Calcitonin salmon injection is used to treat osteoporosis in postmenopausal women. Osteoporosis is a disease that causes bones to weaken and break more easily. Calcitonin salmon injection is also used to treat Paget's disease of bone and to quickly reduce calcium levels in the blood when needed. Calcitonin is a human hormone that is also found in salmon. It works by preventing bone breakdown and increasing bone density (thickness).

Calcitonin salmon comes as a solution to be injected under the skin (subcutaneously) or into the muscle (intramuscularly). It is usually used once a day or once every other day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use calcitonin salmon injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Your doctor, nurse, or pharmacist will show you how to administer the medication. Follow all directions carefully. Dispose of all empty syringes and vials as directed by your healthcare provider.

Before preparing a dose, look at the vial. If the solution is discolored or contains particles, do not use it, and call your pharmacist.

Calcitonin salmon helps treat osteoporosis and Paget's disease of bone but does not cure them. Continue to use calcitonin salmon even if you feel well. Do not stop using calcitonin salmon without talking to your doctor.

Before using calcitonin salmon injection,

• tell your doctor and pharmacist if you are allergic to calcitonin salmon or any other medications. Your doctor may do a skin test before you start calcitonin salmon to make sure you do not have an allergic reaction to it.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using calcitonin salmon, call your doctor.

Do not administer a double dose to make up for a missed one. Use the following dosage schedule guidelines:

If your usual dose is two doses per day, use the missed dose if you remember it within 2 hours of your regularly scheduled dose. Otherwise, skip the missed dose and then continue on the regular dosing schedule.

If your usual dose is one dose per day, use the missed dose if you remember it during the same day. Otherwise, skip the missed dose and continue the regular dosing schedule the next day.

If your usual dose is every other day, use the missed dose as soon as you remember it, either on the regularly scheduled day or the next day. Then, continue a regular dosing schedule of every other day from that point.

If your usual dose is three times a week, give the missed dose on the next day and continue every other day thereafter. Resume the regular dosing schedule at the beginning of the next week.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• upset stomach
• vomiting

Store calcitonin salmon injection in its original container in the refrigerator. Do not freeze this medicine or shake the vials. Let the solution warm to room temperature before administration. Do not use calcitonin salmon injection if it has been out of the refrigerator for more than 24 hours. Keep all supplies in a clean, dry place and out of reach of children.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

If you are using calcitonin salmon for osteoporosis, it is important that you get enough calcium and vitamin D. Your doctor may prescribe supplements if your dietary intake is not enough.

Calcitonin salmon may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• upset stomach
• vomiting
• redness, swelling, or irritation at the site of injection
• flushing (feeling of warmth) of the face or hands
• increased urination at night
• itching of the ear lobes
• feverish feeling
• eye pain
• decreased appetite
• stomach pain
• swelling of the feet
• salty taste

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• hives
• skin rash
• itching
• difficulty breathing or swallowing
• swelling of the tongue or throat

Calcitonin salmon may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Calcitonin salmon injection is also used sometimes to treat osteogenesis imperfecta. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Keep all appointments with your doctor and laboratory. Your doctor may order certain lab tests to check your body's response to calcitonin salmon.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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