[[Parenteral]] salmon [[calcitonin]] (Calcimar®): reduces [[osteoclast]]ic activity directly, [[osteoblast]]ic hyperactivity subsides secondarily. [[Relapse]] may occur even while on calcitonin. Side effects include [[nausea]], facial flushing, and the development of antibodies to salmon calcitonin (these patients may benefit from a more expensive synthetic human preparation (Cibacalcin®) starting at 0.5 mg SQ q d).

50–100 IU (medical research council units) SQ q d × 1 month, then 3 injections per week for several months.

If used pre-op to help decrease bony vascularity, ≈ 6 months of treatment is ideal. Doses as low as ≈ 50 IU units 3 ×per week may be used indefinitely post-op or as a sole treatment ([[alkaline phosphatase]] and urinary hydroxyproline decline by 30–50% in > half of patients in 3–6 months, but they rarely normalize).