calcium chloride (Rx)

Brand and Other Names:CaCl or CaCl(2)
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 100mg/mL
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Hypocalcemia, Emergency Treatment

500-1000 mg IV over 5-10 minutes; may repeat as necessary

Arrhythmias, Emergent

Indicated for arrhythmias associated with hypocalcemia, hyperkalemia, or hypermagnesemia

500-1000 mg IV over 5-10 minutes

Hypermagnesemia

500-1000 mg IV over 2-5 minutes; observe the patient for signs of recovery; may repeat if CNS depression persists

Calcium Channel Blocker Overdose

1-2 g IV infused over 10-20 min; may repeat every 20 minutes prn up to 5 doses

Beta-blocker Overdose, Refractory to Glucagon & High Dose Vasopressor

1000 mg IV bolus via central line

Other Information

1 g (10 mL) vials of calcium chloride 10% solution contain 273 mg (13.6 mEq) elemental calcium

Dosage Forms & Strengths

injectable solution

  • 100 mg/mL
more...

Hypocalcemia, Emergency Treatment

Infants: <75 mg (20 mg elemental Ca) IV; may repeat as necessary

Children: 75-519 mg (20-140 mg elemental Ca) IV, may repeat as necessary

Hypocalcemic Tetany

Neonates: 171 mg/kg/day IV in divided doses 

Infants and Children: 10 mg/kg IV over 5-10 min TID/QID; alternatively, may administer 35-50 mg/kg IV TID/QID

Other Information

(Not recommended) Cardiac Arrest: 20 mg/kg IV push every 10 minutes as necessary

Other Indications & Uses

Medullary thyroid cancer diagnosis

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Interactions

Interaction Checker

and calcium chloride

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Erythema

            Hypomagnesemia

            Hypophosphatemia

            Hypotension

            Hypercalcemia

            Nausea

            Tissue necrosis at injection site

            Vasodilation

            Weakness

            Renal calculi

            Hot flashes

            Serum amylase increased

            Tingling sensations

            Rapid Administration

            Arrhythmia

            Bradycardia

            Calcium taste

            Sense of heat waves

            Ventricular fibrillation

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            Warnings

            Contraindications

            VFib during CPR, hypercalcemia, risk for digitalis toxicity, hypophosphatemia, renal calculi

            IM or SC administration

            Pulseless ventricular tachycardia

            Cautions

            Hepatic impairment, sarcoidosis, CV disease, renal disease, acidosis, cor pulmonale, digitalized patients

            Not recommended in treatment of asystole and electromechanical dissociation

            PALS no longer recommends Ca for pediatric cardiac arrest

            Life-threatening cardiac arrhythmias may occur in severe hypokalemia

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: As a component of human milk calcium enters milk. Use caution.

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Bone mineral component; cofoactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways

            Pharmacokinetics

            Excretion: feces (80%) and urine (20%)

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            Administration

            IV Administration

            1 g (10 mL) vials of calcium chloride 10% solution contain 273 mg (13.6 mEq/mL) elemental calcium

            If time permits warm solution to body temp

            Infuse IV at <45-90 mg/kg/hr (0.6-1.2 mEq/kg/hour)

            Stop infusion if patient experiences pain or discomfort

            Following injection patient should remain recumbent for a short time

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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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