Calcium Gluconate

Indications

Calcium Gluconate is used for: Postmenopausal osteoporosis, Osteoporosis, Hypoparathyroidism, Latent tetany, Rickets, Osteomalacia, Hyperkalemia, Hypocalcemia, Magnesium sulfate overdose

Adult Dose

Hypocalcemia Treatment of conditions arising from calcium deficiency (eg, hypocalcemic tetany, hypoparathyroidism) Mild (ionized calcium 1-1.2 mmol/L) Management of non-life-threatening symptoms IV: 1-2 g over 2 hours Severe (ionized calcium <1 mmol/L) Without seizure or tetany: 0.5 mg/kg/hr IV; may be increased to 2 mg/kg/hr; not to exceed 3-4 g IV over 4 hours Hypocalcemic tetany: 100-300 mg elemental calcium (~3 g calcium gluconate) IV over 5-10 minutes, followed by continuous IV infusion at 0.5 mg/kg/hr (may be increased to 2 mg/kg/hr) Monitor serum calcium q4-6hr to maintain serum calcium levels

Child Dose

Hypocalcemia Treatment of conditions arising from calcium deficiency (eg, hypocalcemic tetany, hypoparathyroidism) Severe Neonates: 200-800 mg/kg/day IV by continuous infusion or divided q6hr as intermittent infusions Infants/children: 200-500 mg/kg/day IV by continuous infusion or divided q6hr as intermittent infusions Hypocalcemic tetany 100-200 mg/kg IV over 10 minutes; may be repeated after 6 hours, or initiate continuous infusion not to exceed 500 mg/kg/day

Renal Dose

Administration

Contra Indications

Patients with calcium renal calculi or history of renal calculi. Conditions associated with hypercalcaemia and hypercalciuria.

Precautions

Impaired renal function; cardiac disease; hypercalcaemia-associated diseases, e.g. sarcoidosis; other malignancies. Pregnancy. Lactation: Calcium enters human milk; use with caution

Pregnancy-Lactation

Pregnancy category: C Lactation: Calcium enters human milk; use with caution

Interactions

Calcium Gluconate: Co-admin of high calcium doses with thiazide diuretics may result in milk-alkali syndrome and hypercalcaemia. May potentiate digoxin toxicity. Decreases effects of calcium-channel blockers. Enhanced absorption with calcitriol (a vitamin D metabolite).

Side Effects

Side effects of Calcium Gluconate : Bradycardia, Hypotension, Headache, Constipation, Diarrhea, Flatulence, Nausea, Vomiting, Hypomagnesemia, Hypophosphatemia, Extravasation necrosis Hypercalcaemia characterised by anorexia, nausea, vomiting, constipation, abdominal pain, muscle weakness, mental disturbances, polydipsia, polyuria, nephrocalcinosis, renal calculi; chalky taste, hot flushes and peripheral vasodilation. Potentially Fatal: Cardiac arrhythmias and coma.

Mode of Action

Calcium gluconate/lactate is used to prevent or treat negative calcium balance. It also helps facilitate nerve and muscle performance as well as normal cardiac function. Bone mineral component; cofoactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways.