Short answer: For Paget's disease of bone and postmenopausal osteoporosis, the Miacalcin label dose is 100 USP Units (0.5 mL) once a day by injection under the skin or into a muscle, with calcium and vitamin D. For hypercalcemia it starts at 4 USP Units/kg every 12 hours and may rise to a maximum of 8 USP Units/kg every 6 hours. The label gives no missed-dose rule.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Miacalcin is approved for: Miacalcin injection is a calcitonin approved for symptomatic Paget's disease of bone when other treatments are not suitable; for early treatment of hypercalcemic emergencies, with other agents; and for postmenopausal osteoporosis in women more than 5 years past menopause when other treatments are not suitable (sections 1.1 to 1.3). The label says fracture reduction has not been shown, and continued use is re-evaluated periodically because of a possible link with cancer (section 1.4).
Source
MIACALCIN (calcitonin salmon) injection, for subcutaneous or intramuscular use, prescribing information. Mylan Institutional (Viatris). DailyMed, version published June 19, 2026. DailyMed setid 89cd4f46-b88a-4c10-b25c-47352280dc4e
Miacalcin is injected subcutaneously or intramuscularly from a 2 mL multi-dose vial containing 200 USP Units per mL (sections 2 and 3).
The vial is checked first: the solution should be clear and colorless, with no particles and no vial damage. If a dose is more than 2 mL, intramuscular injection split across several sites is preferred (section 2.4).
Patients and others who give the injection are taught sterile technique and safe needle disposal (sections 2.4 and 17).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Use | Dose | Route | Notes |
|---|---|---|---|
| Symptomatic Paget's disease of bone | 100 USP Units (0.5 mL) per day | Subcutaneous or intramuscular | Adequate calcium and vitamin D intake |
| Hypercalcemia, starting dose | 4 USP Units/kg body weight every 12 hours | Subcutaneous or intramuscular | If response is not satisfactory after one or two days, may increase to 8 USP Units/kg every 12 hours |
| Hypercalcemia, maximum | 8 USP Units/kg every 6 hours | Subcutaneous or intramuscular | If response remains unsatisfactory after two more days |
| Postmenopausal osteoporosis (more than 5 years after menopause) | 100 USP Units (0.5 mL) per day | Subcutaneous or intramuscular | At least 1000 mg elemental calcium and 400 International Units vitamin D per day |
The minimum effective dose for preventing spinal bone density loss has not been established.
Low calcium is corrected before starting. In people at risk, injectable calcium is kept available during the first several doses, and calcium and symptoms are monitored.
Because of a possible link with cancer, the need for continued therapy is re-evaluated periodically.
In the osteoporosis trials, the injection was given daily at bedtime, with 1,200 mg calcium carbonate and 400 International Units of vitamin D.
Vials are stored in a refrigerator at 2 to 8 C (36 to 46 F) and protected from freezing.
The Miacalcin injection label gives no missed-dose rule. It has no patient leaflet, and the prescribing information does not say what to do if a daily injection is missed.
In Dose Track you set up Miacalcin as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.