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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

What Are Side Effects Associated with Using Calcium Gluconate?

Side effects of Calcium Gluconate include:

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What Other Drugs Interact with Calcium Gluconate?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

Severe interactions of calcium gluconate include:

Serious interactions of calcium gluconate include:

Calcium gluconate has moderate interactions with at least 50 different drugs.

Calcium gluconate has mild interactions with at least 52 different drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

What Are Warnings and Precautions for Calcium Gluconate ( Vasostrict, ADH)?

Warnings

  • This medication contains calcium gluconate. Do not take Gluconate or Ca if you are allergic to calcium gluconate or any ingredients contained in this drug.
  • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.
  • Contraindications

    Effects of Drug Abuse

    • No information available

    Short-Term Effects

    • See "What Are Side Effects Associated with Using Calcium Gluconate?"

    Long-Term Effects

    • See "What Are Side Effects Associated with Using Calcium Gluconate?"

    Cautions

    Pregnancy and Lactation

    • Use calcium gluconate with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.
    • Calcium gluconate enters human milk; use with caution if breastfeeding.
Reviewed on 11/2/2017

SOURCES:
Medscape. Calcium Gluconate.
https://reference.medscape.com/drug/calcium-gluconate-344434
RXlist. Calcium Gluconate.
https://www.rxlist.com/calcium-gluconate-side-effects-drug-center.htm

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