Calcium Chloride 10% Inj, 10ml

Calcium is an essential electrolyte that plays a vital role in numerous physiological processes, including nerve impulse transmission, muscle contraction (cardiac, smooth, and skeletal), blood coagulation, bone formation, and maintenance of cell membrane integrity. Administered intravenously, calcium chloride rapidly increases serum calcium concentrations. In hyperkalemia, calcium directly antagonizes the cardiac membrane effects of hyperkalemia by stabilizing the cardiac cell membrane, reducing excitability, and restoring the normal resting membrane potential. In hypocalcemia, it directly replaces deficient calcium. In magnesium toxicity, it antagonizes the neuromuscular and cardiovascular effects of magnesium.

Urgent Side Effects: Seek Medical Help Right Away

While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high calcium levels, including:
+ Weakness
+ Confusion
+ Feeling tired
+ Headache
+ Upset stomach and vomiting
+ Constipation
+ Bone pain
Tissue damage at the injection site, characterized by:
+ Redness
+ Burning
+ Pain
+ Swelling
+ Blisters
+ Skin sores
+ Leaking of fluid
Rapid infusion-related problems, including:
+ Flushing
+ Slow or abnormal heartbeat
+ Signs of low blood pressure, such as severe dizziness or fainting

Other Possible Side Effects

Most people experience few or no side effects. However, if you encounter any of the following side effects or any other unusual symptoms, consult your doctor or seek medical help:

Bad taste in your mouth
Hot flashes

This is not an exhaustive list of potential side effects. If you have concerns or questions, discuss them with your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have elevated calcium levels in your blood.
* If you are currently taking any of the following medications: ceftriaxone, digoxin, diltiazem, or verapamil.

Please note that this is not an exhaustive list of all potential interactions with this medication. Therefore, it is crucial to discuss all of your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. This will help ensure that it is safe to take this medication in conjunction with your other medications and health conditions.

Remember, do not start, stop, or adjust the dosage of any medication without first consulting your doctor to confirm that it is safe to do so.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood work and laboratory tests should be conducted as directed by your doctor. This medication may contain aluminum, which can lead to aluminum toxicity with long-term use. Individuals with kidney problems and premature infants are at a higher risk. It is crucial to discuss this potential risk with your doctor. If you are pregnant, planning to become pregnant, or are breast-feeding, notify your doctor to discuss the benefits and risks of this medication to both you and your baby.

• Cardiac glycosides (e.g., Digoxin) - concurrent IV administration can lead to severe arrhythmias, including asystole.
• Hypercalcemia
• Ventricular fibrillation

• Thiazide diuretics (e.g., Hydrochlorothiazide): May decrease calcium excretion, leading to hypercalcemia.
• Calcium channel blockers (e.g., Verapamil, Diltiazem): Calcium chloride may antagonize the effects of calcium channel blockers, especially in overdose.
• Phosphate supplements/binders: May form insoluble complexes with calcium, reducing absorption/effectiveness of both.
• Tetracyclines/Fluoroquinolones: Calcium can chelate these antibiotics, reducing their absorption if given orally (not relevant for IV calcium chloride, but important for overall calcium intake).

• Corticosteroids: May decrease calcium absorption and increase calcium excretion.
• Vitamin D analogs: May increase calcium absorption and serum calcium levels.
• Bisphosphonates: Calcium may interfere with bisphosphonate absorption (if given orally, not relevant for IV calcium chloride).

• Signs of hypercalcemia: Nausea, vomiting, constipation, polyuria, polydipsia, muscle weakness, fatigue, confusion, stupor, coma, cardiac arrhythmias.
• Signs of hypocalcemia (if treatment ineffective or underlying cause persists): Tetany, paresthesias (tingling in fingers, toes, around mouth), muscle cramps, seizures, laryngospasm, Chvostek's sign, Trousseau's sign.
• Signs of too rapid IV administration: Flushing, sweating, nausea, vomiting, hypotension, bradycardia, cardiac arrhythmias.

Calcium chloride is classified as Pregnancy Category C. It should be given to a pregnant woman only if clearly needed. Calcium is essential for fetal development, but excessive maternal calcium can be harmful. Use is generally reserved for acute, life-threatening conditions where the benefit outweighs the potential risk.

Calcium is a normal component of breast milk. While calcium chloride is excreted into breast milk, the amount is unlikely to cause adverse effects in a breastfed infant when administered acutely to the mother. Use is generally considered compatible with breastfeeding when clinically indicated.

Dosing must be carefully calculated based on weight and clinical indication. Neonates and infants are particularly susceptible to rapid changes in calcium levels and potential for extravasation. Slow IV administration is crucial. Close monitoring of serum calcium, heart rate, and ECG is essential.

No specific dose adjustment is typically required based on age alone, but elderly patients may have impaired renal function, which necessitates careful monitoring of calcium levels and renal function. They may also be more susceptible to adverse cardiovascular effects (e.g., bradycardia, hypotension) with rapid administration. Administer slowly and monitor closely.

• Calcium chloride is highly irritating to veins and can cause severe tissue necrosis if extravasated. Administer via a central venous line if possible, or a large peripheral vein with careful monitoring.
• Administer slowly (typically over 5-10 minutes for bolus doses) to avoid hypotension, bradycardia, and other adverse effects.
• Calcium chloride contains more elemental calcium per gram than calcium gluconate (27.2% vs 9%). This means a smaller volume of calcium chloride is needed for the same amount of elemental calcium, but it is also more irritating to veins.
• Do NOT mix calcium chloride with bicarbonate-containing solutions or phosphate-containing solutions, as precipitation will occur.
• Always confirm the type of calcium salt (chloride vs. gluconate) before administration, as dosing differs significantly.
• In cardiac arrest, calcium chloride is generally reserved for specific indications (e.g., known hyperkalemia, hypocalcemia, or calcium channel blocker overdose) and is not routinely recommended for all cardiac arrest scenarios.

• Calcium gluconate (less irritating to veins, but requires larger volume for equivalent elemental calcium)
• For hyperkalemia: Insulin/dextrose, sodium bicarbonate, beta-2 agonists (e.g., albuterol), potassium-binding resins (e.g., sodium polystyrene sulfonate), dialysis.
• For hypocalcemia: Oral calcium supplements (for chronic management), Vitamin D supplementation.
• For magnesium toxicity: IV fluids, loop diuretics (to promote magnesium excretion).

If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly; do not flush them down the toilet or pour them down the drain unless instructed to do so by a healthcare professional. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the quantity, and the time it was taken to ensure timely and appropriate treatment.