Calcimar

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Calcimar

Property Description
Active ingredient Calcitonin Salmon (Salcatonin)
Form Sterile Solution (Injection), Nasal Spray
Pharmacological class Calcium Metabolism Modifier
General Purpose Bone density conservation, hypercalcemia management
Origin Synthetic Peptide Hormone

What is the Core Identity and Class of Calcimar?

Calcimar is a brand name for a prescription medication classified as a Calcium Metabolism Modifier, an agent that actively regulates mineral levels in the body. The drug's core is the single active substance, Calcitonin Salmon (INN: Salcatonin), which is a synthetic peptide hormone composed of 32 amino acids. This substance is deliberately synthesized from the salmon sequence because it is clinically recognized for exhibiting greater potency and a longer biological duration of action compared to the naturally occurring human form of calcitonin.

Is Calcitonin Salmon Synthetic, and How is it Formulated?

Calcitonin Salmon is a synthetic peptide, manufactured for high purity and pharmaceutical consistency, allowing it to function as a protein-based therapy. Calcimar is commonly supplied as a sterile solution intended for administration via subcutaneous or intramuscular injection, although the active ingredient is also available in nasal spray form under other trade names. The injectable form is an aqueous solution containing the peptide and basic stabilizing excipients. This choice of formulation ensures the drug is delivered systemically for maximum effect on the skeletal and mineral systems.

What is the General Purpose of Calcimar's Action?

The general therapeutic purpose of Calcimar is two-fold: to assist in the regulation of calcium and to support skeletal stability. Its physiological action is that of a powerful calcitonin receptor agonist, which directly and quickly inhibits osteoclastic bone resorption—the process central to bone breakdown. This fundamental anti-resorptive mechanism makes the medication a bone density conservation agent. Furthermore, the drug's action contributes to decreasing elevated serum calcium levels, which is essential for rapidly restoring critical mineral balance when calcium concentrations are excessively high.

Regulatory References

  1. greater potency and a longer biological duration of action
  2. anti-resorptive mechanism
  3. decreasing elevated serum calcium levels

What side effects are possible with Calcimar?

Possible Side Effects and Safety Information

The safety profile for Calcimar (Calcitonin Salmon), available as an injection or nasal spray, is officially categorized based on regulatory clinical data, focusing on common adverse reactions, system-organ classes affected, and documented serious risks.


Adverse Reaction Scope

Classification Description based on Regulatory Documents
Common Side Effects Injection: Nausea (often decreasing with continued use) and local reactions at the injection site (e.g., pain, inflammation), which are reported in approximately 10% of patients. Nasal Spray: Nasal symptoms such as rhinitis, irritation, crusting, and nosebleeds (epistaxis) are frequently reported, along with headache, back pain, and joint pain (arthralgia).
System-Organ Classes Adverse reactions are documented across the Gastrointestinal System (nausea, vomiting), the Vascular System (flushing of the face or hands), the Musculoskeletal System, and the Nervous System (headache).

Serious Safety Information

The official labeling includes documentation of serious hypersensitivity reactions, including reports of anaphylaxis and rare fatalities. Because of the risk of severe complications, hypocalcemia (low calcium levels) must be corrected prior to treatment initiation. Additionally, a meta-analysis of clinical trials involving the nasal and oral forms suggested an increased risk of overall malignancies associated with long-term exposure, a risk that cannot be definitively excluded with the injectable form.


Specific Safety Constraints

Circulating antibodies to Calcitonin Salmon have been reported, which may be associated with a loss of therapeutic response over time. The safety and efficacy of the medication have not been established in pediatric patients, and its use is generally not recommended during pregnancy or lactation.

Overdose and Emergency Response

Overdose Scope: Officially Documented Manifestations

Regulatory documents define Calcimar (Calcitonin Salmon) overdosage primarily by the exacerbation of its known pharmacological effects. Documented clinical manifestations of overdose, particularly following parenteral administration, include pronounced nausea and vomiting. These effects are considered dose-dependent.

Serious Outcomes and Immediate Action

The most significant metabolic risk associated with Calcimar overdosage is the potential for severe hypocalcemia (abnormally low serum calcium levels). This condition may lead to the life-threatening consequence of tetany, involving involuntary muscle contractions.

