Trade Names:Calcium gluconate- Tablets 300 mg- Tablets 500 mg- Tablets 555.6 mg- Tablets 648 to 650 mg- Tablets 972 to 975 mg- Powder 346.7 mg per 3.9 g (1 Tbsp)- Injection 10% (elemental calcium 9.3 mg per mL)
Trade Names:Cal-G- Capsules 700 mg
Trade Names:Cal-GLU- Capsules 515 mg
Trade Names:Calgonate- Gel 2.5%
Essential for maintenance of the functional integrity of nervous, muscular, and skeletal systems and cell membrane and capillary permeability. It is also an important activator in many enzymatic reactions and is essential to a number of physiologic processes, including transmission of nerve impulses; contraction of cardiac, smooth, and skeletal muscles; renal function; respiration; and blood coagulation. Calcium also plays regulatory roles in the release and storage of neurotransmitters and hormones, in the uptake and binding of amino acids, and in cyanocobalamin (vitamin B 12 ) absorption and gastrin secretion. 1 g (10 mL) of calcium gluconate 10% contains 93 mg (4.65 mEq) calcium.
Oral absorption occurs primarily from the small intestine by active transport and passive diffusion and is enhanced by calcitriol, a vitamin D metabolite.
Excess calcium is primarily excreted renally while unabsorbed calcium is excreted in the feces along with that secreted in the bile and pancreatic juice.
Parenterally, as treatment of hypocalcemic tetany, hypocalcemia related to hypoparathyroidism, and hypocalcemia caused by rapid growth or pregnancy; treatment of hyperkalemia-induced cardiac toxicity, provided the patient is not receiving digitalis therapy; to decrease capillary permeability in allergic conditions, nonthrombocytopenic purpura, and exudative dermatoses, such as dermatitis herpetiformis, and for pruritus of eruptions caused by certain drugs; treatment of black widow spider bites to relieve muscle cramping; adjunctive treatment of rickets, osteomalacia, lead colic, and magnesium sulfate overdosage. Orally as a dietary supplement.
Hypercalcemia; ventricular fibrillation.
PO 500 to 8,000 mg/day (as calcium gluconate), in divided doses, preferably 1 to 2 h after meals. For the powder, 3 Tbsp/day with food or liquid. IV 500 mg to 2 g (5 to 20 mL of 10% solution).Children
IV 200 to 500 mg (2 to 5 mL of 10% solution).Infants
IV No more than 200 mg (no more than 2 mL of 10% solution).
Store at 15° to 30°C (59° to 86°F). Do not freeze. Do not expose oral products to excessive heat or moisture.
May decrease oral absorption of these drugs.Cardiac glycosides (eg, digoxin)
May potentiate digitalis and calcium toxicities.Ceftriaxone
Do not mix or administer with ceftriaxone.Proton pump inhibitors (eg, omeprazole)
May reduce calcium absorption.Tetracyclines
Do not mix with tetracyclines.Thiazide diuretics (eg, hydrochlorothiazide)
May cause possible calcium toxicity and hypercalcemia.Verapamil
May reverse clinical effects and toxicities of verapamil.
Parenteral calcium gluconate may produce false-negative values for serum and urinary magnesium. Transient elevations of plasma II-hydroxy-corticosteroid levels (Glenn-Nelson technique) may occur.
Sense of oppression.
Calcium or chalky taste in mouth, GI irritation.
Sensation of heat waves, tingling sensation.
Monitor plasma calcium levels closely in patients with renal function impairment and/or if large doses of vitamin D are used concurrently.
Category C .
Excreted in breast milk.
Premature neonates are at particular risk of aluminum toxicity.
Use with caution. Avoid use in patients with calcium renal calculi or a history of renal calculi. Aluminum toxicity may occur in patients with impaired kidney function, including premature neonates.
Use cautiously in patients with diseases associated with hypercalcemia, such as sarcoidosis and some malignancies.
Rapid IV injection may cause vasodilation, decreased blood pressure, bradycardia, cardiac arrhythmias, syncope, and cardiac arrest. Local necrosis and abscess formation may occur with IM injection.
Parenteral products may contain aluminum that may be toxic.
Use may precipitate arrhythmias.
Avoid overtreatment of hypocalcemia because hypercalcemia may be more dangerous than hypocalcemia.
Other therapy, such as parathyroid hormone or vitamin D, may be indicated according to the etiology of the tetany.
Hypercalcemia with symptoms of abdominal pain, anorexia, constipation, mental disturbances, muscle weakness, nausea, nephrocalcinosis, polydipsia, polyuria, renal calculi, and vomiting. Severe cases of hypercalcemia may cause cardiac arrhythmias and coma.
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