Miacalcin (Calcitonin Salmon) for Osteoporosis

Miacalcin (calcitonin salmon) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat osteoporosis in women who have been through menopause for more than five years.

How Miacalcin Works and How It’s Taken

Miacalcin is a form of calcitonin salmon. It works by attaching to calcitonin receptors in the body and acts mainly on bone. With continued use, it can slow the process that breaks down bone. The exact role of calcitonin in normal bone health is not fully understood.

Doctors prescribe Miacalcin for osteoporosis in women who are more than five years past menopause when other osteoporosis treatments are not suitable.

Miacalcin is given once a day as an injection under the skin or into a muscle. With proper training in sterile injection technique, injections can be given at home.

Typical Dosing for Osteoporosis

The recommended dose of Miacalcin for postmenopausal osteoporosis is 100 United States Pharmacopeia (USP) units, or 0.5 milliliters, once a day. It is injected under the skin or into a muscle.

People taking Miacalcin for postmenopausal osteoporosis should get at least 1,000 milligrams of elemental calcium and at least 400 international units of vitamin D each day.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Miacalcin Side Effects

In clinical studies of Miacalcin, the most common side effects occurred in about 2 percent to 10 percent of people. These include:

Nausea (with or without vomiting)
Injection site reactions (such as skin discoloration, swelling, or irritation where the shot is given)
Flushing (warmth, skin color changes, or a “flushed” feeling of the face or hands)

Serious Side Effects and Warnings

Miacalcin can cause serious side effects that may require immediate medical attention. These include:

Serious allergic reactions — Hypersensitivity reactions can occur, including anaphylaxis, which is a life-threatening allergic reaction that can cause trouble breathing, swelling of the tongue or throat, or shock.
Hypocalcemia — Low calcium levels in the blood can cause muscle cramps or twitching and, in severe cases, seizures.
Malignancy (cancer) risk — Studies found a higher overall rate of cancer in people treated with calcitonin salmon than in people given a placebo. The studies did not prove that calcitonin salmon caused the cancers.

Get medical help right away if you think you are having a serious reaction.

How To Save on Miacalcin

Viatris Inc, the manufacturer of Miacalcin, offers the Viatris Patient Assistance Program. Eligible people with demonstrated financial need may receive certain medicines at no cost.

The Viatris Patient Assistance Program also offers customer support for questions and assistance.

To learn more, visit the Viatris Patient Assistance Program website or call 888-417-5780. You can also download the application form here.

What To Know Before Taking Miacalcin

Before starting Miacalcin, your doctor will check calcium levels in your blood and low levels should be corrected. Other problems that affect minerals in your body, such as vitamin D deficiency, should also be treated.

Tell your doctor if you have any allergies to calcitonin salmon or any ingredients in Miacalcin.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Do not take Miacalcin if you have had a serious allergic reaction to calcitonin salmon or any of its ingredients.

Miacalcin is also FDA-approved to treat symptomatic Paget’s disease of bone when other treatments are not suitable and to treat hypercalcemia, which means calcium levels in the blood are too high.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Miacalcin, talk with your doctor about the risks and benefits.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Miacalcin for osteoporosis?

In two studies that lasted two years, researchers looked at women ages 50 to 74 who had gone through menopause. Total body calcium increased after one year of daily Miacalcin. At two years, it had gone down from the one-year level but was still above where it started.

Miacalcin has not been shown to lower the risk of bone fractures. In the first year of the studies, there were six new spinal compression fractures in the Miacalcin group and five in the control group. In the second year, there were seven new fractures in each group. Another controlled study that ended early also did not show that Miacalcin reduced fracture rates.

How long does Miacalcin take to work for osteoporosis?

The osteoporosis studies reported results at one year and two years. Total body calcium increased from the starting level at one year. At two years, it had decreased from the one-year level but was still above the starting level. It does not give an earlier time point for when Miacalcin starts to provide an osteoporosis benefit.

What tests or monitoring are needed with Miacalcin for osteoporosis?

Before starting Miacalcin, low calcium levels in the blood should be corrected. Other problems that affect minerals in the body, such as vitamin D deficiency, should also be treated.

If you are at risk for low blood calcium, your healthcare provider may check your blood calcium level and watch for symptoms such as muscle cramps, twitching, or seizures, especially during the first several doses.

Your healthcare provider may also consider periodic urine tests to look for changes in urine sediment.