Paget's disease of bone. Hypercalcemia. Postmenopausal osteoporosis.
Paget's: 100Units SC or IM daily. Hypercalcemia: initially 4Units/kg SC or IM every 12hrs, may increase after 1–2 days to 8Units/kg every 12hrs, and then after 2 more days to max 8Units/kg every 6hrs. Postmenopausal osteoporosis: 100Units SC or IM every other day.
For nasal spray: do periodic nasal exams; discontinue if severe ulceration occurs. For inj: monitor for hypocalcemic tetany initially and urine sediments in chronic use; serum alkaline phosphatase and hydroxyproline in Paget's. Postmenopausal osteoporosis: supplement diet with calcium (1–1.5g/day) and Vit.D (400 IU/day); reevaluate periodically. Pregnancy (Cat.C), nursing mothers: not recommended.
May antagonize lithium. Nasal spray: may be antagonized by prior diphosphonate therapy in patients with Paget's disease.
Nasal spray: rhinitis and other nasal/respiratory symptoms, back pain, GI upset. Inj: GI upset, local inflammation, flushing, rash, antibody formation. Both: hypersensitivity reactions, anaphylaxis.
Nasal spray (3.7mL)—1 (30 doses); Inj (2mL) vial—1