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DERMATOLOGICALS › OTHER DERMATOLOGICAL PREPARATIONS › OTHER DERMATOLOGICAL PREPARATIONS › Other dermatologicals
calcium gluconate
D11AX03
Forms & Strengths
- Injection: 10% solution (100 mg/mL, containing 0.46 mEq or 9 mg of elemental calcium per mL) in 10 mL ampules, vials, and prefilled syringes
- Oral tablets: 500 mg, 650 mg, 1000 mg
Adult Dosing
- Severe hypocalcemia / Cardiac arrest / Hyperkalemia / Hypermagnesemia: 1 to 2 g (10 to 20 mL of 10% solution) IV administered slowly over 5 to 10 minutes; may repeat PRN
- Continuous IV infusion: 3 to 6 g in 1000 mL D5W or NS titrated to maintain serum calcium
Pediatric Dosing
- Hypocalcemia: 60 to 100 mg/kg (0.6 to 1 mL/kg of 10% solution) IV slowly over 5 to 10 minutes; maximum 2 g/dose
- Continuous IV infusion (Neonates/Infants): 200 to 500 mg/kg/day
Indications
- Treatment of acute symptomatic hypocalcemia
- Adjunctive treatment of hyperkalemia with electrocardiographic manifestations
- Treatment of hypermagnesemia
- Calcium channel blocker overdose
Mechanism of Action
- Provides exogenous calcium ions to increase serum calcium concentrations
- Essential for the maintenance of nervous, muscular, and skeletal systems
- Restores myocardial function and decreases neuromuscular irritability
- Directly antagonizes the cardiac and electrophysiologic toxicity of hyperkalemia and hypermagnesemia
Contraindications
- Hypercalcemia
- Ventricular fibrillation during cardiac resuscitation
- Severe renal disease (for repeated or large doses)
- Concomitant digitalis toxicity
Adverse Reactions
- Rapid infusion reactions: Bradycardia, arrhythmias, hypotension, syncope, vasodilation
- Local reactions: Tissue necrosis, sloughing, calcinosis cutis, and pain following extravasation
- Gastrointestinal (oral): Constipation, nausea, flatulence
Drug Interactions
- Cardiac glycosides (Digitalis): Concomitant IV calcium increases risk of severe arrhythmias and digitalis toxicity
- Calcium channel blockers: Calcium may antagonize the therapeutic effects of CCBs
- Thiazide diuretics: Can decrease renal calcium excretion, increasing hypercalcemia risk
- Tetracyclines, fluoroquinolones, and iron: Oral calcium chelates these agents, decreasing their absorption
Curated Content: Needs Vetting Before Put to Clinical Use