Calcium Glu/nacl 1gm/100ml Soln
It is used to treat or prevent low calcium levels.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Electrolyte replacement; Antidote; Mineral supplement
Pharmacologic Class
Calcium salt
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Calcium gluconate is a medicine given by injection into a vein. It's used to quickly raise calcium levels in your blood if they are too low, or to protect your heart from the effects of too much potassium or magnesium in your blood. It's also used in certain types of poisoning.
How to Use This Medicine
To use this medication correctly, follow your doctor's instructions and carefully read all the information provided to you. It is essential to follow the dosage instructions closely. This medication is administered intravenously over a specified period.
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
In the event that you miss a dose, contact your doctor promptly to receive guidance on the appropriate course of action.
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
In the event that you miss a dose, contact your doctor promptly to receive guidance on the appropriate course of action.
Lifestyle & Tips
- This medication is given in a hospital or clinic setting, so lifestyle modifications are not typically applicable during administration.
- Follow your doctor's instructions regarding diet and other medications once discharged.
Available Forms & Alternatives
Available Strengths:
- Calcium Carb 1250mg/5ml Susp
- Calcium Chloride 10% Inj, 10ml
- Calcium Oyster Shell 500mg Tablets
- Calcium 500mg Tablets
- Calcium Acetate 667mg Capsules
- Calcium 600+d (400u) Tablets
- Calcium 600mg Tablets
- Calcium 600mg + D Tablets
- Calcium 500 W/vit D3 Tablets
- Calcium Citrate 250mg Tablets
- Calcium Antacid 500mg Chw Tablets
- Calcium Carb 500mg Chewtablets
- Calcium Acetate 667mg Tablets
- Calcium Carb 648mg Tablets
- Calcium 500mg W/ Vit D Chw Tablets
- Calcium Citrate W/ Vit D Tablets
- Calcium/d3 600mg-200iu Tablets
- Calcium 500mg Chewable Tablets
- Calcium Gluconate 10% Inj, 50ml
- Calcium Antacid 750mg Chw Tablets
- Calcium Citrate 200mg Tablets
- Calcium Citrate+d3 Tablets
- Calcium Gluconate 10% Inj, 10ml
- Calcium Glu/nacl 1gm/100ml Soln
- Cal Glu/nacl 2000mg/100ml Inj 100ml
- Cal Glu/nacl 1gm/50ml Inj, 50ml
- Calcium Gluc 100mg/ml Inj, 50ml
- Calcium Gluconate 10% Inj, 100ml
- Calcium Gluc 100mg/ml Inj, 100ml
- Calcium Gluc 100mg/ml Inj, 10ml
Dosing & Administration
Adult Dosing
Standard Dose:
Varies significantly by indication. For acute symptomatic hypocalcemia: 1-2 g (10-20 mL of 10% solution) IV over 10-20 minutes. For hyperkalemia/magnesium toxicity: 1-3 g (10-30 mL of 10% solution) IV over 5-10 minutes.
Dose Range:
1000 - 3000 mg
Condition-Specific Dosing:
Acute Hypocalcemia:
1-2 g IV (10-20 mL of 10% solution) over 10-20 minutes, followed by continuous infusion if needed.
Hyperkalemia (cardiac stabilization):
1-3 g IV (10-30 mL of 10% solution) over 5-10 minutes, repeat as needed.
Magnesium Toxicity:
1-3 g IV (10-30 mL of 10% solution) over 5-10 minutes, repeat as needed based on clinical response and serum magnesium levels.
Calcium Channel Blocker Overdose:
1-3 g IV (10-30 mL of 10% solution) over 5-10 minutes, repeat as needed.
Pediatric Dosing
Neonatal:
Acute Hypocalcemia: 50-100 mg/kg/dose IV (0.5-1 mL/kg of 10% solution) over 5-10 minutes, may repeat every 6-8 hours or as continuous infusion.
Infant:
Acute Hypocalcemia: 50-100 mg/kg/dose IV (0.5-1 mL/kg of 10% solution) over 5-10 minutes, may repeat every 6-8 hours or as continuous infusion.
Child:
Acute Hypocalcemia: 50-100 mg/kg/dose IV (0.5-1 mL/kg of 10% solution) over 5-10 minutes, max 3 g/dose. Hyperkalemia/Magnesium Toxicity: 60-100 mg/kg/dose IV (0.6-1 mL/kg of 10% solution) over 5-10 minutes, max 3 g/dose.
