Miacalcin vs Fortical: What’s the Difference?

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
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Miacalcin and Fortical have very similar active ingredients, and are both used to treat osteoporosis. However, they are two different drugs and can’t be substituted for each other.

Here are the 5 major differences:

  1. Approved uses. Miacalcin (calcitonin salmon) is approved by the FDA to treat Paget’s disease, hypercalcemia, and postmenopausal osteoporosis. Fortical (calcitonin salmon, rDNA origin) is only approved to treat postmenopausal osteoporosis.
  2. Dosage forms. Miacalcin is available as a nasal spray or an injection; Fortical is only available as a nasal spray.
  3. Active ingredients. Although both Miacalcin and Fortical contain calcitonin salmon as their main ingredient, there are some slight differences in the type of calcitonin salmon. They are NOT bioequivalent and therefore NOT interchangeable.
  4. How they’re made. Miacalcin and Fortical are both man-made forms of the hormone calcitonin salmon. However, Fortical(calcitonin salmon, rDNA origin) is created by recombinant DNA technology while Miacalcin(calcitonin salmon) is created through a chemical reaction.
  5. Generic available. ONLY Miacalcin has a generic nasal spray. Fortical is still brand-only. With a GoodRx discount, Fortical runs about $20 more expensive than generic calcitonin salmon ($70 vs $50), so you may want to consider the cost when talking to your doctor.

Have you had any experiences with Miacalcin or Fortical?

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