When overdosage is suspected or known, the regulatory requirement is to seek immediate medical attention. This action is critical because there is no specific antidote known for Calcitonin Salmon. Management is therefore strictly symptomatic and supportive.

Supportive Care and Monitoring Requirements

Official labeling describes procedural steps for managing severe overdose, including the provision for parenteral administration of calcium to correct pronounced hypocalcemia. Patients must be maintained under close observation and serum calcium levels must be continuously monitored to guide supportive treatment. Due to the rapid clearance of the peptide, treatment focuses on timely management of the metabolic and symptomatic consequences.

Therapeutic Uses of Calcimar

The primary role of Calcimar (Calcitonin Salmon) is to provide targeted therapeutic support across areas involving systemic or localized discomfort. The medication is generally used for patients for whom alternative standard treatments are not suitable or appropriate.

This medication may be applied in contexts where additional symptomatic support is needed across several areas, including symptomatic Paget’s disease of bone, postmenopausal osteoporosis, and acute hypercalcemia (excessively high serum calcium).


Stabilization of Chronic Bone Disease

Calcimar may be part of symptomatic management for conditions presenting with systemic or localized discomfort, such as Paget's disease and postmenopausal osteoporosis. Its primary benefit helps support bone health and contributes to maintaining a sense of stability when symptoms are more noticeable.

Correction and Comfort

Calcimar may be applied in contexts where short-term symptomatic assistance is needed for hypercalcemia. This therapeutic area is relevant in clinical settings that involve temporary physiological imbalance where a reduction in high blood calcium concentrations is appropriate. The medication is commonly used to help ease the burden of acute bone pain associated with symptoms related to physical discomfort. This application assists with maintaining functional stability and contributes to improved day-to-day comfort.


Quick Fact: Relief for Acute Skeletal Discomfort Calcimar is applied when symptoms are driven by acute structural skeletal trauma, supporting the patient during difficult episodes by easing the overall symptom load associated with bone pain.

Regulatory References

  1. DailyMed US National Library of Medicine

Eligibility and Restrictions for Use

Who can and cannot use Calcimar? — Official Regulatory Information

The eligibility profile for Calcimar (Calcitonin Salmon) is defined by official regulatory bodies, focusing on patient status, required pre-treatment conditions, and strict usage limitations.

Eligibility scope

Category Official Regulatory Statement
Populations for whom use is allowed Adult patients (18 years and older) for labeled indications (e.g., Paget's disease, hypercalcemia). Use is reserved for patients for whom alternative treatments are not suitable.
Populations for whom use is not recommended Children and adolescents (use not established). Breastfeeding women. Patients with postmenopausal osteoporosis (use is withdrawn/not recommended in many regions due to long-term risk).
Populations for whom use is contraindicated Patients with known hypersensitivity to Calcitonin Salmon. Patients with existing hypocalcemia (low serum calcium).
Age-related eligibility rules Pediatric Use: Safety and effectiveness have not been established. Geriatric Use: No significant difference in response compared to younger adults has been identified.
Condition-specific eligibility rules Hypocalcemia and other mineral disorders must be corrected before initiating therapy. Patients with Hepatic Impairment show no evidence of reduced tolerability.
Pregnancy and lactation eligibility Pregnancy: Use is only if treatment is considered absolutely essential. Lactation: Not recommended during treatment.
Eligibility-related restrictions Treatment duration for chronic indications (e.g., Paget's disease) is limited to the shortest possible time (e.g., three months) due to the possible increased risk of malignancy associated with long-term use.

Eligibility classifications (high-level)

Classification Official Regulatory Wording
Eligibility severity classification Contraindicated (Hypersensitivity, Hypocalcemia); Not Recommended (Pediatric Use, Lactation); Use Only If Essential (Pregnancy).
Eligibility-context constraints Metabolic pre-treatment is required; Alternative therapy failure is necessary for eligibility; Duration limits apply due to malignancy risk.

Resulting eligibility structure

Official eligibility statements formally contraindicate the medicine in specific allergic and metabolic states. Use is restricted to adults only, and therapy is typically reserved for second-line use when alternatives are unsuitable. Stringent duration limits are imposed for all chronic use based on long-term safety data, defining a critical constraint on who can receive continued treatment.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The regulatory information for Calcimar (Calcitonin Salmon) identifies interaction patterns primarily related to its influence on the body's mineral and electrolyte balance and its effect on the renal clearance of co-administered medicines. Official documents note that formal studies designed to evaluate the potential for drug interactions involving CYP-mediated enzyme systems have not been conducted.

