What is Calcitonin Nasal Spray: Uses, Dosage, Side Effects and More

Calcitonin nasal spray is a hormone-based medication that helps strengthen bones and reduce fracture risk in people with osteoporosis. It's a synthetic version of a natural hormone your body produces to regulate calcium levels and bone health.

This nasal spray offers a convenient alternative to daily pills for bone protection. Many people find it easier to use than other osteoporosis treatments, especially if they have trouble swallowing tablets or experience stomach upset with oral medications.

What is Calcitonin?

Calcitonin is a hormone naturally made by your thyroid gland that helps control calcium levels in your blood and bones. When you use the nasal spray form, you're getting a man-made version of this same hormone.

The synthetic calcitonin in the nasal spray comes from salmon, which is why you might see it called "salmon calcitonin." Don't worry - this doesn't mean it contains fish proteins that could trigger allergies. The medication is specially processed to be safe for human use.

Your body uses calcitonin to slow down bone breakdown and help maintain bone strength. As we age, our natural calcitonin production decreases, which can contribute to bone loss and osteoporosis.

What is Calcitonin Nasal Spray Used For?

Calcitonin nasal spray is primarily prescribed to treat osteoporosis in postmenopausal women who are at least five years past menopause. It helps reduce the risk of spine fractures by slowing bone loss and maintaining bone density.

Your doctor might recommend this medication if you can't take or don't respond well to other osteoporosis treatments like bisphosphonates. Some women experience severe stomach problems with oral bone medications, making the nasal spray a gentler alternative.

In some cases, doctors also prescribe calcitonin nasal spray to help manage bone pain associated with osteoporotic fractures. The medication can provide pain relief while also working to strengthen your bones over time.

How Does Calcitonin Nasal Spray Work?

Calcitonin nasal spray works by slowing down the cells that break down bone tissue, called osteoclasts. This helps tip the balance toward bone building rather than bone loss.

The medication is considered a moderate-strength bone treatment. It's not as powerful as some newer osteoporosis drugs, but it's gentler on your system and causes fewer side effects than stronger medications.

When you spray it into your nose, the medication is absorbed through the nasal tissues and enters your bloodstream. From there, it travels to your bones where it begins working to preserve bone density and reduce fracture risk.

You'll need to use this medication consistently for several months before seeing meaningful improvements in bone density. Most people start noticing reduced bone pain within a few weeks if that was a concern.

How Should I Take Calcitonin Nasal Spray?

Take calcitonin nasal spray once daily, preferably at the same time each day to help you remember. You can use it with or without food, but many people find it easier to incorporate into their morning routine.

Before using the spray, gently blow your nose to clear any mucus. Hold the bottle upright and insert the tip into one nostril. Press down firmly on the pump while breathing in gently through your nose.

Alternate nostrils each day to prevent irritation. If you used your right nostril yesterday, use your left nostril today. This simple rotation helps keep your nasal passages healthy.

Don't tilt your head back or sniff hard after spraying. Simply breathe normally and let the medication absorb naturally. If you taste something slightly salty or fishy, that's normal and means the medication is working properly.

How Long Should I Take Calcitonin Nasal Spray?

Most doctors recommend using calcitonin nasal spray for no more than five years due to potential long-term risks. Recent studies have raised concerns about increased cancer risk with extended use beyond this timeframe.

Your doctor will likely evaluate your bone density and fracture risk annually to determine if you should continue treatment. Some people may need to switch to different osteoporosis medications after completing their calcitonin treatment course.

The medication typically takes 6-12 months to show significant improvements in bone density tests. However, you might notice reduced bone pain sooner, often within the first few weeks of consistent use.

Don't stop taking the medication suddenly without talking to your doctor first. They may want to transition you to another bone-strengthening treatment to maintain the progress you've made.

What Are the Side Effects of Calcitonin Nasal Spray?

Most people tolerate calcitonin nasal spray well, with side effects typically being mild and temporary. The most common issues are related to nasal irritation since you're spraying medication directly into your nose.

Here are the side effects you might experience, starting with the most common ones:

• Runny or stuffy nose
• Sneezing or nasal irritation
• Nosebleeds (usually minor)
• Headache
• Dizziness
• Nausea or stomach upset
• Joint or back pain
• Flushing or feeling warm

These common side effects usually improve as your body adjusts to the medication over the first few weeks of use.

Less common but more serious side effects can occur, though they're rare. Contact your doctor if you experience severe nasal bleeding, persistent sinus pain, or signs of an allergic reaction like rash, swelling, or difficulty breathing.

Some people develop thickening or sores in their nasal passages with long-term use. Your doctor should check your nose periodically during treatment to watch for these changes.

Who Should Not Take Calcitonin Nasal Spray?

Calcitonin nasal spray isn't suitable for everyone, and certain health conditions or circumstances make it unsafe to use. Your doctor needs to know your complete medical history before prescribing this medication.

You should not use calcitonin nasal spray if you're allergic to salmon or any ingredients in the medication. People with certain nasal conditions like severe rhinitis or nasal polyps may also need to avoid this treatment.

Here are situations where calcitonin nasal spray is typically not recommended:

• Pregnancy or breastfeeding
• Severe kidney disease
• Active nasal infections or sores
• History of allergic reactions to calcitonin
• Chronic sinusitis or severe nasal congestion
• Recent nasal surgery
• Children and adolescents (safety not established)

Your doctor will carefully weigh the benefits against potential risks before prescribing this medication, especially if you have any of these conditions.

Calcitonin Nasal Spray Brand Names

The most common brand name for calcitonin nasal spray is Miacalcin, manufactured by Novartis. This is the version most commonly prescribed in the United States.

You might also see it referred to as salmon calcitonin nasal spray or simply calcitonin nasal solution. Some pharmacies may carry generic versions, though the brand name version is still widely used.

Always check with your pharmacist to ensure you're getting the correct medication and strength your doctor prescribed. The concentration and dosing instructions can vary between different formulations.

Calcitonin Nasal Spray Alternatives

Several other medications can treat osteoporosis if calcitonin nasal spray isn't right for you. The most common alternatives are bisphosphonates like alendronate (Fosamax) or risedronate (Actonel), which are typically taken as weekly pills.

Newer options include denosumab (Prolia), given as an injection every six months, or teriparatide (Forteo), which requires daily injections but actually builds new bone rather than just preventing bone loss.

Your doctor might also recommend hormone therapy, selective estrogen receptor modulators, or newer medications like romosozumab (Evenity) depending on your specific situation and risk factors.

Each treatment has its own benefits and side effects, so your doctor will help you choose the best option based on your health history, lifestyle, and preferences.

Is Calcitonin Nasal Spray Better Than Alendronate?

Calcitonin nasal spray and alendronate (Fosamax) both treat osteoporosis, but they work differently and have distinct advantages. Alendronate is generally considered more effective at increasing bone density and reducing fracture risk.

However, calcitonin nasal spray can be better for people who experience severe stomach problems with alendronate. The nasal spray bypasses the digestive system entirely, making it gentler on your stomach.

Alendronate requires strict dosing instructions - you must take it on an empty stomach and remain upright for at least 30 minutes. Calcitonin nasal spray is much more convenient with fewer restrictions.

Your doctor will consider your individual situation, including how well you tolerate medications, your fracture risk level, and your lifestyle preferences when deciding between these treatments.