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Calcium Gluconate

Brand Name: Gluconate, Ca

Generic Name: Calcium Gluconate

Drug Class: Antidotes, Other; Calcium Salts

What Is Calcium Gluconate and How Does It Work?

Calcium gluconate is the calcium salt of gluconic acid, an intravenous medication used to treat conditions arising from calcium deficiencies such as hypocalcemic tetany, hypocalcemia related to hypoparathyrodism, and hypocalcemia due to rapid growth or pregnancy.

Calcium gluconate is available under the following different brand names: Gluconate and Ca.

Dosages of Calcium Gluconate:

Dosage Forms and Strengths

Injectable solution

  • 100mg/mL (10%)

Tablet

  • 50mg
  • 500mg
  • 650mg

Capsule (adult only)

  • 500mg

Dosage Considerations – Should be Given as Follows:

Calcium Supplementation

  • Adults 19-50 years old: 1000 mg/day orally divided every 8-12 hours, preferably 1-2 hours after meals
  • Adults over 50 years old: 1200 mg/day orally divided every 8-12 hours, preferably 1-2 hours after meals
  • Pregnant or breastfeeding patient: 1000/day orally divided every 8-12 hours, preferably 1-2 hours after meals
  • Children 9-18 years old: 1300 mg/day orally divided every 8-12 hours, preferably 1-2 hours after meals
  • Children 4-8 years old: 800 mg/day orally divided every 8-12 hours, preferably 1-2 hours after meals
  • Children 1-3 years old: 500 mg/day orally divided every 8-12 hours, preferably 1-2 hours after meals
  • Infants 7-12 months old: 270 mg/day orally divided every 8-12 hours, preferably 1-2 hours after meals
  • Infants 0-6 months old: 210 mg/day orally divided every 8-12 hours, preferably 1-2 hours after meals

Dosing Considerations

  • Dietary reference intakes are expressed as elemental calcium

Hypocalcemia

Treatment of conditions arising from calcium deficiency (e.g., hypocalcemic tetany, hypoparathyroidism)

Mild (ionized calcium 1-1.2 mmol/L)

  • Management of non-life-threatening symptoms
  • Adult, oral: 1-3 g/day in divided doses; oral repletion may be considered and administered on outpatient basis
  • Adult, intravenous (IV): 1-2 g over 2 hours
  • Neonates: 500-1500 mg/kg/day orally divided every 4-6 hours
  • Infants/children: 500-725 mg/kg/day orally divided every 6-8 hours

Severe (ionized calcium less than 1 mmol/L)

  • Adult, without seizure or tetany: 0.5 mg/kg/hour intravenously (IV); may be increased to 2 mg/kg/hour; not to exceed 3-4 g IV over 4 hours
  • Adult, monitor serum calcium every 4-6 hours to maintain serum calcium levels
  • Neonates: 200-800 mg/kg/day IV by continuous infusion or divided every 6 hours as intermittent infusions
  • Infants/children: 200-500 mg/kg/day IV by continuous infusion or divided every 6 hours as intermittent infusions

Hypocalcemic tetany

  • Adult: 100-300 mg elemental calcium (approximately 3 g calcium gluconate) intravenously (IV) over 5-10 minutes, followed by continuous IV infusion at 0.5 mg/kg/hour (may be increased to 2 mg/kg/hour)
  • Pediatric: 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

Cardiac Arrest (Off-label)

Management of cardiac arrest only in presence of hyperkalemia, hypocalcemia, or hypermagnesemia (routine use for cardiac arrest not recommended, because it yields no improvement in survival)

1.5-3 g intravenously (IV) over 2-5 minutes

Hydrofluoric Acid Burn (Off-label)

Topical: Use 2.5% gel, placing in glove to apply to hand; if gel unavailable, prepare with 10% calcium gluconate solution in 3 times volume of KY gel

Subcutaneous: 10% calcium gluconate, no more than 0.5 mL/cm² of skin; do not use in digits

If topical and/or subcutaneous do not work, consider intra-arterial

Intra-arterial calcium infusion for moderate to severe burns: Infuse 10 mL 10% calcium gluconate mixed with 40-50 mL D5W over 4 hours, repeating as needed (need to indicate with high-pressure pump)

Calcium Channel Blocker Overdose (Off-label)

60-120 mg/kg/hour intravenously (IV) or 60 mg/kg IV over 5 minutes every 10-20 minutes as needed up to 3-4 doses; not to exceed 3-4 g/dose

Hyperkalemia (Off-label)

1.5-3 g intravenously (IV) infused over 2-5 minutes

Hypermagnesemia (Off-label)

1.5-3 g intravenously (IV) infused over 2-5 minutes

Medically Reviewed by a Doctor on 11/2/2017



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