The structure of all calcitonins shows a chain of 32 amino acids and a ring of seven amino acid residues at the N-end, the sequence of which is not the same in different species. Because salmon calcitonin has higher affinity for the receptor (as compared with calcitonin mammals), its action is expressed to the greatest degree both in strength and duration. By inhibiting osteoclast activity by acting on specific receptors, salmon calcitonin significantly reduces bone turnover rate to a normal level in conditions with increased rate of resorption, such as osteoporosis. As in animals and humans have shown that dianabol stack possess analgesic activity with pain of bone origin, which presumably is due to a direct effect on the central nervous system. Even after a single application nasal Spray in humans indicated a clinically relevant biological response that is manifested by increased urinary excretion of calcium, phosphorus, and sodium (by reducing their tubular reabsorption) and decreased excretion of hydroxyproline. In long-term (over 5 years!) Application achieved significant and sustained reduction in the level of biochemical markers of bone turnover such as serum C-telopeptides (sCTX) and skeletal isoenzymes of alkaline phosphatase. Application nasal spray results in a statistically significant increase (1- 2%) in bone mineral density of the lumbar vertebrae, which is defined in the first year of treatment and lasts up to 5 years. Maintains mineral density in the femur. Application nasal spray at a dose of 200 ME per day resulted in a statistically and clinically significant reduction (36%) the risk of new vertebral fractures in patients treated Miakaltsik (in combination with vitamin D th preparations calcium), compared with the group of patients treated with the placebo (in combination with the same agents). Calcitonin reduces gastric and exocrine pancreatic secretion.
Bioavailability Miakaltsik applied intranasally is 3.5% relative to the bioavailability of the drug applied parenterally. Miakaltsik rapidly absorbed through the nasal mucosa and the maximum plasma concentration is achieved within the first hour (mean of about 10 minutes). The half-life of about 20 minutes. Repeated use of the drug accumulation was observed. In applying the drug in doses greater than recommended, its concentration in the blood were higher (which was confirmed by an increase in the area under the curve “concentration-time» (AUC)), but the relative bioavailability is not increased.
Determination of concentration of calcitonin salmon in plasma, as well as concentrations of other polypeptide hormones, it is of little value, since the level of concentration is impossible to predict the therapeutic efficacy of the drug. Thus, Miakaltsik activity should be evaluated in clinical performance indicators.
Salmon calcitonin does not cross the placental barrier in humans.
- Treatment of postmenopausal osteoporosis.
- Bone pain associated with osteolysis and / or osteopenia.
- Paget’s disease (osteitis deformans).
- Neurodystrophic diseases (synonyms: algoneyrodistrofiya, Zudeka atrophy) caused by various etiological and predisposing factors such as post-traumatic painful osteoporosis, reflex dystrophy, frozen shoulder syndrome, causalgia, drug neurotrophic disorders.
: Hypersensitivity to synthetic salmon calcitonin or to any other component of the drug.
Pregnancy and lactation
In experimental studies had no embryotoxic and teratogenic effects and does not pass the placental barrier.
However, clinical data on the safety of use during pregnancy Miakaltsik not. In this regard, the drug should not be used in women during pregnancy.
It is not known whether salmon calcitonin into breast milk in humans penetrates, so the period of drug therapy is recommended to stop breastfeeding.
Dosing and Administration
The drug is to be applied intranasally. Introduction Miakaltsik nasal spray is recommended to turn it into one or the other nostril.
For treatment of osteoporosis a recommended dose of 200 ME per day. In order to prevent the progressive loss of bone mass at the same time using a nasal spray Miakaltsik recommended assignment of adequate doses of calcium and vitamin D. Treatment should be carried out for a long time. Bone pain associated with osteolysis and / or osteopenia . The daily dose is 200-400 ME daily. Daily dose of 200 ME, can be administered for 1 time. Higher doses should be divided into multiple administrations. The dose should be adjusted to the individual needs of the patient. To achieve the full analgesic effect may take several days. During the long-term therapy the initial daily dose is usually reduced and / or increase the interval between doses. Paget’s disease . The drug is administered daily at a daily dose of 200 ME. In some cases, the beginning of treatment may be required in a dose of 400 ME day appointed in several administrations. Duration of treatment is at least 3 months; it may be greater if required. The dose should be adjusted to suit individual patient needs. Note . In Paget’s disease treatment duration Miakaltsik should be from several months to several years. The treatment a significant decrease in the concentration of alkaline phosphatase in the blood and the urine hydroxyproline excretion, sometimes dianabol stack up to the normal range. However, in some cases, after an initial decrease in the values of these indicators may rise again. . In these cases, the doctor, guided by the clinical picture, has to decide whether to cancel the treatment should be and when it can be resumed after one or several months after discontinuation of treatment disorders of bone metabolism may recur; in this case it will require a new course. neurodystrophic disease . It is extremely important early diagnosis. Treatment should be started immediately after the confirmation of the diagnosis. Assign to 200 IU / day (single administration) each day for 2-4 weeks. Perhaps the additional appointment of 200 ME in a day for up to 6 weeks depending on the dynamics of the patient’s condition. Use in children Experience with Miakaltsik nasal spray in children is limited, therefore the nepredstavlyaetsya possible to make recommendations for this age group. Use in elderly patients age and individual patient groups Extensive experience with Miakaltsik nasal spray in elderly patients suggest that this age group is not marked deterioration tolerability or the need to modify the dosing regimen. The same applies to patients with reduced renal or hepatic function, although studies specifically patients have not been conducted for these groups.
