Calcitonin Salmon
Calcitonin-salmon (32-amino acid polypeptide)
Also known as: Miacalcin · Calcimar · Fortical · calcitonin-salmon · calcitoninum salmonis · SCT-1
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Hypervitaminosis D (toxicity)/hypercalcemia | 4-8 Units/kg | SC | two to three times a day | — | 🌎 NA |
| Hypervitaminosis D (toxicity)/hypercalcemia | 4-6 Units/kg | SC | q2-3 hours | until serum calcium levels are normalized | 🌎 NA |
| Adjunctive therapy if fluid deficit replacement, saline diuresis, furosemide and prednisone have failed to control calcium | 4 Units/kg IV, then 4-8 Units/kg SC | IV, then SC | q12-24h | — | 🌎 NA |
| Hypervitaminosis D (toxicity)/hypercalcemia | 4-6 Units/kg | SC | q8-12h | — | 🌎 NA |
- Hypervitaminosis D (toxicity)/hypercalcemia: Effects are short-lived and multiple treatments are required.
Reptiles
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Hypercalcemia (Green iguanas) | 1.5 Units/kg | SC | q8h | for several weeks if necessary | 🌎 NA |
| Nutritional secondary hyperparathyroidism (NSHP) | 50 Units/kg | IM | once weekly | for 2-3 doses | 🌎 NA |
| Nutritional secondary hyperparathyroidism (NSHP) | 50 Units/kg | IM | weekly | for 2-3 doses | 🌎 NA |
- Hypercalcemia (Green iguanas): In combination with fluid therapy
- Nutritional secondary hyperparathyroidism (NSHP): Use if reptile is not hypocalcemic.
- Nutritional secondary hyperparathyroidism (NSHP): Correct husbandry problems and correct hypocalcemia with calcium and vitamin D first. Once calcium level is normal and patient is on oral calcium supplementation (usually about 7 days after starting therapy) give calcitonin. Supportive care can be tapered off once patient becomes stable.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Calcitonin salmon is a synthetic polypeptide hormone primarily used in veterinary medicine to manage severe hypercalcemia (e.g., secondary to cholecalciferol rodenticide toxicity, apocrine gland anal sac adenocarcinoma, or lymphoma) and nutritional secondary hyperparathyroidism (NSHP) in reptiles. It may also be used as an adjunctive treatment for severe bone pain.
- Clinical Pearl: Salmon calcitonin is utilized therapeutically because it is approximately 50 times more potent and has a longer duration of action than mammalian (human) calcitonin.
- Limitation: Its clinical utility is often limited by expense and the rapid development of tachyphylaxis (downregulation of receptors), meaning it typically loses efficacy after a few days of continuous treatment.
- Caution: Do not confuse calcitonin (which lowers serum calcium) with calcitriol (which raises serum calcium).
Mechanism of action
Calcitonin exerts a multitude of physiologic effects to rapidly lower serum calcium levels:
- Bone: Binds directly to calcitonin receptors on osteoclasts → profoundly inhibits osteoclastic bone resorption → decreases the release of calcium and phosphorus from bone into the extracellular fluid.
- Kidneys: Acts on the renal tubules → reduces tubular reabsorption of calcium, phosphate, sodium, magnesium, potassium, and chloride → promotes their renal excretion.
- Gastrointestinal Tract: Increases jejunal secretion of water, sodium, potassium, and chloride (but notably not calcium).
Safety & warnings
Contraindications
- Hypersensitivity to calcitonin
- Patients with a history of hypersensitivity to other proteins may be at risk
Adverse effects
- Anorexia
- Vomiting
- Hypocalcemia (with overmedication)
- Diarrhea
- Injection site pain and swelling
- Redness
- Peripheral paresthesias (reported in humans)
- Allergic reactions (rare)
- Tachyphylaxis (resistance to therapy over time)
Precautions
Important Warnings
- Age Sensitivity: Young animals are reportedly up to 100 times more sensitive to the effects of calcitonin than older adult animals.
- Tachyphylaxis: Resistance to the drug's effects frequently develops after several days of treatment.
- Pregnancy: FDA Category C. Very high doses have decreased birth weights in laboratory animals due to metabolic effects. It does not cross the placenta.
- Lactation: Calcitonin has been shown to inhibit lactation. Safe use during nursing has not been established.
Drug interactions
May interfere with the efficacy of calcitonin
May interfere with the efficacy of calcitonin
Monitoring
- Serum Calcium
Pharmacokinetics
Absorption
Destroyed in the gut after oral administration; must be given parenterally. IV onset is immediate. IM or SC onset occurs within 15 minutes with maximal effects at about 4 hours. Duration of action is 8-14 hours after IM or SC injection.
Distribution
Does not cross the placenta.
Metabolism
Thought to be rapidly metabolized by the kidneys, in the blood, and in peripheral tissues.
Elimination
Renal excretion.
Overdose
Very limited data is available. Nausea and vomiting have been reported after accidental overdose injections. Chronic overdosing can lead to severe hypocalcemia.
Available products
Formulations
- Injection
- Intranasal spray
Human-labeled
- Calcitonin Salmon for Injection: 200 IU/mL in 2 mL vials; Miacalcin® (Novartis)
- Calcitonin Salmon Intranasal Spray: 200 Units/activation (0.09 mL/dose) in 2 mL vials (Miacalcin®) and 3.7 mL metered-dose (Fortical®) glass bottle with pump
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Injection: Store in the refrigerator (2-8°C). Nasal solution: Store in the refrigerator but protect from freezing. Once in use, store at room temperature in an upright position and use within 35 days.
Client information
Calcitonin is a hormone used to rapidly lower dangerously high calcium levels in the blood, or to treat severe metabolic bone disease (especially in reptiles).
- Administration: It must be given by injection, as it is destroyed in the stomach if given orally.
- Side Effects: Watch your pet for loss of appetite or vomiting. Let your veterinarian know if these occur.
- Monitoring: Your veterinarian will need to perform frequent blood tests to monitor calcium levels and ensure they do not drop too low.
- Reptile Owners: If treating metabolic bone disease, calcitonin is only one part of the therapy. Correcting diet, lighting (UVB), and providing calcium supplements as directed by your veterinarian are critical for long-term success.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.