From the Guidelines
Calcium gluconate should be administered at a dose of 50-100 mg/kg in patients with symptomatic hypocalcemia, such as tetany and seizures, and cautiously repeated if necessary. This recommendation is based on the consensus conference on the management of tumor lysis syndrome 1. The use of calcium gluconate is specifically mentioned in the context of treating symptomatic hypocalcemia, whereas asymptomatic hypocalcemia does not require treatment.
Key Points to Consider
- Calcium gluconate is used to treat symptomatic hypocalcemia, with a dose range of 50-100 mg/kg 1.
- Asymptomatic hypocalcemia does not require treatment, according to the consensus conference on tumor lysis syndrome 1.
- The dose of calcium gluconate should be cautiously repeated if necessary, to avoid potential complications.
Clinical Context
In clinical practice, calcium gluconate is an essential medication for managing hypocalcemia, particularly in patients with tumor lysis syndrome. The recommended dose and administration guidelines should be followed to ensure safe and effective treatment. It is also important to monitor patients for potential complications, such as cardiac arrhythmias, and to adjust the dose accordingly.
Administration Guidelines
When administering calcium gluconate, it is crucial to follow proper guidelines to minimize the risk of complications. The medication should be infused slowly, and the injection site should be monitored for extravasation, which can cause tissue necrosis. Additionally, patients should be closely monitored for signs of hypocalcemia, such as tetany and seizures, and the dose of calcium gluconate should be adjusted accordingly.
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. The safety of Calcium Gluconate Injection for long term use has not been established. Contains 100 mg of calcium gluconate per mL which contains 9.3 mg (0. 465 mEq) of elemental calcium Administer intravenously (bolus or continuous infusion) via a secure intravenous line Individualize the dose within the recommended range in adults and pediatric patients depending on the severity of symptoms of hypocalcemia, the serum calcium level, and the acuity of onset of hypocalcemia.
Calcium gluconate use is indicated for the treatment of acute symptomatic hypocalcemia in pediatric and adult patients. The dose should be individualized based on the severity of symptoms, serum calcium level, and acuity of onset of hypocalcemia. Administration is via intravenous route, and the dose contains 9.3 mg (0.465 mEq) of elemental calcium per 100 mg of calcium gluconate. Key considerations include:
- Contraindications: Hypercalcemia, neonates receiving ceftriaxone
- Warnings and precautions: Arrhythmias with concomitant cardiac glycoside use, end-organ damage due to intravascular ceftriaxone-calcium precipitates, tissue necrosis and calcinosis, hypotension, bradycardia, and cardiac arrhythmias with rapid administration, aluminum toxicity 2
From the Research
Calcium Gluconate Use
- Calcium gluconate is used to treat moderate to severe acute hypocalcemia in critically ill patients 3.
- A study found that an infusion of 4g of calcium gluconate significantly increased serum ionized calcium levels in critically ill, adult, multiple-trauma patients with moderate to severe hypocalcemia 3.
- Calcium gluconate is preferred over calcium chloride due to its lower irritation of the vessel wall and better compatibility with other nutrients in parenteral nutrition 4.
- Calcium gluconate is used to treat hypocalcemia, as well as other conditions such as fluoride or oxalic acid poisoning, decreased myocardial contractility, and acute allergic conditions 4.
Administration and Dosage
- Calcium gluconate can be administered intravenously, with a dosage regimen of 4g infused at a rate of 1g/h 3.
- The efficacy of calcium gluconate infusion in treating hypocalcemia has been demonstrated in several studies, with significant increases in serum ionized calcium levels observed 3, 4.
- The use of calcium gluconate in parenteral nutrition has also been studied, with findings suggesting its safety and efficacy in this setting 4, 5.
Comparison with Other Treatments
- Calcium gluconate has been compared to other treatments for hypocalcemia, including calcium chloride and teriparatide 4, 6.
- While calcium chloride may provide greater and more highly ionized amounts of calcium, calcium gluconate is preferred due to its lower irritation of the vessel wall and better compatibility with other nutrients in parenteral nutrition 4.
- Teriparatide has been used to treat hypoparathyroidism, including cases refractory to vitamin D therapy, and has been shown to be effective in normalizing serum calcium levels 6.