Adolescent:
Acute Hypocalcemia: 1-2 g IV (10-20 mL of 10% solution) over 10-20 minutes. Hyperkalemia/Magnesium Toxicity: 1-3 g IV (10-30 mL of 10% solution) over 5-10 minutes.
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment, but monitor calcium levels closely.
Moderate:
No specific dose adjustment, but monitor calcium levels closely; consider lower end of dosing range.
Severe:
Use with caution; monitor calcium and phosphate levels closely. Avoid if hyperphosphatemia is present. Dose adjustment may be necessary based on serum calcium levels.
Dialysis:
Administer post-dialysis if needed. Monitor calcium levels closely as dialysis can affect calcium balance.
Hepatic Impairment:
Mild:
No adjustment needed.
Moderate:
No adjustment needed.
Severe:
No adjustment needed.
Pharmacology
Mechanism of Action
Calcium is an essential electrolyte that plays a vital role in many physiological processes, including nerve impulse transmission, muscle contraction (cardiac, smooth, and skeletal), blood coagulation, bone formation, and maintenance of cell membrane integrity. As an antidote for hyperkalemia or magnesium toxicity, calcium gluconate directly antagonizes the cardiotoxic effects of elevated potassium or magnesium by stabilizing the cardiac cell membrane potential, without directly lowering serum potassium or magnesium levels.
Pharmacokinetics
Absorption:
Bioavailability:
100% (IV administration)
Tmax:
Immediate (IV administration)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Approximately 0.2 L/kg (distributes throughout extracellular fluid)
ProteinBinding:
Approximately 40-50% (primarily to albumin)
CnssPenetration:
Limited
Elimination:
HalfLife:
Variable, typically 0.5-2 hours (for ionized calcium in plasma)
Clearance:
Primarily renal excretion, influenced by parathyroid hormone, vitamin D, and calcitonin.
ExcretionRoute:
Renal (urine), also fecal excretion.
Unchanged:
Not applicable (excreted as calcium ion)
Pharmacodynamics
OnsetOfAction:
Immediate (within minutes of IV administration)
PeakEffect:
Within minutes
DurationOfAction:
Short (approximately 30 minutes to 2 hours, depending on dose and patient's underlying condition)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience 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
Symptoms that may occur if the medication is administered too quickly, such as:
+ Flushing
+ Slow or abnormal heartbeat
+ Signs of low blood pressure, including severe dizziness or fainting
Tissue damage at the injection site, characterized by:
+ Redness
+ Burning
+ Pain
+ Swelling
+ Blisters
+ Skin sores
+ Leaking of fluid
If you experience any of these symptoms, notify your doctor or nurse immediately.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
* Constipation
This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience 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
Symptoms that may occur if the medication is administered too quickly, such as:
+ Flushing
+ Slow or abnormal heartbeat
+ Signs of low blood pressure, including severe dizziness or fainting
Tissue damage at the injection site, characterized by:
+ Redness
+ Burning
+ Pain
+ Swelling
+ Blisters
+ Skin sores
+ Leaking of fluid
If you experience any of these symptoms, notify your doctor or nurse immediately.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
* Constipation
This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- If you feel any pain, burning, or swelling at the injection site, tell your nurse immediately.
- Report any new or worsening symptoms such as nausea, vomiting, constipation, increased thirst or urination, muscle weakness, confusion, or irregular heartbeats, as these could be signs of too much calcium.
Before Using This Medicine
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 ceftriaxone or digoxin.
Please note that this is not an exhaustive list of all potential interactions with this medication. To ensure your safety, it is crucial to disclose all of your medications, including:
Prescription and over-the-counter (OTC) drugs
Natural products
Vitamins
Additionally, inform your doctor about any existing health problems. It is vital to verify that it is safe to take this medication in conjunction with your other medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting 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 ceftriaxone or digoxin.
Please note that this is not an exhaustive list of all potential interactions with this medication. To ensure your safety, it is crucial to disclose all of your medications, including:
Prescription and over-the-counter (OTC) drugs
Natural products
Vitamins
Additionally, inform your doctor about any existing health problems. It is vital to verify that it is safe to take this medication in conjunction with your other medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Your doctor will likely recommend regular blood tests and other laboratory evaluations to monitor your condition. Be aware that this medication may interfere with certain lab tests, so it is crucial to notify all healthcare providers and laboratory personnel that you are taking this drug.
Additionally, this medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. This risk is particularly higher if you have kidney problems or if you are a premature infant. It is vital to discuss this potential risk with your doctor.
