Salmon Calcitonin vs Teriparatide

Calcitonin suppresses osteoclasts to slow bone resorption; teriparatide intermittently stimulates osteoblasts to build bone. They act on opposite sides of bone remodelling.

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Salmon Calcitonin

A 32-amino-acid thyroid hormone (salmon form) that inhibits bone resorption, used for decades in osteoporosis and Paget’s disease.

BEST STUDIED FOR

Repair & immune

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Teriparatide

The 1–34 fragment of human parathyroid hormone — the first bone-building (anabolic) osteoporosis medicine.

BEST STUDIED FOR

Repair & immune

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SIDE BY SIDE

	Salmon Calcitonin	Teriparatide
The key difference	Inhibits bone breakdown	Stimulates bone formation
Class	Repair & immune	Repair & immune
Mechanism	Calcitonin acts on osteoclast calcitonin receptors to reduce bone resorption and lowers renal calcium reabsorption; an analgesic effect after vertebral fracture is also described.	Intermittent, once-daily activation of the PTH1 receptor stimulates osteoblasts more than osteoclasts, building new bone; continuous PTH exposure does the opposite.
Status	Registered medicine with declining use; nasal and oral forms were studied extensively.	Approved for severe osteoporosis in many countries (prescription-only). Head-to-head fracture trials (VERO) and combination studies with denosumab (DATA) are its landmark data.
Reported safety signals	A possible association with cancer led to regulatory restrictions; a review and meta-analysis examined the strength of that signal.	Reviews document hypercalcaemia and dizziness; an osteosarcoma signal in rats led to historical duration limits in labelling.
A key study	Reviews salmon calcitonin’s use in metabolic bone diseases over more than 30 years. (Osteoporos Int 2008, PMID 18071651)	VERO compared new fractures with teriparatide versus risedronate in severe postmenopausal osteoporosis. (Lancet 2018, PMID 29129436)

WHEN TO RESEARCH WHICH

Calcitonin for anti-resorptive research; teriparatide for anabolic bone research. Both are discussed here strictly as research compounds; nothing on this page is medical advice or a dosing guide.

REFERENCES (PUBMED)

[Salmon Calcitonin] Salmon calcitonin: a review of current and future therapeutic indications — Osteoporos Int 2008. PMID 18071651
[Salmon Calcitonin] Does salmon calcitonin cause cancer? A review and meta-analysis — Osteoporos Int 2016. PMID 26438308
[Salmon Calcitonin] Intranasal salmon calcitonin. A review of its pharmacological properties and potential utility in metabolic bone disorders associated with aging — Drugs Aging 1991. PMID 1794028
[Teriparatide] Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial — Lancet 2018. PMID 29129436
[Teriparatide] Teriparatide and denosumab, alone or combined, in women with postmenopausal osteoporosis: the DATA study randomised trial — Lancet 2013. PMID 23683600
[Teriparatide] Teriparatide: a review — Clin Ther 2004. PMID 15262455

FREQUENTLY ASKED

What is the difference between Salmon Calcitonin and Teriparatide?

Calcitonin suppresses osteoclasts to slow bone resorption; teriparatide intermittently stimulates osteoblasts to build bone. They act on opposite sides of bone remodelling.

What is the regulatory status of Salmon Calcitonin and Teriparatide?

Salmon Calcitonin: Registered medicine with declining use; nasal and oral forms were studied extensively. Teriparatide: Approved for severe osteoporosis in many countries (prescription-only). Head-to-head fracture trials (VERO) and combination studies with denosumab (DATA) are its landmark data.

What safety signals have been reported?

Salmon Calcitonin: A possible association with cancer led to regulatory restrictions; a review and meta-analysis examined the strength of that signal. Teriparatide: Reviews document hypercalcaemia and dizziness; an osteosarcoma signal in rats led to historical duration limits in labelling.

Which studies is this comparison based on?

For Salmon Calcitonin: “Salmon calcitonin: a review of current and future therapeutic indications” (PMID 18071651); “Does salmon calcitonin cause cancer? A review and meta-analysis” (PMID 26438308); “Intranasal salmon calcitonin. A review of its pharmacological properties and potential utility in metabolic bone disorders associated with aging” (PMID 1794028). For Teriparatide: “Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial” (PMID 29129436); “Teriparatide and denosumab, alone or combined, in women with postmenopausal osteoporosis: the DATA study randomised trial” (PMID 23683600); “Teriparatide: a review” (PMID 15262455).