Calcium%2525252525252525252525252525252525252525252520gluconate

# Calcium Gluconate ## Overview Calcium gluconate is an inorganic salt of calcium used to treat or prevent calcium deficiencies. It is available in oral and intravenous formulations. ## Primary Indications * Treatment and prevention of hypocalcemia. * Management of magnesium sulfate overdose. * Adjunctive treatment in certain cases of fluoride poisoning and hydrofluoric acid burns (topical). ## Adult Dosing * **Hypocalcemia:** * **Intravenous:** 10 mL of 10% calcium gluconate solution (90 mg elemental calcium) administered slowly over 10-20 minutes. May be repeated every 1-6 hours as needed. Continuous infusion may be used in critical care settings, often guided by serum calcium levels and clinical response. Specific rates depend on local protocol. * **Oral:** Varies widely depending on formulation and elemental calcium content. Typical doses range from 1-2 grams of elemental calcium daily, divided into multiple doses. * **Magnesium Sulfate Overdose:** * **Intravenous:** 10 mL of 10% calcium gluconate solution (90 mg elemental calcium) administered intravenously over 3-5 minutes. May be repeated as needed based on response. ## Pediatric Dosing * **Hypocalcemia:** * **Intravenous:** 0.5-1 mL/kg of 10% calcium gluconate solution (45-90 mg elemental calcium/kg) administered slowly over 10-20 minutes. Maximum dose usually 10 mL (90 mg elemental calcium). May be repeated every 4-6 hours. Specific rates and total daily doses depend on local protocol and serum calcium levels. * **Oral:** Varies widely depending on formulation and elemental calcium content. Typical doses range from 45-50 mg elemental calcium/kg/day, divided into doses. ## Dose Adjustments No dose adjustment is typically required for renal or hepatic impairment, but caution is advised in patients with impaired renal function due to potential for hypercalcemia. ## Contraindications * Hypercalcemia. * History of calcium-containing kidney stones (relative contraindication, especially with oral formulations). * Ventricular fibrillation. * Certain cardiac conditions where risk outweighs benefit. ## Adverse Effects * **Intravenous:** Hypotension, bradycardia, arrhythmias, cardiac arrest, local irritation, extravasation injury, hypercalcemia (symptoms include constipation, nausea, vomiting, abdominal pain, confusion, lethargy, muscle weakness, polyuria, polydipsia). * **Oral:** Constipation, gastrointestinal upset, hypercalcemia. ## Key Drug Interactions * **Tetracyclines and Fluoroquinolones:** Calcium gluconate can chelate with these antibiotics, reducing their absorption. Separate administration by at least 2 hours. * **Bisphosphonates:** Reduced absorption of bisphosphonates. Separate administration by at least 2 hours. * **Digoxin:** Increased risk of digoxin toxicity in the presence of hypercalcemia. * **Thiazide Diuretics:** May increase serum calcium levels. * **Calcium Channel Blockers:** May decrease the efficacy of calcium channel blockers. ## Monitoring * Serum calcium levels (frequently during IV administration and periodically during oral therapy). * Renal function. * Cardiac rhythm (especially during rapid IV administration). * Signs and symptoms of hypercalcemia. ## Clinical Pearls * Intravenous calcium gluconate should be administered slowly and diluted when appropriate to prevent adverse cardiac events and local irritation. * Never administer intravenous calcium through the same IV line as bicarbonate or phosphate solutions due to risk of precipitation. * Oral calcium gluconate absorption may be enhanced when taken with food. * Topical calcium gluconate gel is the treatment of choice for hydrofluoric acid burns. *** **Disclaimer:** This information is intended for healthcare professionals. Always consult the official prescribing information and relevant guidelines for the most current and comprehensive drug details before making any clinical decisions.