Calcium chloride

Generic Medicine Info
Indications and Dosage
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.

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.

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.

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.

Antidote in severe hypermagnesaemia
Adult: Initially, 500 mg administered promptly. Observe patient for signs of recovery before further doses.
May form precipitate or complex with phosphates, carbonates, sulfates, tartrates and antibiotics (e.g. ceftriaxone, tetracyclines).
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
Monitoring Parameters
Monitor infusion site, serum Ca, Mg and phosphate concentrations; ECG when necessary.
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).
Mechanism of Action: 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.
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%).
Store between 15-30°C.
MIMS Class
AFT Pharmaceuticals Ltd. Calcium chloride injection data sheet February 2019. Medsafe. Accessed 04/05/2020.

Anon. Calcium chloride. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. Accessed 04/05/2020.

Anon. Calcium Salts. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. Accessed 04/05/2020.

Buckingham R (ed). Calcium. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. Accessed 04/05/2020.

Calcium chloride Injection (International Medication Systems, Ltd.). DailyMed. Source: U.S. National Library of Medicine. Accessed 04/05/2020.

Calcium Chloride Injection Minijet 10% w/v (International Medication Systems Limited). MHRA. Accessed 04/05/2020.

Calcium Chloride Injection, Solution (Hospira, Inc.). DailyMed. Source: U.S. National Library of Medicine. Accessed 16/06/2020.

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 © 2024 MIMS. All rights reserved. Powered by
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