Calcitonin Therapy Guidelines

Monitoring and Duration Protocol

The American College of Gastroenterology recommends that calcitonin therapy should be continued for at least three years, and possibly for as long as osteoporosis persists, with yearly bone mineral density (BMD) measurements to monitor response 1, 2
BMD should be measured yearly while on calcitonin treatment to assess effectiveness 2
If BMD falls >4% per year in two successive years, treatment should be changed to another drug 1, 2
If no deterioration is observed, calcitonin should be continued for at least three years 2
After three years, treatment may be continued for as long as osteoporosis persists 1, 2

For men over 55 years with osteoporosis, especially those with fragility fractures, calcitonin should be considered if testosterone is normal or if BMD does not improve on testosterone replacement 1, 4

Calcitonin is significantly more expensive than bisphosphonates (approximately eight times more expensive than alendronate) 2, 4
The optimal duration of treatment is not definitively established, and recommendations are based on limited long-term studies 2