Calcium chloride

Calcium chloride
	Adult Indications & Dosage
	Pediatric Indications & Dosage
	Contraindications
	Warnings & Precautions
	Adverse Reactions
	Drug Interactions
	Use in Specific Populations
	Administration & Monitoring
	Overdosage
	Pharmacology
	Clinical Studies
	How Supplied
	Images
	Patient Counseling Information
	Precautions with Alcohol
	Brand Names
	Look-Alike Names

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

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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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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

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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.