Interacting Substance/Class Official Interaction Pattern Contextual Constraint
Lithium Leads to a reduction in plasma concentrations resulting from the drug's effect on increased urinary clearance. Dosing of Lithium may require adjustment due to altered drug exposure.
Bisphosphonates May cause an additive pharmacodynamic effect that further lowers serum calcium concentrations. Co-administration requires careful consideration due to compounded effects.
Cardiac Glycosides / Calcium Channel Blockers Therapeutic effects may be modified by changes in cellular electrolyte concentrations. Clinical care is advised when co-administering due to potential electrolyte fluctuation.
Calcium and Vitamin D Adequate intake of both supplements is a mandatory condition for use in treating postmenopausal osteoporosis and Paget's disease. Required to support the medication’s intended action on bone health.

A significant procedural constraint is that pre-existing hypocalcaemia must be corrected before therapy initiation, as it is formally listed as a contraindication. Population-specific data indicates that metabolic clearance is notably lower in patients with end-stage renal failure compared to healthy subjects, a consideration noted in regulatory summaries.

Mechanism of Action

Calcimar is a synthetic form of the hormone calcitonin that functions by targeting and modulating specific receptor systems within the body, influencing mineral homeostasis and specific neural pathways. Its mechanism operates through three distinct domains: bone, kidney, and central nervous system pathways.

Bone Resorption and Calcium Homeostasis

Calcimar's primary mechanistic action involves binding as an agonist to the Calcitonin Receptor (CTR), which is highly expressed on osteoclasts—the cells responsible for bone breakdown. Activation of this receptor initiates a signaling cascade that rapidly inhibits osteoclast activity and their capacity to resorb bone. This activity results in a reduction in the rate of osteoclast-mediated bone resorption and decreases the flux of calcium and phosphate from the bone matrix into the circulation.

Regulation of Renal Mineral Excretion

The drug acts on the CTR in the renal tubules of the kidney. This mechanistic domain involves altering the signaling dynamics within the renal epithelium to affect the tubular handling of minerals. This mechanism results in the increased urinary excretion of calcium and phosphate, altering the systemic mineral equilibrium.

Modulation of Central Neural Pathways

Calcimar modulates signaling within neural pathways by activating CTRs found in specific areas of the central nervous system (CNS), including the spinal cord and brain. This engagement with neural signaling sequences is associated with the release of endogenous opioid mediators, thereby influencing pathways related to sensory input.

Dosage and Administration Information

Calcimar (calcitonin-salmon) is administered by subcutaneous (SC) or intramuscular (IM) injection. It is important to receive clear instructions from your healthcare provider or nurse on the proper preparation and technique for injection before self-administering this medication at home.

Dosage and Administration

Dosage regimens vary significantly based on the condition being treated and the patient's individual response. Treatment should be limited to the shortest possible duration at the minimum effective dose due to a potential increased risk of malignancies with long-term calcitonin use.

  • For Paget's Disease: The typical initial dosage is 100 International Units (I.U.) daily by SC or IM injection. A maintenance regimen may be adjusted down to 50 I.U. three times weekly. Duration of treatment should not normally exceed three months, though it may be extended to a maximum of six months under specific, exceptional circumstances (e.g., impending pathological fracture).
  • For Hypercalcemia: The recommended starting dose is 4 I.U. per kilogram of body weight every 12 hours via SC or IM injection. This may be increased based on the patient's response, up to a maximum of 8 I.U./kg every six hours. If the injection volume exceeds 2 mL, multiple injection sites should be used.

General Injection Guidelines

  • Visual Inspection: Before use, visually inspect the solution for discoloration or the presence of particles. Do not use the solution if either is observed.
  • Injection Site Rotation: Always rotate the injection site with each dose to avoid skin complications.
  • Storage: Store unopened Calcimar in the refrigerator (2°C to 8°C). Do not freeze. Before administration, allow the solution to reach room temperature.

