Both injectable and nasal spray calcitonins have been utilized in the treatment of postmenopausal osteoporosis for over 25 years. More widespread use of calcitonin in the treatment of osteoporosis has been hampered in part due to poor patient acceptability and compliance and the inability of patients to take this medication as an oral pill. In recent years, an oral preparation of calcitonin has been developed that combines the active peptide hormone with a caprylic acid derivative to enhance bioavailability. Clinical trials with oral calcitonin in patients with osteoarthritis are currently being conducted. A recent phase 3 study failed to demonstrate significant vertebral fracture reduction, and as a result the clinical program for oral calcitonin in osteoporosis is under review for further consideration.