If you are pregnant, planning to become pregnant, or breastfeeding, you must consult your doctor to weigh the benefits and risks of this medication to both you and your baby. Your doctor will help you make an informed decision about using this medication during this time.
Additionally, this medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. This risk is particularly higher if you have kidney problems or if you are a premature infant. It is vital to discuss this potential risk with your doctor.
If you are pregnant, planning to become pregnant, or breastfeeding, you must consult your doctor to weigh the benefits and risks of this medication to both you and your baby. Your doctor will help you make an informed decision about using this medication during this time.
Overdose Information
Overdose Symptoms:
- Severe hypercalcemia (calcium levels too high)
- Nausea, vomiting, constipation
- Polyuria (frequent urination), polydipsia (excessive thirst)
- Muscle weakness, fatigue, lethargy
- Confusion, stupor, coma
- Shortened QT interval on ECG, bradycardia, arrhythmias, cardiac arrest
What to Do:
Immediately discontinue calcium gluconate. Administer IV fluids (0.9% NaCl) to promote renal calcium excretion. Loop diuretics (e.g., furosemide) may be used after adequate hydration. In severe cases, calcitonin, bisphosphonates, or hemodialysis may be necessary. Call 1-800-222-1222 (Poison Control) for further guidance.
Drug Interactions
Contraindicated Interactions
- Digoxin (concurrent IV administration in non-life-threatening hypocalcemia due to increased risk of arrhythmias)
- Ceftriaxone (in neonates, due to risk of precipitation in lungs and kidneys)
Major Interactions
- Digoxin (increased risk of cardiac arrhythmias, especially with rapid IV calcium or hypercalcemia)
- Thiazide diuretics (may increase serum calcium levels, leading to hypercalcemia)
- Phosphate-containing solutions (risk of calcium phosphate precipitation)
- Sodium polystyrene sulfonate (risk of intestinal necrosis with sorbitol-containing formulations)
Moderate Interactions
- Calcium channel blockers (calcium may antagonize the effects of CCBs)
- Tetracyclines (oral calcium can chelate and reduce absorption of oral tetracyclines; not relevant for IV calcium gluconate)
- Fluoride (may form insoluble calcium fluoride)
Monitoring
Baseline Monitoring
Serum Calcium (total and ionized)
Rationale: To establish baseline and guide initial dosing for hypocalcemia; to assess calcium status in other indications.
Timing: Prior to administration
Serum Electrolytes (Potassium, Magnesium, Phosphate)
Rationale: To assess overall electrolyte balance, especially in hyperkalemia or magnesium toxicity; to identify potential for precipitation with phosphate.
Timing: Prior to administration
Renal Function (BUN, Creatinine)
Rationale: To assess kidney's ability to excrete calcium and guide fluid management.
Timing: Prior to administration
Electrocardiogram (ECG)
Rationale: To assess cardiac rhythm and identify signs of hypocalcemia (prolonged QT) or hyperkalemia (peaked T waves, wide QRS).
Timing: Prior to administration, especially in cardiac-related indications
Routine Monitoring
Serum Calcium (ionized preferred)
Frequency: Every 4-6 hours initially, then daily or as clinically indicated during continuous infusion.
Target: Ionized: 1.12-1.32 mmol/L (4.5-5.3 mg/dL); Total: 8.5-10.5 mg/dL
Action Threshold: Ionized < 1.12 mmol/L (consider additional bolus/infusion increase); Ionized > 1.32 mmol/L (consider infusion decrease/discontinuation).
Serum Electrolytes (K, Mg, Phos)
Frequency: Daily or as clinically indicated.
Target: Normal physiological ranges
Action Threshold: Significant deviations from normal (e.g., hyperphosphatemia, hypomagnesemia) may require intervention.
Electrocardiogram (ECG)
Frequency: Continuous monitoring during rapid IV infusion; periodically during continuous infusion.
Target: Normal sinus rhythm, absence of arrhythmias
Action Threshold: Development of bradycardia, arrhythmias, or signs of hypercalcemia (shortened QT interval).
Vital Signs (Heart Rate, Blood Pressure)
Frequency: Every 15-30 minutes during rapid infusion, then every 1-4 hours.
Target: Within patient's normal range
Action Threshold: Significant bradycardia, hypotension, or hypertension.
IV Site Inspection
Frequency: Regularly (e.g., every 1-2 hours) during infusion.
Target: No signs of redness, swelling, pain, or extravasation.
