Calcitonin (Into the nose)

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have Paget's disease of the bone.
• Your doctor might give you an allergy skin test to see if you are allergic to calcitonin before using this medicine.
• This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth while you are using this medicine.
• This medicine may cause irritation in the nose that can be painful and serious. Stop using this medicine and check with your doctor right away if you have more than one of the following symptoms: sneezing; runny or stuffy nose; shortness of breath; troubled breathing; or heavy nosebleeds.
• Your doctor will need to check your urine at regular visits while you are using this medicine. Be sure to keep all appointments.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to 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
• Chest pain.
• Fever, chills, cough, sore throat, and body aches.
• Heavy or ongoing bleeding from your nose.
• Joint or muscle pain.
• Numbness, tingling, or burning feeling in your hands, arms, legs, or feet.
• Severe sores, redness, or irritation in your nose.
• Shortness of breath or troubled breathing.
• Swollen, painful, or tender lymph glands in the neck, armpit, or groin.
• Unusual tiredness or weakness.

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

• Back pain.
• Diarrhea, constipation, nausea, stomach pain or upset.
• Dizziness.
• Feeling sad or depressed.
• Light bleeding from your nose.
• Mild itching, dryness, or tenderness in your nose.
• Runny or stuffy nose.
• Skin rash.
• Warmth or redness in your face, neck, arms, or upper chest.

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

Introduction

Calcitonin (kal-si-TOE-nin)

Treats osteoporosis (bone loss) in women who are past menopause.

Brand Name(s)

Miacalcin, Fortical

When This Medicine Should Not Be Used

How to Use This Medicine

Spray

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• You might also need to take calcium and vitamin D supplements while you are using calcitonin.
• 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.
• This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
• Before using 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 one nostril each day. It is best to change which nostril you use each day. As an example, you should spray into the left side on the first day, then into the right side on the second day, and back to the left side on the third 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 unused medicine after 30 doses, even if the bottle is not completely empty.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

• Keep the bottle tightly closed when not using it.
• 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. An opened bottle of Miacalcin® can be stored for up to 35 days, and an opened bottle of Fortical® can be stored for up to 30 days. Throw away any unused medicine after 30 or 35 days based on the brand you are using.
• 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 away from children and 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 are using lithium (Eskalith®, Lithobid®), or other medicines for osteoporosis (such as etidronate, risedronate, Actonel®, or Didronel®).