1. Osteoporosis 20 g (120 IU) daily or 40 g (240 IU) daily or every other day, in a single dose or in divided doses; depending on the condition and the patient's response. 2. Bone pain with osteolysis and/or bone loss Adjust dose according to individual needs, 40 g (240 IU) to 80 g (480 IU) daily. The maximum dose for a single dose is 40 g (240 IU); when larger doses are needed, they should be given in divided doses. Several days of treatment may be required for the full pain-relieving effect of the medication to be realized. To allow for long-term treatment, the initial daily dose can usually be reduced or the time interval between administrations can be lengthened. 3. Paget s disease (metamorphic osteitis) 40 g (240 IU) daily, given as a single dose or in divided doses. In some cases, 80 g (480 IU) per day must be given when treatment is initiated. Regardless of the mode of administration, the medication should be continued for at least 3 months or longer, and the dose should be adjusted according to the patient's needs. In Paget s disease (metaplastic osteitis) and some other chronic diseases with high bone turnover, treatment with salmon calcitonin should be maintained for at least several months to several years. Treatment results in a significant decrease in serum alkaline phosphatase and markedly reduces urinary hydroxyproline excretion, often to normal values. In rare cases, however, the initial decrease is followed by a resurgence, and the physician must make a judgment call based on the clinical picture as to whether treatment should be discontinued and when it should be resumed. Bone metabolism disorders may recur one or several months after discontinuation of therapy, requiring a new course of salmon calcitonin. 4. Hypercalcemia Long-term treatment of chronic hypercalcemia involves the administration of 40 g (240 IU) to 80 g (480 IU) per day, up to a maximum of 40 g (240 IU) in a single dose, or in divided doses when higher doses are needed. 5. Neurotrophic Dystrophy Early diagnosis of this disorder is very important and treatment should be initiated as soon as the diagnosis is made. For 2 to 4 weeks, 40 g (240 IU) should be given once daily, and then, depending on the clinical situation, a further 40 g (240 IU) may be given every other day for 6 weeks. Patients on long-term use of this product may develop antibodies to calcitonin, although this does not usually affect clinical efficacy. The desaturation sometimes seen with prolonged treatment may be due to saturation of the binding site, which is apparently unrelated to antibody production. The patient's response to salmon calcitonin may be restored after treatment interruption.