Calcium Gluconate Dosing for a 13-Year-Old
For a 13-year-old patient requiring calcium gluconate supplementation, the recommended dose is 60 mg/kg administered slowly. 1
Dosing Guidelines for Pediatric Patients
- The American Academy of Pediatrics recommends a dose of 60 mg/kg for pediatric patients with hypocalcemia, hyperkalemia, hypermagnesemia, or calcium channel blocker toxicity 1
- For symptomatic hypocalcemia (tetany, seizures), a single dose of calcium gluconate 50-100 mg/kg should be infused and cautiously repeated if necessary 2
- Calcium gluconate contains 9% elemental calcium, meaning each 10-mL ampule of 10% calcium gluconate provides approximately 90 mg of elemental calcium 3
Administration Considerations
- Calcium gluconate should preferably be administered through a central venous catheter to prevent severe skin and soft tissue injury from extravasation 1
- For most indications, calcium gluconate should be infused over 30-60 minutes 1
- In emergency situations, the infusion rate may be adjusted based on clinical need, but careful monitoring is required 1
- Maximum dose of elemental calcium that should be taken at a time is 500 mg 4
Clinical Applications
- For asymptomatic hypocalcemia in newborns, elementary calcium replacement of 40 to 80 mg/kg/day is recommended 5
- For acute treatment of symptomatic hypocalcemia (tetany or hypocalcemic convulsion), elementary calcium of 10 to 20 mg/kg (1-2 mL/kg/dose of 10% calcium gluconate) is given as a slow intravenous infusion 5
- When treating hypocalcemia following parathyroidectomy, calcium gluconate infusions are dosed based on elemental calcium content at 1-2 mg/kg/hour 3
Important Considerations and Monitoring
- Calcium gluconate injection should be stopped if symptomatic bradycardia occurs during administration 3
- ECG monitoring is recommended during calcium administration, especially in patients with hyperkalemia 2
- Approximately half of the administered elemental calcium dose is retained in the exchangeable calcium space 6
- Serum ionized calcium concentrations typically achieve a plateau within 10 hours after completion of calcium gluconate infusion 6
- Calcium gluconate is preferred over calcium chloride in patients with abnormal liver function 3
Calcium Salt Comparisons
- Calcium gluconate (9% elemental calcium) is less concentrated than other calcium salts: 3
- Calcium lactate: 13% elemental calcium
- Calcium acetate: 25% elemental calcium
- Calcium carbonate: 40% elemental calcium
- Calcium lactate and calcium gluconate are less concentrated forms of calcium and are not practical for oral supplements 4