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CALCIUM GLUCONATE is a brand name for Calcium Gluconate. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Parenteral administration of calcium is indicated where the pharmacological action of a high calcium ion concentration is required, as for example, in acute hypocalcaemia, and some cases of neonatal tetany. Intravenous injections of calcium have been used in the treatment of the acute colic of lead poisoning. Advice…
Verbatim from this product's MHRA label. Tap a section to expand.
5 mEq per litre. Treatment should be aimed at restoring or maintaining this level. During therapy, serum calcium levels should be monitored closely. 46 mEq of calcium. If necessary, the dose may be repeated, depending on the patient’s clinical condition.
Subsequent doses should be adjusted according to the actual serum calcium level. Paediatric patients (< 18 years) The dose and the route of administration depend on the degree of hypocalcaemia and the nature and severity of the symptoms.
In the case of mild neuromuscular symptoms oral calcium administration should be preferred. g. 45 mmol calcium per kg body weight) may be necessary for a quick restoration of a normal serum calcium level. Also, if necessary, the dose may be repeated, depending on the patient’s clinical condition.
Subsequent doses should be adjusted according to the actual serum calcium level. g. in cases of calciferol deficiency.
Elderly patients:
Although there is no evidence that tolerance of Calcium gluconate 10% w/v Solution for injection is directly affected by advanced age, factors that may sometimes be associated with ageing, such as impaired renal function and poor diet, may indirectly affect tolerance and may require a reduction in dosage.
3) for repeated or prolonged administration in patients with impaired renal function. 5-1 g/kg/d) over 1-2 days. Heart rate should be monitored during the infusion. The IV site should also be watched closely because tissue infiltration by a calcium solution is irritating and may cause local tissue damage or necrosis.
Fluoride poisoning Calcium gluconate regime for hypocalcaemia in fluoride poisoning: Immediate: - give 10 mL of 10% calcium gluconate intravenously on presentation, repeat at 1 hour, or - give 30 mL of 10% calcium gluconate intravenously if tetany present.
Maintenance: - Maintain serum calcium with intravenous 10% calcium gluconate 10 mL every 4 hours, adjusting according to frequent serum calcium concentrations.
Mild to moderate dermal toxicity due to hydrofluoric acid/fluoride exposure:
Subcutaneous calcium gluconate (10%) for dermal exposure of hydrofluoric acid > 20%. 5 mL of 10% calcium gluconate. In the case of significant burn due to hydrofluoric acid /fluoride exposure, calcium salts may be administered intravenously (for systemic toxicity) or intra-arterially (for hand burns predominantly).
8. In the case of adipose patients a longer needle will have to be chosen for safe positioning of the injection into the muscle and not into adipose tissues. If repeated injections are necessary, the injection site should be changed every time.
,45 mmol of calcium) per minute. Paediatric patients (<18 years) Only slow intravenous injection or intravenous infusion (both after dilution), in order to achieve sufficiently low administration rates and to avoid irritation/necrosis in case of accidental extravasation.
6) of Calcium gluconate 10% w/v Solution for injection in children and adolescents. Intramuscular injections should not be performed in paediatric patients. g. in hyperparathyroidism, hypervitaminosis D, neoplastic disease with decalcification of bone), severe hypercalciuria, and in patients receiving cardiac glycosides.
4 Special warnings and precautions for use Plasma calcium levels and calcium excretion should be monitored when calcium is administered parenterally, especially in children, in chronic renal failure or where there is evidence of calculi formation within the urinary tract.
75mmol per litre or if 24 hour urinary calcium excretion exceeds 5mg/kg, treatment should be discontinued immediately as cardiac arrhythmias may occur at these levels. 3. In the exceptional case of intravenous administration of calcium gluconate to patients receiving cardiac glycosides, adequate cardiac monitoring is mandatory and emergency treatment of cardiac complications such as serious arrhythmias must be available.
Intravenous injections should be accompanied by heart rate or ECG control because bradycardia with vasodilatation or arrhythmia can occur when calcium is administered too quickly. Renal impairment may be associated with hypercalcaemia and secondary hyperparathyroidism.
Therefore, in patients with renal impairment, parenteral calcium should be administered only after careful assessment of the indication and the calcium-phosphate balance should be monitored. Calcium salts should be used with caution in patients with nephrocalcinosis.
Plasma calcium levels and calcium excretion should be monitored when calcium is administered parenterally, especially in children, in chronic renal failure or where there is evidence of calculi formation within the urinary tract. 75mmol per litre or if 24 hour urinary calcium excretion exceeds 5mg/kg, treatment should be discontinued immediately as cardiac arrhythmias may occur at these levels.
3. In the exceptional case of intravenous administration of calcium gluconate to patients receiving cardiac glycosides, adequate cardiac monitoring is mandatory and emergency treatment of cardiac complications such as serious arrhythmias must be available.
Intravenous injections should be accompanied by heart rate or ECG control because bradycardia with vasodilatation or arrhythmia can occur when calcium is administered too quickly. Renal impairment may be associated with hypercalcaemia and secondary hyperparathyroidism.
Therefore, in patients with renal impairment, parenteral calcium should be administered only after careful assessment of the indication and the calcium-phosphate balance should be monitored. Calcium salts should be used with caution in patients with nephrocalcinosis.
Care is also required in patients with cardiac disease. 5). Calcium salts are irritant. The infusion site must be monitored regularly to ensure extravasation injury has not occurred. 2). Care should be taken to avoid admixture of calcium gluconate and incompatible medicinal products in giving sets, or in the circulation after separate administration.
