From the Guidelines
Calcium gluconate should be administered at a dose of 50-100 mg/kg intravenously to treat symptomatic hypocalcemia, with cautious repetition if necessary, as recommended by the most recent guidelines 1.
Key Considerations
- The use of calcium gluconate is primarily for emergency treatment of conditions like hypocalcemia, hyperkalemia, or calcium channel blocker overdose.
- For oral supplementation, typical doses range from 500-2000 mg taken 1-3 times daily with food to enhance absorption, although this is not the primary use in the context of the provided evidence.
- The injectable form (10% solution) is used in emergency settings, and the dose should be administered slowly intravenously under medical supervision.
- Calcium gluconate works by directly increasing serum calcium levels, which is essential for proper nerve, muscle, and cardiac function.
Important Precautions
- Patients should be aware that calcium supplements can interact with certain medications, including antibiotics, bisphosphonates, and thyroid medications, so proper spacing between doses is important.
- Those with kidney stones, hypercalcemia, or certain cardiac conditions should use calcium gluconate only under medical supervision.
- Care must be taken because increased calcium might increase the risk of calcium phosphate precipitation in the tissues and consequential obstructive uropathy, especially if the patient’s phosphate levels are high 1.
Clinical Context
- The management of hypocalcemia, as outlined in the guidelines for tumor lysis syndrome, emphasizes the importance of treating symptomatic patients with calcium gluconate while being cautious of the potential risks 1.
- The choice between different calcium salts, such as calcium carbonate or calcium citrate, may depend on factors like cost, bioavailability, and patient tolerance, but calcium gluconate is specifically recommended for emergency intravenous use in the context of hypocalcemia 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Calcium Gluconate Uses
- Calcium gluconate is used to treat hypocalcemia, a condition where the blood calcium level is too low 2, 3, 4, 5.
- It is commonly used in critically ill patients, particularly those with multiple trauma, to prevent and treat hypocalcemia 2, 3.
- Calcium gluconate can be administered intravenously to rapidly increase blood calcium levels 2, 3, 6.
Dosage and Administration
- The dosage of calcium gluconate varies depending on the severity of hypocalcemia and the patient's response to treatment 2, 3.
- A common dosage is 1-4 grams of calcium gluconate infused at a rate of 1 gram per hour 2, 3.
- The infusion rate can be adjusted to maintain a stable blood calcium level and prevent hypocalcemic reactions 6.
Efficacy and Safety
- Calcium gluconate has been shown to be effective in increasing blood calcium levels and preventing hypocalcemic reactions in critically ill patients 2, 3, 6.
- However, it can cause mild hypercalcemia in some patients, and careful monitoring of blood calcium levels is necessary to avoid this complication 2, 3.
- Calcium gluconate is generally well-tolerated, but it can cause side effects such as nausea, vomiting, and constipation 4.