Calcium chloride

10% Calcium Chloride Injection, USP is indicated for the treatment of hypocalcemia in those conditions requiring a prompt increase in plasma calcium levels.

• 10% Calcium Chloride Injection, USP is administered only by slow intravenous injection (not to exceed 1 mL/min), preferably in a central or deep vein
• 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
• The usual adult dosage in hypocalcemic disorders ranges from 200 mg to 1 g (2 -10 mL) at intervals of 1 to 3 days depending on the response of the patient and/or results of serum ionized calcium determinations
• Repeated injections may be required because of rapid excretion of calcium
• The pediatric dosage in hypocalcemic disorders ranges from 2.7 to 5.0 mg/kg hydrated calcium chloride (or 0.136 to 0.252 mEq elemental calcium per kg, or 0.027 to 0.05 mL of 10% Calcium Chloride Injection per kg)
• No data from clinical trials is available about repeated dosages, though textbook references recommend repeat dosages q 4 to 6 hours
• Caution: 10% Calcium Chloride Injection consists of 1 gram of calcium chloride in a 10 mL syringe, or 100 mg/mL
• This concentration represents 27 mg or 1.4 mEq of elemental calcium per mL
• Thus, one 10 mL syringe provides 270 mg of elemental calcium
• The dosage recommendation in various references is given either as amount of calcium chloride or amount of elemental calcium, and often it is not specified. …

Safety and effectiveness are based on similar clinical conditions in children and adults.

An evaluation of current literature revealed no clinical experience identifying differences in response between elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

PRECAUTIONS Do not administer unless solution is clear and seal is intact. Discard unused portion. Because of its additive effect, calcium should be administered very cautiously to a patient who is digitalized or who is taking effective doses of digitalis or digitalis-like preparations. Injections should be made slowly through a small needle into a large vein to minimize venous irritation and avoid undesirable reactions. It is particularly important to prevent a high concentration of calcium from reaching the heart because of the danger of cardiac syncope. Pediatric Use: Safety and effectiveness are based on similar clinical conditions in children and adults. …

Rapid 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 vasodilatation as well as a local “burning” sensation and there may be a moderate fall in blood pressure. Should perivascular infiltration occur, I.V. administration at that site should be discontinued at once. Local infiltration of the affected area with 1% procaine hydrochloride, to which hyaluronidase may be added, will often reduce venospasm and dilute the calcium remaining in the tissues locally. Local application of heat may also be helpful.

Pregnancy: Animal reproduction studies have not been conducted with calcium chloride. It also is not known whether calcium chloride can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. Calcium chloride should be given to a pregnant woman only if clearly needed.

Too rapid injection may produce lowering of blood pressure and cardiac syncope. Persistent hypercalcemia from overdosage of calcium is unlikely because of rapid excretion. In the event of untoward effects from excessive calcium administration, the drug should be discontinued promptly, the patient re-evaluated and appropriate countermeasures instituted, if necessary. See PRECAUTIONS and ADVERSE REACTIONS .

None known.

Take it when you remember, unless it is nearly time for the next dose. Then skip the missed one. Never take two doses at once to make up for it. Check your leaflet, as some medicines are different.