reported adverse effects such as nausea, vomiting, dizziness, slight flushing, accompanied by a sensation of heat, arthralgia. Nausea, vomiting, dizziness, hot flushes are dose dependent and often occur after intravenous than after intramuscular or subcutaneous administration. . Against the background of Miakaltsik may develop polyuria and fever, which usually disappear on their own, and only occasionally require temporary dose reduction
incidence of adverse events possibly related to use of the drug is estimated as follows: very common ( > 1/10); common ( > 1/100, <1/10); sometimes ( > 1/1 000, <1/100); rare ( > 1/10 000, <1/1 000), including isolated reports. Immune system : rarely – hypersensitivity; very rare anaphylactic or anaphylactoid reactions, anaphylactic shock; the nervous system : the frequency of headache, dizziness, taste disorders; From the sensory organs : rarely – visual impairment. Since dianabol stack the cardiovascular system : often -prilivy; sometimes – hypertension; the part of the respiratory tract : the frequency is very painful to the nose, congestion, swelling in the nasal mucosa, sneezing, rhinitis, dryness in the nose, allergic rhinitis, nasal mucosal erythema, irritation, odor, in the formation of excoriations nasal; often – nose bleeds, sinus infection, ulcerative rhinitis, pharyngitis; INB ^ yes – cough Gastro-intestinal tract : often – nausea, stomach pain, diarrhea; sometimes -rvota; Skin and subcutaneous tissue : rare – generalized rash.From the musculoskeletal system and connective tissue disorders : often – arthralgia; sometimes – pain in bones and muscles; From the urinary system : rarely – polyuria. On the part of the body in general and local reactions : often – fatigue; sometimes -grippopodobny syndrome, facial swelling, peripheral and generalized edema, rare – fever, injection site reactions drug itching.
For parenteral administration Miakaltsik nausea, vomiting, flushing and dizziness are dose-dependent. Therefore, when an overdose Miakaltsik applied intranasally, you can expect similar effects. However, there are reports of cases where Miakaltsik nasal spray was applied in a dose of up to 1600 and once in ME 800 ME dose per day for 3 days, while There were no serious adverse events. There have been reports of individual cases of overdose. Treat symptomatically.
In case of overdose may develop hypocalcaemia with symptoms such as muscle twitching, paresthesia. Treatment: administration of calcium gluconate.
Interactions with other drugs
When using calcitonin together with lithium therapy may decrease plasma concentrations of lithium. Thus, while the appointment and lithium Miakaltsik preparations may be necessary to correct the last dose.
Because salmon calcitonin is a peptide, there is a possibility of systemic allergic reactions. There are reports of allergic reactions including isolated cases of anaphylactic shock, which occurred in patients treated with Miakaltsik nasal spray. If you suspect that the increased patient sensitivity to salmon calcitonin prior to the start of treatment should be carried out skin tests using diluted sterile solution for injection, Miakaltsik. Note . When long-term therapy is possible the formation of antibodies to calcitonin, but the clinical efficacy is usually not affected. The phenomenon of habituation, which occurs mainly in patients with Paget’s disease receiving long-term therapy may be due to a saturation of binding sites and apparently not related to the formation of antibodies. Therapeutic effect Miakaltsik restored after interruption of treatment.
Effects on ability to drive vehicles and use machines
The effect of Miakaltsik on the ability to drive vehicles and operate machinery has not been studied. Some side effects of the drug, such as dizziness, fatigue and visual disturbances may negatively affect the ability to drive and perform potentially hazardous activities that require high concentration and speed of psychomotor reactions. Buy dmz prohormone online