Recent Clinical Evidence

Calcimar: Recent Clinical Evidence


Evidence for Managing Paget’s Disease of Bone

Research on Calcimar for Paget’s disease has been conducted using prospective clinical trials, including studies that explored how the subcutaneous injection compares to other forms. Researchers monitored physiological changes and patient experiences. They measured outcomes such as changes in serum alkaline phosphatase (ALP) activity, a key marker of bone turnover. Studies also examined how symptoms change over time, focusing on patient-reported outcomes describing perceived discomfort.

What remains unclear is the long-term duration of these findings, as follow-up durations were limited. Patterns related to the development of biochemical changes in some patients during chronic administration was observed in some studies. Data for certain groups remain insufficient, as research often examined specific populations.


Evidence for Evaluating Postmenopausal Osteoporosis

Calcimar was evaluated in large-scale, long-term Randomized, Placebo-Controlled Trials (RCTs) to examine the relationship between Calcimar and changes in bone density and the incidence of fractures in postmenopausal women. The studies explored specific outcomes: the incidence of new vertebral fractures (fractures of the spine), changes in non-vertebral fracture rates, and changes in Bone Mineral Density (BMD).

The data show patterns related to the frequency of new vertebral fractures when the studied populations were compared to those receiving a placebo. However, studies reported that data for certain groups remain insufficient regarding non-vertebral fracture rates. The overall magnitude of the reported change in fracture incidence remains an area where limited evidence is available.


Evidence for Acute Control of High Calcium Levels

Studies monitoring outcomes monitoring physiological strain or stress by measuring the change in elevated serum calcium levels and the time required to reach a more stable mineral balance. Studies reported that change in high serum calcium levels was monitored following administration. The potential for patterns related to a lessened physiological response observed in some studies with continuous administration remains an area of study.

Key Studies & References

  1. DailyMed: CALCIMAR- calcitonin salmon injection, solution
  2. A meta-analysis of the analgesic effect of calcitonin for pain relief in osteoporosis and vertebral fractures

Frequently Asked Questions (FAQ)

Common questions about Calcimar (FAQ)


Q: Is Calcimar the same as other medicines for bone conditions?

Calcimar is classified in official documents as a Calcium Metabolism Modifier and a synthetic peptide hormone. This classification is different from the categories of other medications used for bone health, such as bisphosphonates, which are mentioned in the product information regarding potential interactions.


Q: Can Calcimar be used for people who have kidney issues?

Regulatory information notes that the body's clearance of the drug is notably lower in people with end-stage renal failure compared to healthy subjects. Due to this, the official product information indicates that the patient’s renal function is a factor for consideration by a healthcare professional.


Q: Is Calcimar something that requires regular blood tests?

Official information advises that low calcium levels, known as hypocalcemia, must be corrected before starting Calcimar therapy. Regulatory documents mention that, given the drug's effects, periodic laboratory tests may be used by healthcare professionals to monitor mineral balance.


Q: Is Calcimar generally considered a long-term treatment?

Official guidance indicates that treatment for chronic conditions should be limited to the shortest effective duration possible. Regulatory documents note an increased risk of overall malignancy suggested by studies of long-term use of the nasal/oral forms. Due to this risk, the drug is subject to duration limits for chronic use in official labeling.


Q: Are there any known interactions between Calcimar and heart medications?

Official product labeling notes that the effects of certain heart medicines, specifically Cardiac Glycosides and Calcium Channel Blockers, may be modified by changes in the body's electrolyte concentrations that Calcimar can influence. The interaction is noted in official documents when co-administering these classes of medicines.


Q: How quickly can I expect to notice any effects from Calcimar?

For the treatment of hypercalcemia (high calcium levels), an initial effect may be observed relatively quickly, sometimes within two hours of administration. Its action involves a rapid, transient inhibition of bone breakdown.


Q: Are there any foods or drinks I need to avoid while taking Calcimar?

According to official regulatory and drug information sources, there are no known interactions between calcitonin salmon and general foods or drinks. However, for the treatment of hypercalcemia, a low-calcium diet may be prescribed as part of the management of that condition.


Q: What kind of studies have been done on Calcimar?

The research base for Calcimar includes studies such as Randomized, Placebo-Controlled Trials (RCTs) and prospective clinical trials. These studies were used to examine patient outcomes, including changes in Bone Mineral Density (BMD) and the effects on the incidence of fractures for its labeled indications.


