From the Guidelines
Calcium gluconate is a crucial medication used to treat or prevent calcium deficiency, and its use is recommended in emergency situations for hypocalcemia, hyperkalemia, or calcium channel blocker overdose, with a typical intravenous dose of 1-2 grams given slowly over 10-20 minutes 1.
Key Points
- Calcium gluconate is available as an oral supplement or intravenous solution, with the IV form commonly used in emergency situations.
- The intravenous dose for adults in emergency situations is usually 1-2 grams given slowly over 10-20 minutes, as recommended by experts in the management of calcium channel blocker poisoning in adults 1.
- Calcium gluconate works by directly increasing serum calcium levels, which is essential for nerve transmission, muscle contraction, blood clotting, and bone health.
- Side effects may include gastrointestinal upset with oral forms or burning sensations at the injection site with IV administration.
- Patients with kidney stones, hypercalcemia, or certain cardiac conditions should use calcium supplements cautiously under medical supervision.
Clinical Use
- Calcium gluconate is used to treat hypocalcemia, hyperkalemia, or calcium channel blocker overdose, and its use is supported by observational studies and case series 1.
- The medication is also used to prevent calcium deficiency, and its use is recommended in patients at risk of developing calcium deficiency.
- Calcium gluconate should be used with caution in patients with certain medical conditions, such as kidney disease or heart problems, and its use should be monitored closely to avoid adverse effects.
Dosage and Administration
- The typical intravenous dose of calcium gluconate for adults in emergency situations is 1-2 grams given slowly over 10-20 minutes, as recommended by experts in the management of calcium channel blocker poisoning in adults 1.
- The dose and administration of calcium gluconate may vary depending on the patient's condition and the severity of the deficiency or overdose.
- Calcium gluconate should be administered slowly and carefully to avoid adverse effects, such as cardiac arrhythmias or tissue damage.
From the FDA Drug Label
Calcium Gluconate Injection is a form of calcium indicated for pediatric and adult patients for the treatment of acute symptomatic hypocalcemia. Calcium Gluconate Injection is indicated for pediatric and adult patients for the treatment of acute symptomatic hypocalcemia.
The use of calcium gluconate is for the treatment of acute symptomatic hypocalcemia in pediatric and adult patients 2 2.
- The indications for use include:
- Treatment of acute symptomatic hypocalcemia
- Limitations of use:
- The safety of Calcium Gluconate Injection for long-term use has not been established.
From the Research
Uses of Calcium Gluconate
- Treatment of moderate to severe acute hypocalcemia in critically ill trauma patients, where an infusion of 4 g of calcium gluconate can significantly increase serum ionized calcium concentration 3
- Prevention of hypocalcemic reactions during therapeutic plasma exchange, where a direct intravenous infusion of calcium gluconate can maintain plasma ionized calcium concentration and prevent hypocalcemic reactions 4
- Intravenous therapy of hypocalcemia, where calcium gluconate is preferred due to its lesser irritation of the vessel wall and better compatibility with other nutrients in parenteral nutrition 5
- Treatment of hypocalcemic disorders, including acute and chronic hypocalcemia, where intravenous administration of calcium gluconate can rapidly resolve symptoms of acute hypocalcemia 6
- Treatment of symptomatic hypocalcemia, where intravenous calcium gluconate is used to treat patients with calcium levels less than 7.6 mg/dL 7
Specific Conditions Treated with Calcium Gluconate
- Hypocalcemia caused by vitamin D deficiency 7
- Hypoparathyroidism, a classic cause of chronic hypocalcemia 6
- Disorders that disrupt the metabolism of vitamin D, which can lead to chronic hypocalcemia 6
- Fluoride or oxalic acid poisoning, decreased myocardial contractility caused by overdose of calcium intake blockers or beta blockers, and other conditions 5
Administration and Dosage
- Infusion of 4 g of calcium gluconate at a rate of 1 g/h in a small volume admixture for the treatment of moderate to severe acute hypocalcemia 3
- Direct intravenous infusion of calcium gluconate at a rate of 1.0 or 1.6 g/h for the prevention of hypocalcemic reactions during therapeutic plasma exchange 4