Bone & calcium
Calcitonin (salmon)
A salmon-derived hormone peptide once common in bone disease, now used more narrowly after regulators weighed modest benefit against a debated malignancy signal.
- How settled this rating is:
- moderate confidence in the current evidence rating
- Routes studied:
- Nasal, Subcutaneous injection, Intramuscular
- Also known as:
- salmon calcitonin, Miacalcin, Fortical
- Last reviewed:
- 2026-08-23
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Evidence passport
Calcitonin (salmon)
A one-screen evidence identity for this compound. These fields describe research maturity, confidence and legal status. They are not a safety guarantee, efficacy percentage or recommendation.
- Evidence level
- L4Good human trials
- Confidence
- Moderate confidence in rating
- Regulatory status
- Approved medicine (jurisdiction-specific) · See jurisdiction details
- Development status
- Approved
Evidence strength
Higher = more and better-quality human evidence. It does not mean the effect is bigger or that the compound works for you.
Higher = more mature, better-documented human safety data. It does not mean the compound is safer than one with a lower number.
The 0-100 values rate the strength and maturity of evidence, not how effective or safe the compound is.
- Evidence base
- Includes human studies
- Furthest established stage
- Approved
- Human research maturity
- Established medicine with a narrowed modern role
- Source curation
- Source curation pending
Routes recorded
Overview
Higher = more and better-quality human evidence. It does not mean the effect is bigger or that the compound works for you.
Higher = more animal, tissue or cell research. Preclinical results are a starting point, not proof of a human benefit.
Higher = more mature, better-documented human safety data. It does not mean the compound is safer than one with a lower number.
How to read these scores
Every number here rates the evidence, not the compound. They are editorial 0-100 strength ratings, not percentages, and not a rating out of five stars.
- Human efficacy evidence strength — Higher = more and better-quality human evidence. It does not mean the effect is bigger or that the compound works for you.
- Preclinical evidence strength — Higher = more animal, tissue or cell research. Preclinical results are a starting point, not proof of a human benefit.
- Human safety evidence strength — Higher = more mature, better-documented human safety data. It does not mean the compound is safer than one with a lower number. A score of 80 does not mean “80% safe”.
- Evidence level (L0-L5) — the strongest type of study behind the compound, from anecdote (L0) to large replicated human trials (L5). It is a description of the study evidence, not a quality, safety or recommendation rating.
- Confidence — how likely we think it is that this rating changes as new research lands. Low confidence means the picture is unsettled, not that the compound is bad.
None of these ratings is medical advice, a safety guarantee, or a recommendation to use anything. How we grade evidence.
How far human research has progressed: Established medicine with a narrowed modern role
Routes & formulations
Studied / approved routes
Injectable and nasal products carry different approved indications; evidence for one does not generalise to the other.
Route availability is not evidence of efficacy, and evidence from one route does not transfer to another. The Registry never provides dosing or sourcing information.
Peptide lifecycle
Discovery
Preclinical
Phase I
Phase II
Phase III
Approved
What it is
A synthetic version of salmon calcitonin, a hormone peptide that slows bone breakdown by acting on osteoclasts; more potent milligram-for-milligram than human calcitonin.
What people claim
- Slows bone loss in postmenopausal osteoporosis
- Treats Paget's disease and high blood calcium
What the evidence actually says
Older controlled trials support its labelled bone indications, but its fracture-prevention effect is weaker than newer osteoporosis medicines, and regulators in Europe and the US have weighed a small numerical imbalance in malignancy rates seen across long-term trials. Its modern role is deliberately narrow.
Related evidence
Useful next reads based on this compound — not recommendations.
- Related compound
Teriparatide evidence profile
A parathyroid-hormone fragment that builds bone — one of the few anabolic osteoporosis treatments.
- Compare
Compare Calcitonin (salmon) vs Teriparatide evidence
Same questions, same fields, side by side — including how much human evidence exists.
- Context
Safety Centre
What approved, investigational and unapproved actually mean for documented human safety.
- Context
Research Desk
How to read animal, early-phase and controlled human studies without over-reading them.
Human evidence
- Randomised trials in postmenopausal osteoporosis and Paget's disease.
- Regulatory safety reviews (EU 2012; US advisory discussion in 2013) of a malignancy imbalance.
Preclinical evidence
- Osteoclast pharmacology and bone-turnover models.
Animal and cell findings are Level 1–2 evidence.
Mechanism and pathways
- Calcitonin-receptor activation inhibits osteoclast-mediated bone resorption.
Safety and unknowns
- Regulators reviewed a small numerical imbalance in malignancy rates across long-term trials; causality was not established, but EU indications were narrowed.
- Hypocalcaemia and hypersensitivity reactions are labelled.
Cancer relevance
This section covers questions raised by how the compound works in the body, plus anything regulators and trial teams keep an eye on. It is not a statement that this compound causes cancer — for most compounds here, no human data exist in either direction.
Monitored in trials; not demonstrated in humans
Regulatory status
Regulatory decisions apply to specific jurisdictions, products, formulations and indications. An approval elsewhere is not automatically an approval in your country.
Named regulators: FDA (US), European regulators
Approved formulations have included injectable products (e.g. for Paget's disease and hypercalcaemia) and nasal spray products (for postmenopausal osteoporosis in women at least five years past menopause when alternatives are unsuitable). Availability and indications vary by product and market; European regulators restricted uses after a 2012 safety review.
Evidence grade
Completed, adequately informative controlled human trials supporting a specified outcome; replication and longer-term safety may remain uncertain.
What would change our rating?
- Definitive resolution of the long-standing malignancy-imbalance question.
References and sources
Source transparency
A provenance snapshot of this profile. Counts show what kinds of sources are cited, not how much scientific weight each source deserves.
- Last editorial review
- 2026-08-23
- Recently reviewed · 54 days ago
- Linked curated sources
- 0
- Sources still pending
- 1
- External specialist reviews
- 0
- None recorded for this profile
Review provenance
Registry editorial review: Colin Jackson-White, creator and editor, who is not a doctor or clinician. External specialist review is credited only when a named reviewer has completed a review of this exact profile.
Literature-discovery and AI tools may help locate or challenge candidate evidence, but they are not counted as evidence sources here. Registry judgements are tied to the underlying papers, trial records, regulator documents and official study records.
- To be curatedSources to be curated
Source hierarchy: regulatory documents and trial registries first, peer-reviewed work next, sponsor material flagged as non-independent. We never use supplier or clinic marketing as evidence, and where a verified source has not yet been curated we say so rather than inventing one.
Evidence change history
These entries record changes to our assessment of the published evidence — not changes to the compound itself.
No recorded changes yet. Baseline position set on 2026-08-23.