Serious complications, including fatalities, have occurred following microcrystallisation of insoluble calcium salts in the body following separate administration of physically incompatible solutions or total parenteral nutrition solutions containing calcium and phosphate.
Cases of fatal reactions with calcium-ceftriaxone precipitates in lungs and kidneys in premature and full-term newborns aged less than 1 month have been described. At least one of them had received ceftriaxone and calcium at different times and through different intravenous lines.
g. in hyperparathyroidism, hypervitaminosis D, neoplastic disease with decalcification of bone), severe hypercalciuria, and in patients receiving cardiac glycosides. 2)
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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- 10 mL of 10% calcium gluconate plus heparin 5000 units in a total volume of 40 mL is administered intravenously. 9% sodium chloride solution is intra-arterially infused over 4 h. Hypocalcaemia during transfusion Adults Calcium should be administered during massive transfusion if Ca2+ concentration is low, in order to preserve normocalcaemia.
10 mL of a 10% solution of Calcium gluconate 10% w/v Solution for injection IV diluted in 100 mL D5W (5% Glucose in water), given over 10 min or 10-20 mL Calcium gluconate for each 500 mL of blood infused. Pediatric patients (< 18 years) During transfusion / exchange transfusion the patient’s clinical condition and the calcium serum concentration have to be monitored, and a clinically significant hypocalcaemia should be treated according to dosing recommendations for acute hypocalcaemia.
Method of administration The patient should be in the lying position and should be closely observed during injection. Monitoring should include heart rate or ECG. Adults Slow intravenous or deep intramuscular injection. For the intramuscular route, if intravenous injection is not possible, only the 10% w/v solution should be used.
Because of the risk of local irritation, intramuscular injections should only be performed if intravenous injection is not possible. Care should be taken to administer the intramuscular injections sufficiently deep IM, preferably into the gluteal region.
8. In the case of adipose patients a longer needle will have to be chosen for safe positioning of the injection into the muscle and not into adipose tissues. If repeated injections are necessary, the injection site should be changed every time.
,45 mmol of calcium) per minute. Paediatric patients (<18 years) Only slow intravenous injection or intravenous infusion (both after dilution), in order to achieve sufficiently low administration rates and to avoid irritation/necrosis in case of accidental extravasation.
6) of Calcium gluconate 10% w/v Solution for injection in children and adolescents. Intramuscular injections should not be performed in paediatric patients.
Care is also required in patients with cardiac disease. 5). Calcium salts are irritant. The infusion site must be monitored regularly to ensure extravasation injury has not occurred. 2). Care should be taken to avoid admixture of calcium gluconate and incompatible medicinal products in giving sets, or in the circulation after separate administration.
Serious complications, including fatalities, have occurred following microcrystallisation of insoluble calcium salts in the body following separate administration of physically incompatible solutions or total parenteral nutrition solutions containing calcium and phosphate.
Cases of fatal reactions with calcium-ceftriaxone precipitates in lungs and kidneys in premature and full-term newborns aged less than 1 month have been described. At least one of them had received ceftriaxone and calcium at different times and through different intravenous lines.
In the available scientific data, there are no reports of confirmed intravascular precipitations in patients, other than newborns, treated with ceftriaxone and calcium-containing solutions or any other calcium-containing products. In vitro studies demonstrated that newborns have an increased risk of precipitation of ceftriaxone-calcium compared to other age groups.
In patients of any age ceftriaxone must not be mixed or administered simultaneously with any calcium-containing IV solutions, even via different infusion lines or at different infusion sites. However, in patients older than 28 days of age ceftriaxone and calcium-containing solutions may be administered sequentially one after another if infusion lines at different sites are used or if the infusion lines are replaced or thoroughly flushed between infusions with physiological salt-solution to avoid precipitation.
2). In children, Calcium gluconate 10% w/v Solution for injection should not be injected intramuscularly but only slowly intravenously. Calcium is insoluble in adipose tissue and may therefore cause infiltration and subsequent abscess formation, tissue induration and necrosis.
8). Extravasation must be avoided; the injection site should be monitored carefully. 5 Interaction with other medicinal products and other forms of interaction Cardiac glycosides The effects of digoxin and other cardiac glycosides may be accentuated by calcium and digitalis intoxication may be precipitated.
Thiazide diuretics There is increased risk of hypercalcaemia with thiazides. 4). Magnesium Calcium and magnesium mutually antagonise their effects. Calcium antagonists Calcium may antagonise the […]
In the available scientific data, there are no reports of confirmed intravascular precipitations in patients, other than newborns, treated with ceftriaxone and calcium-containing solutions or any other calcium-containing products. In vitro studies demonstrated that newborns have an increased risk of precipitation of ceftriaxone-calcium compared to other age groups.
In patients of any age ceftriaxone must not be mixed or administered simultaneously with any calcium-containing IV solutions, even via different infusion lines or at different infusion sites. However, in patients older than 28 days of age ceftriaxone and calcium-containing solutions may be administered sequentially one after another if infusion lines at different sites are used or if the infusion lines are replaced or thoroughly flushed between infusions with physiological salt-solution to avoid precipitation.
2). In children, Calcium gluconate 10% w/v Solution for injection should not be injected intramuscularly but only slowly intravenously. Calcium is insoluble in adipose tissue and may therefore cause infiltration and subsequent abscess formation, tissue induration and necrosis.
8). Extravasation must be avoided; the injection site should be monitored carefully.