Miacalcic Nasal Spray

Spray

Treatment of postmenopausal osteoporosis in women (usually >5 years after menopause) to reduce bone loss; may be used in Paget’s disease of bone when other treatments are not suitable; may be used for hypercalcaemia of malignancy (typically injectable form—use as per physician advice).

Salmon calcitonin is a hormone that lowers blood calcium and inhibits osteoclast-mediated bone resorption. It helps slow bone breakdown and can modestly improve bone mineral density and reduce vertebral fracture risk in some patients.

Use only in the nose as prescribed. Prime the pump before first use as per pack insert. Usually 1 spray (200 IU) once daily, alternating nostrils each day; use at the same time daily. Avoid blowing nose immediately after dosing; if you miss a dose, take the next dose as scheduled.

Nasal irritation, runny nose (rhinitis), nosebleed (epistaxis), sneezing, headache, dizziness, nausea, flushing, altered taste, sore throat

Prescription medicine. Do not use if allergic to calcitonin/salmon proteins. Nasal adverse effects are common—seek medical advice for persistent ulceration, severe irritation or recurrent nosebleeds. Rare severe allergic reactions (including anaphylaxis) can occur. Long-term use has been associated with a small increased risk of malignancy in some studies; use the lowest effective duration and follow doctor’s advice. Ensure adequate calcium and vitamin D intake if prescribed. Caution in patients with hypocalcaemia—correct calcium levels before starting.

No major clinically significant interactions are common; concomitant lithium may reduce lithium levels (monitor). Use caution with other drugs affecting calcium/bone metabolism (e.g., bisphosphonates, denosumab) as per specialist advice.

Store refrigerated at 2–8°C (do not freeze). Protect from light. After first use, store as directed on pack (often at room temperature below 25°C for a limited period) and keep the bottle upright; discard after the in-use period mentioned in the leaflet.

Miacalcic 200IU Nasal Spray (other pack), Calcitonin Salmon Nasal Spray 200IU (generic, if available), Calcitonin Salmon Injection (alternative form, prescription only), Fortical (calcitonin nasal spray brand, if available)