Action Threshold: Any signs of extravasation (stop infusion immediately).
Symptom Monitoring
- Signs of hypercalcemia (nausea, vomiting, constipation, polyuria, polydipsia, muscle weakness, confusion, lethargy, cardiac arrhythmias)
- Signs of hypocalcemia (paresthesias, muscle cramps, tetany, Chvostek's sign, Trousseau's sign, seizures, cardiac arrhythmias)
- Symptoms of extravasation (pain, swelling, redness at injection site)
Special Patient Groups
Pregnancy
Category C. Calcium is essential for fetal development. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Close monitoring of maternal calcium levels is recommended.
Trimester-Specific Risks:
First Trimester:
No specific increased risk identified beyond general Category C considerations.
Second Trimester:
No specific increased risk identified beyond general Category C considerations.
Third Trimester:
No specific increased risk identified beyond general Category C considerations. May be used for pre-eclampsia/eclampsia if magnesium toxicity occurs.
Lactation
Calcium is a natural component of breast milk. While IV administration can transiently increase maternal serum calcium, significant adverse effects on the infant are not expected with therapeutic doses. Monitor infant for signs of hypercalcemia if concerns arise.
Infant Risk:
Low
Pediatric Use
Dosing is weight-based and varies by indication. Careful calculation and slow administration are crucial to avoid hypercalcemia and cardiac effects. Neonates are particularly sensitive to rapid calcium infusions and precipitation with ceftriaxone.
Geriatric Use
Use with caution in elderly patients, who may have age-related decreases in renal function. Monitor serum calcium and renal function closely. Start at the lower end of the dosing range and titrate based on response and tolerability.
Clinical Information
Clinical Pearls
- Administer IV calcium gluconate slowly (typically over 5-10 minutes for bolus doses) to minimize the risk of hypotension, bradycardia, and cardiac arrhythmias.
- Calcium gluconate is less irritating to veins than calcium chloride and is preferred for peripheral IV administration, though central line is preferred for continuous infusions or high doses.
- Avoid extravasation, as it can cause severe tissue necrosis and calcification. If extravasation occurs, stop infusion immediately, aspirate residual drug, and consider hyaluronidase injection.
- Do NOT administer calcium gluconate concurrently with ceftriaxone in neonates due to the risk of fatal calcium-ceftriaxone precipitation in the lungs and kidneys.
- Monitor ECG continuously during rapid IV administration, especially in patients on digoxin, due to the risk of potentiating digoxin toxicity.
- Calcium gluconate provides 90 mg (4.5 mEq) of elemental calcium per 1 gram (10 mL of 10% solution), whereas calcium chloride provides 270 mg (13.6 mEq) of elemental calcium per 1 gram (10 mL of 10% solution). Dosing must be adjusted accordingly if switching between formulations.
Alternative Therapies
- Calcium Chloride (provides more elemental calcium per gram, but is more irritating to veins and typically reserved for central line administration or cardiac arrest)
- Oral Calcium Supplements (for chronic hypocalcemia or prevention)
- Magnesium Sulfate (for hypomagnesemia)
- Sodium Bicarbonate (for hyperkalemia, but mechanism differs)
Cost & Coverage
Average Cost:
$10 - $50 per 10 mL vial (10% solution)
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Generic)
General Drug Facts
If your symptoms or health problems do not improve or worsen over time, it is essential to contact your doctor for further evaluation and guidance. To ensure safe use, never share your prescription medications with others, and do not take medications that have been prescribed to someone else.
All medications should be stored in a secure location, out of the reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless specifically instructed to do so by a healthcare professional or pharmacist, avoid flushing medications down the toilet or pouring them down the drain. If you are unsure about the proper disposal method, consult with your pharmacist, who can provide guidance on safe disposal practices or inform you about potential drug take-back programs in your area.
Some medications may come with an additional patient information leaflet, so it is a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, do not hesitate to 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 critical information, including the name of the medication taken, the amount, and the time it was taken, to ensure prompt and effective treatment.
All medications should be stored in a secure location, out of the reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless specifically instructed to do so by a healthcare professional or pharmacist, avoid flushing medications down the toilet or pouring them down the drain. If you are unsure about the proper disposal method, consult with your pharmacist, who can provide guidance on safe disposal practices or inform you about potential drug take-back programs in your area.
Some medications may come with an additional patient information leaflet, so it is a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, do not hesitate to 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 critical information, including the name of the medication taken, the amount, and the time it was taken, to ensure prompt and effective treatment.