Elemental Calcium Content in 1 Ampule of Calcium Gluconate
One 10-mL ampule of 10% calcium gluconate contains 90 mg of elemental calcium. 1
Calcium Gluconate Composition Details
- Each 10-mL ampule of 10% calcium gluconate solution contains 1,000 mg of calcium gluconate 2
- The elemental calcium content in calcium gluconate is 9.3 mg (0.465 mEq) per mL 2
- Therefore, a standard 10-mL ampule provides 93 mg of elemental calcium, commonly rounded to 90 mg in clinical practice 1
Clinical Relevance of Calcium Content
- When treating hypocalcemia following parathyroidectomy, calcium gluconate infusions are dosed based on elemental calcium content at 1-2 mg/kg/hour 1
- For comparison, other calcium salts contain different percentages of elemental calcium:
Administration Considerations
- Maximum recommended dose of elemental calcium that should be taken at one time is 500 mg 3
- For IV administration, calcium gluconate should be diluted in 5% dextrose or normal saline 2
- Infusion rates should not exceed 200 mg/minute in adults or 100 mg/minute in pediatric patients 2
- For continuous infusion, dilute to a concentration of 5.8-10 mg/mL 2
Clinical Applications
- In post-parathyroidectomy management, if ionized calcium falls below normal (<0.9 mmol/L), calcium gluconate infusion should be initiated at 1-2 mg elemental calcium per kg body weight per hour 1
- For therapeutic plasma exchange, infusion rates of 1.6 g/hour of calcium gluconate have been shown to better maintain plasma ionized calcium levels compared to 1.0 g/hour 4
- For mild hypocalcemia (ionized calcium 1-1.12 mmol/L), 1-2 g of IV calcium gluconate is effective in normalizing calcium levels in approximately 79% of patients 5
Important Considerations
- Calcium chloride contains more elemental calcium than calcium gluconate but should be avoided in patients with CKD due to risk of metabolic acidosis 1
- Calcium gluconate is preferred over calcium chloride in the setting of abnormal liver function, where decreased citrate metabolism results in slower release of ionized calcium 1
- Serum calcium should be monitored every 4-6 hours during intermittent infusions and every 1-4 hours during continuous infusion 2