Q: Is Calcimar a hormone or a vitamin?

Calcimar is a brand name for the active ingredient Calcitonin Salmon. This substance is classified as a synthetic peptide hormone that works to regulate mineral levels in the body; it is not a vitamin.


Q: Do older adults typically use Calcimar?

The drug is approved for adult-only indications. Official information indicates that its use for adult-only conditions includes the geriatric population, as no significant difference in response was identified compared to younger adults.


Q: Why is Calcimar sometimes given as a nasal spray?

The active ingredient in Calcimar, calcitonin salmon, is available in a nasal spray form under other trade names, which was used for the treatment of postmenopausal osteoporosis. This route of administration offers a different option for the systemic delivery of the medication.


Q: What if I am taking supplements, can I still use Calcimar?

Official product information describes that adequate intake of calcium and Vitamin D supplements is required for use when treating certain bone conditions. Interactions with other types of general supplements are not uniformly described in the product label.


Q: Where does the active ingredient in Calcimar come from?

The active ingredient is Calcitonin Salmon (Salcatonin), which is a synthetic peptide. It is chemically manufactured in a laboratory to be identical to the calcitonin molecule naturally produced by salmon. This synthetic form is used for pharmaceutical purposes.


Q: How long does the effect of a Calcimar dose last?

Following a subcutaneous or intramuscular injection, the effect of the drug in lowering high calcium levels is reported to last between 6 to 8 hours. The half-life, which is the time it takes for half of the drug to be eliminated from the body, is approximately 43 to 64 minutes.


Q: Have there been any recent updates to the safety information for Calcimar?

Regulatory bodies like the FDA actively review the drug's administrative and safety status. The FDA confirmed that the Calcimar injection was not withdrawn from the market for safety or effectiveness reasons, providing a current status update.


Q: Does Calcimar have any effect on blood pressure?

Adverse reaction reports associated with the medication have included mentions of changes in the vascular system. These reports cite instances of hypertension (high blood pressure) and flushing (a warming and redness of the face or hands).


Q: Can Calcimar affect the results of other medical tests?

Regulatory documents note that the formation of circulating antibodies (immune proteins) to Calcitonin Salmon has been reported in some patients. This presence of antibodies may be associated with a loss of the medication's therapeutic response over time, which could be reflected in follow-up tests.


Q: Is there a generic version of Calcimar available?

The FDA determined in 2019 that the original CALCIMAR (calcitonin salmon) Injection product was not withdrawn for safety or effectiveness reasons. This regulatory action legally allows for the potential approval of generic versions if they meet all other regulatory requirements.


Q: Is Calcimar meant to be taken at a specific time of day?

Official guidance indicates that the medication is typically administered once a day or every other day. However, the instructions for use do not specify a mandatory time of day (such as morning or evening) for administration.


Q: Do official documents mention any effects of Calcimar on sleep?

Adverse reaction reports have included mentions of side effects that may affect a patient’s rest. These reports cite occurrences such as waking to urinate at night (nocturia) and descriptions of generally having trouble sleeping.


Q: How is the safety of Calcimar monitored by regulatory bodies?

Regulatory bodies actively monitor the drug's safety by continually reviewing records, published literature, and reports of possible postmarketing adverse events. They issue public determinations, ensuring the drug's status remains current based on available data.

How should Calcimar be stored and disposed of?

Storage and Disposal Instructions for Calcimar (Calcitonin Salmon) Injection

Mandatory Storage Conditions

Calcimar injection must be stored under refrigeration at a temperature between 2 C and 8 C (36 F and 46 F). It is essential that the product not be frozen and that it remains protected from light. Store the solution in its original container and allow it to warm to room temperature before use.

Stability and Child Safety

The stability of the product is compromised outside the cold chain. The injection must be discarded if it has been kept out of refrigeration for more than 24 hours. Before use, visually inspect the solution, as it must be clear and colorless, free of particles. As a mandated safety rule, keep this medicine out of the sight and reach of children and pets.

Official Disposal Rules

Dispose of used needles, syringes, and vials in an FDA-cleared sharps disposal container. Do not flush the unused or expired medication down the toilet or pour it into a drain. Disposal of the remaining drug product should be done in accordance with local pharmaceutical waste regulations.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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