Calcium chloride
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]
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Overview
Calcium chloride is a {{{drugClass}}} that is FDA approved for the {{{indicationType}}} of a list of indications, separated by commas.. Common adverse reactions include a list of adverse reactions, separated by commas..
Adult Indications and Dosage
FDA-Labeled Indications and Dosage (Adult)
Indications
Calcium Chloride Injection, USP, 10% is indicated:
- In the treatment of hypocalcemia in conditions requiring a prompt increase in plasma calcium levels (e.g., neonatal tetany and tetany due to parathyroid deficiency, vitamin D deficiency and alkalosis) and for prevention of hypocalcemia during exchange transfusions.
- As adjunctive therapy in the management of acute symptoms in lead colic.
- In the treatment of magnesium intoxication due to overdosage of magnesium sulfate.
- In severe hyperkalemia, to combat deleterious effects on electrocardiographic (ECG) function, pending correction of the potassium level in the extracellular fluid.
- In cardiac resuscitation, particularly after open heart surgery, when epinephrine fails to improve weak or ineffective myocardial contractions.
Dosing
INJECT SLOWLY Calcium Chloride Injection, USP, 10%, is administered only by slow intravenous injection (not to exceed 1 mL/min) and / or in cardiac resuscitation, by injection into the ventricular cavity. It must not be injected into the myocardium.
The usual precautions for intravenous therapy should be observed. If time permits, the solution should be warmed to body temperature. The injection should be halted if the patient complains of any discomfort; it may be resumed when symptoms disappear. Following injection, the patient should remain recumbent for a short time.
INTRACARDIAC USE For cardiac resuscitation, inject into the ventricular cavity, not into the heart muscle.
Usual Adult Dosage: 200 to 800 mg (2 to 8 mL) when injected into the ventricular cavity.
INTRAVENOUS USE Hypocalcemic Disorders
Usual Adult Dosage: 500 mg to 1 g (5 to 10 mL) at intervals of 1 to 3 days, depending on the response of the patient and / or results of serum calcium determinations. Repeated injections may be required because of rapid excretion of calcium.
Magnesium Intoxication
Initial Adult Dose: 500 mg (5 mL) administered promptly and the patient observed for signs of recovery before further doses are given.
Hyperkalemic ECG Disturbances of Cardiac Function Dosage should be adjusted by constant monitoring of ECG changes during administration.
Off-Label Use and Dosage (Adult)
Guideline-Supported Use
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Condition 2
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Non–Guideline-Supported Use
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Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
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Off-Label Use and Dosage (Pediatric)
Guideline-Supported Use
Indications and Dosing
- Contains 100 mg calcium chloride per mL; 27.3 mg or 1.36 mEq of elemental calcium per mL.
- Hypocalcemia: 200 mg to 1 g calcium chloride (2 to 10 mL of a 10% solution; 55 to 273 mg elemental calcium) IV every 1 to 3 days; MAX rate, 1 mL/min.
Non–Guideline-Supported Use
Condition 1
- Dosing Information
Contraindications
- Calcium chloride is contraindicated for cardiac resuscitation in the presence of ventricular fibrillation.
Warnings
- Calcium chloride should be injected into a large vein very slowly, as it may cause peripheral vasodilatation and a cutaneous burning sensation. A moderate fall in blood pressure due to vasodilatation may attend the injection. Since calcium chloride is an acidifying salt, it is usually undesirable in the treatment of hypocalcemia or renal insufficiency.
Adverse Reactions
Clinical Trials Experience
- Rapid I.V. injection may cause the patient to complain of tingling sensations, a calcium taste, a sense of oppression or “heat wave.”
Injections of calcium chloride are accompanied by peripheral vasodilation as well as a local “burning” sensation, and there may be a moderate fall in blood pressure.
Gastrointestinal
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Condition 2
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Postmarketing Experience
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Drug Interactions
There is limited information regarding Calcium chloride Drug Interactions in the drug label.
Use in Specific Populations
Pregnancy
Pregnancy Category (FDA):
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Pregnancy Category (AUS):
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Labor and Delivery
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Nursing Mothers
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Pediatric Use
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Geriatic Use
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Gender
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Race
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Renal Impairment
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Hepatic Impairment
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Females of Reproductive Potential and Males
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Immunocompromised Patients
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Others
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Administration and Monitoring
Administration
(Oral/Intravenous/etc)
Monitoring
Condition 1
(Description regarding monitoring, from Warnings section)
Condition 2
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Condition 3
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IV Compatibility
Solution
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Not Tested
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Variable
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Incompatible
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Y-Site
Compatible
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Not Tested
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Variable
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Incompatible
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Admixture
Compatible
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Not Tested
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Variable
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Incompatible
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Syringe
Compatible
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Not Tested
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Variable
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Incompatible
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TPN/TNA
Compatible
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Not Tested
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Variable
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Incompatible
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Overdosage
Acute Overdose
Signs and Symptoms
(Description)
Management
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Chronic Overdose
Signs and Symptoms
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Management
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Pharmacology
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Calcium chloride
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Mechanism of Action
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Structure
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Pharmacodynamics
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Pharmacokinetics
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Nonclinical Toxicology
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Clinical Studies
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How Supplied
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Storage
There is limited information regarding Calcium chloride Storage in the drug label.
Images
Drug Images
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Package and Label Display Panel
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Patient Counseling Information
(Patient Counseling Information)
Precautions with Alcohol
Alcohol-Calcium chloride interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
Brand Names
There is limited information regarding Calcium chloride Brand Names in the drug label.
Look-Alike Drug Names
- (Paired Confused Name 1a) — (Paired Confused Name 1b)
- (Paired Confused Name 2a) — (Paired Confused Name 2b)
- (Paired Confused Name 3a) — (Paired Confused Name 3b)
Drug Shortage Status
Drug Shortage
Price
References
The contents of this FDA label are provided by the National Library of Medicine.