Calcium chloride


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Hypocalcaemic tetany Initial: 2.25-8 mmol (4.5-16 mEq) Ca repeated as needed. Acute hypocalcaemia Initial: 3.5-7 mmol (7-14 mEq) Ca repeated every 1-3 days as needed. Hypocalcaemia 200-1000 mg repeated every 1-3 days depending on patient response or serum Ca determinations. Hyperkalaemia With secondary cardiac toxicity: Initial: 1.12-7 mmol (2.25-14 mEq) Ca, may be repeated after 1-2 minutes as needed. Antidote in severe hypermagnesaemia Initial: 500 mg administered promptly.
Dosage Details
Intravenous
Hypocalcaemia
Adult: 200-1,000 mg repeated every 1-3 days depending on patient response or serum Ca determinations.
Child: 2.7-5 mg (0.136-0.252 mEq Ca)/kg repeated 4-6 hourly. Max: 1,000 mg.

Intravenous
Acute hypocalcaemia
Adult: Initially, 3.5-7 mmol (7-14 mEq) Ca repeated every 1-3 days as needed.
Child: Initially, 0.5-3.5 mmol Ca/kg repeated every 1-3 days as needed.

Intravenous
Hypocalcaemic tetany
Adult: Initially, 2.25-8 mmol (4.5-16 mEq) Ca repeated as needed.
Child: Initially, 0.25-0.35 mmol Ca/kg repeated 6-8 hourly until a response is achieved.

Intravenous
Hyperkalaemia
Adult: With secondary cardiac toxicity: Initially, 1.12-7 mmol (2.25-14 mEq) Ca, may be repeated after 1-2 minutes as needed. Titrate dose by constant ECG changes monitoring during administration.

Intravenous
Antidote in severe hypermagnesaemia
Adult: Initially, 500 mg administered promptly. Observe patient for signs of recovery before further doses.
Incompatibility
May form precipitate or complex with phosphates, carbonates, sulfates, tartrates and antibiotics (e.g. ceftriaxone, tetracyclines).
Contraindications
Known or suspected digoxin toxicity, hypercalcaemia, hypercalciuria, ventricular fibrillation, renal calculi, elevated vitamin D levels (e.g. sarcoidosis). Concurrent digitalis therapy; IV ceftriaxone in newborns (<28 days).
Special Precautions
Patient with respiratory acidosis or failure, cor pulmonale, severe hypophosphatemia or hypokalaemia, hypomagnesemia, increased risk of hypercalcaemia (e.g. some malignancies, dehydration, electrolyte imbalance), cardiac disease. Not to be administered via IM, SC or into perivascular tissue. Renal impairment. Children. Pregnancy and lactation.
Adverse Reactions
Significant: Extravasation resulting to severe necrosis and sloughing, moderate hypotension.
Cardiac disorders: Bradycardia, cardiac arrest, cardiac arrhythmias, syncope.
Gastrointestinal disorders: Gastrointestinal irritation, thirst, nausea, vomiting, constipation, polyuria, abdominal pain, dysgeusia (chalky taste), Ca taste (rapid inj).
General disorders and administration site conditions: Tissue calcification, local burning sensation.
Investigations: Increased serum amylase.
Metabolism and nutrition disorders: Hypercalcaemia.
Nervous system disorders: Tingling sensation (rapid inj).
Vascular disorders: Vasodilation, venous irritation, hot flushes (rapid inj).
IV/Parenteral: C
MonitoringParameters
Monitor infusion site, serum Ca, Mg and phosphate concentrations; ECG when necessary.
Overdosage
Symptoms: nausea, vomiting, constipation, thirst, polyuria, abdominal pain, muscle weakness, and mental disturbances. In severe cases, cardiac arrhythmias and coma. Management: Withhold therapy and monitor serum Ca concentrations. In serious cases, rehydrate with 0.9% NaCl infusion and administer non-thiazide diuretics to increase Ca excretion. Monitor cardiac function and use β-blockers to protect the heart against arrhythmia. Monitor serum K and Mg levels and consider early use of replacement therapy.
Drug Interactions
May increase risk of hypercalcaemia with thiazide diuretics. May reduce response to Ca channel blockers (e.g. verapamil). May increase risk of hypercalcaemia or hypermagnesemia with other Ca- or Mg-containing medications. May reverse the effects of nondepolarizing neuromuscular blocking agents. May enhance or prolong neuromuscular activity of tubocurarine.
Potentially Fatal: Increased risk of arrhythmia with cardiac glycosides (e.g. digitalis). Increased risk of precipitation causing lung and kidney damage with IV ceftriaxone (newborns up to 28 days).
Action
Description: Calcium regulates the function of the nervous and muscular systems by facilitating the action potential excitation threshold. Ca is essential in activating many enzymatic reactions and various physiological processes such as contraction of cardiac, smooth and skeletal muscles; transmission of nerve impulses, renal function and respiration.
Pharmacokinetics:
Absorption: Mainly absorbed from the small intestine via active transport and passive diffusion.
Distribution: Crosses the placenta and enters the breast milk. Plasma protein binding: Approx 40% (mainly to albumin).
Excretion: Mainly via faeces (80% as insoluble Ca salts); urine (20%).
Storage
Store between 15-30°C.
MIMS Class
ATC Classification
B05XA07 - calcium chloride ; Belongs to the class of electrolyte solutions used in I.V. solutions.
A12AA07 - calcium chloride ; Belongs to the class of calcium-containing preparations. Used as dietary supplements.
Disclaimer: This information is independently developed by MIMS based on Calcium chloride from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in