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BLOOD AND BLOOD FORMING ORGANS › BLOOD SUBSTITUTES AND PERFUSION SOLUTIONS › I.V. SOLUTION ADDITIVES › Electrolyte solutions
calcium gluconate
B05XA19
Forms & Strengths
- 10% solution for injection, 100mg/mL calcium ion
- Tablets, 500mg or 650mg calcium gluconate, equivalent to 45mg or 58.5mg calcium
- Gluconate injection, USP 10% (0.1g/mL) calcium gluconate
Adult Dosing
- Hyperkalemia treatment: 2.5 to 5 mL (125-250mg calcium ion) IV, may repeat
- Hypocalcemia treatment: 10-20 mL (1-2g calcium gluconate, 90-180mg calcium ion) IV
- Cardiac arrest and calcium channel blocker overdose, 500-700mg IV (60-85mg calcium ion)
Pediatric Dosing
- Hyperkalemia treatment: 0.5 to 1.5 mL/kg (50-150mg/kg or 6.25-18.75mg/kg calcium ion) IV, max 2.5mL (125mg calcium ion) at any one time
- Hypocalcemia neonates: 0.45-1.8 mL/kg (45-180mg/kg or 5.6-22.5mg/kg calcium ion) IV
- For tetany: 1 to 3 mL (10-30mg calcium ion)/kg IV, up to max dose
Indications
- Hypocalcemia treatment and prevention
- Hyperkalemia management
- Calcium channel blocker overdose
- Tetany, including preeclampsia and eclampsia
- Cardiac arrest due to hyperkalemia or hypocalcemia
Mechanism of Action
- Replenishes calcium in plasma
- Stabilizes cell membranes
- Neutralizes hyperkalemia cardiac toxicity
- Antagonizes the toxic effects of hypermagnesemia
- Antagonizes calcium channel blockers by restoring normal calcium ion flux and distribution
Contraindications
- Hypercalcemia
- Digitalis toxicity with hypercalcemia
- Renal calculi or hypercalciuria
- Suspected or known severe respiratory insufficiency, unless patient is mechanically ventilated
Adverse Reactions
- Hypotension or bradycardia with rapid IV
- Pain, thrombophlebitis or tissue necrosis at injection site with extravenous administration
- Hypercalcemia, nausea, and vomiting with high doses
- Allergic reactions
- Calcium deposits in lung, kidney after long-term therapy
Drug Interactions
- Magnesium: increased ionized calcium
- Cardiac glycosides, beta blockers: potentiate arrhythmias with hypercalcemia
- Tetracyclines and fluoroquinolones: reduced antibiotic absorption
- Calcium channel blockers: may antagonize therapeutic effects of calcium channel blockers
Curated Content: Needs Vetting Before Put to Clinical Use