Compatibility of Calcium 10% with Sodium Chloride Solution
Calcium 10% (calcium chloride) can be safely mixed with sodium chloride solution for intravenous administration, provided there are no phosphate-containing additives in the sodium chloride solution.
Compatibility Considerations
Physical Compatibility
- Calcium chloride is physically compatible with sodium chloride solutions when administered together 1
- Unlike calcium phosphate combinations, calcium chloride with sodium chloride does not form precipitates that could cause patient harm 2
- The compatibility is important because precipitation can lead to:
- Catheter occlusion
- Potential pulmonary embolism
- Tissue damage if extravasation occurs
Important Precautions
- Calcium chloride should NOT be mixed with solutions containing phosphates, as this creates an immediate precipitation risk 2, 3
- Administration through a central venous catheter is preferred; extravasation through a peripheral IV line may cause severe skin and soft tissue injury 4
- Monitor for symptomatic bradycardia during administration and stop injection if it occurs 4
Administration Guidelines
Proper Administration Technique
- When administering calcium chloride 10% (20 mL):
- Give by slow push for cardiac arrest situations
- Infuse over 30-60 minutes for other indications 4
- Monitor heart rate throughout administration
- Repeat doses as necessary based on clinical effect
Monitoring During Administration
- Monitor for:
- Heart rate changes (especially bradycardia)
- Signs of extravasation at injection site
- Clinical response to calcium administration
Clinical Applications
Indications for Calcium Chloride Administration
- Hypocalcemia
- Hyperkalemia
- Hypermagnesemia
- Calcium channel blocker toxicity 4
Dosing Considerations
- For pediatric patients: 20 mg/kg (0.2 mL/kg for 10% CaCl₂)
- For cardiac arrest situations: administer by slow push
- For other indications: infuse over 30-60 minutes 4
Potential Pitfalls and Contraindications
Avoid These Common Errors
- Never mix calcium chloride with:
Extravasation Risk
- Calcium chloride is highly caustic to tissues
- Administration through a central venous catheter is preferred
- Extravasation can cause severe tissue damage and necrosis 4
By following these guidelines, calcium chloride 10% (20 mL) can be safely administered with sodium chloride solution, providing an effective way to deliver calcium supplementation while minimizing risks to the patient.