When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to calcitonin.

How to Use This Medicine:
Spray

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• This medicine is for use only in the nose. Do not get any of it in your eyes or on your skin. If it does get on these areas, rinse it off right away.
• This medicine is used in only 1 nostril each day. It is best to change which nostril you use each day.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Always remove a new bottle of medicine from the refrigerator and let it come to room temperature before you use it.
• You will need to prime the spray the first time you use the bottle. To do this, pump or squeeze the bottle at least 5 times until some of the medicine sprays out. Now it is ready to use. You do not need to prime the bottle before each use.
• After using the nasal spray, wipe the tip of the bottle with a clean tissue and put the cap back on.
• Each spray bottle contains 30 doses of the medicine. Keep track of the doses you use. Throw away the bottle after 30 doses, even if it is not completely empty.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the unopened bottle in the refrigerator. Do not freeze. Store the opened bottle in an upright position at room temperature, away from heat and direct light.
• Keep the bottle tightly closed when you are not using it.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how calcitonin works. Tell your doctor if you are using lithium.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have a vitamin D deficiency.
• This medicine may cause the following problems:
  
  • Low calcium levels in your blood
  • Painful and serious irritation in your nose
  • Increased risk of cancer
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments. Your doctor may also check your nose before and during treatment with this medicine.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Muscle cramps or spasms, numbness or tingling in your fingers, toes, or around your mouth, confusion, seizures
• Severe sores, crusting, redness, or irritation in your nose
• Trouble breathing, heavy nosebleeds

If you notice these less serious side effects, talk with your doctor:

• Light bleeding from your nose
• Mild itching, dryness, or tenderness in your nose
• Runny or stuffy nose

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088