Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 100mg/mL
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
Renal impairment
Initiate treatment at lowest recommended dose within recommended dose range; monitor serum calcium levels frequently based on severity of renal impairment and risk of a high calcium- phosphorus product (eg, q4hr)
Hepatic impairment
Not studied
Dosage Forms & Strengths
injectable solution
- 100 mg/mL
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
Renal impairment
Initiate treatment at lowest recommended dose within recommended dose range; monitor serum calcium levels frequently based on severity of renal impairment and risk of a high calcium- phosphorus product (eg, q4hr)
Hepatic impairment
Not studied
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- ceftriaxone
ceftriaxone, calcium chloride. Other (see comment). Contraindicated. Comment: Contraindicated in neonates if they require (or are expected to require) treatment with calcium containing IV solutions, including continuous calcium containing infusions such as parenteral nutrition because of the risk of precipitation of ceftriaxone and calcium. Separate IV ceftriaxone and IV calcium by at least 48 hrs. However, in patients other than neonates, ceftriaxone and calcium containing solutions may be administered sequentially of one another if the IV infusion lines are thoroughly flushed between infusions with a compatible fluid.
Serious - Use Alternative (7)
- baloxavir marboxil
calcium chloride will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. Avoid or Use Alternate Drug. Baloxavir may bind to polyvalent cations resulting in decreased absorption. Studies in monkeys showed concurrent use with calcium, aluminum, or iron caused significantly decreased plasma levels. Human studies not conducted.
- demeclocycline
calcium chloride, demeclocycline. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- doxycycline
calcium chloride, doxycycline. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- eltrombopag
calcium chloride decreases levels of eltrombopag by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Separate by at least 4 hours.
- minocycline
calcium chloride, minocycline. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- oxytetracycline
calcium chloride, oxytetracycline. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- tetracycline
calcium chloride, tetracycline. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
Monitor Closely (51)
- acebutolol
calcium chloride decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.
- alendronate
calcium chloride decreases levels of alendronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 30 minutes.
- amlodipine
calcium chloride decreases effects of amlodipine by pharmacodynamic antagonism. Use Caution/Monitor.
- atenolol
calcium chloride decreases effects of atenolol by unspecified interaction mechanism. Use Caution/Monitor.
- betaxolol
calcium chloride decreases effects of betaxolol by unspecified interaction mechanism. Use Caution/Monitor.
- bisoprolol
calcium chloride decreases effects of bisoprolol by unspecified interaction mechanism. Use Caution/Monitor.
- carvedilol
calcium chloride decreases effects of carvedilol by unspecified interaction mechanism. Use Caution/Monitor.
- celiprolol
calcium chloride decreases effects of celiprolol by unspecified interaction mechanism. Use Caution/Monitor.
- ciprofloxacin
calcium chloride decreases effects of ciprofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Ciprofloxacin should be administered 2 hr before or 6 hr after calcium salts.
- clevidipine
calcium chloride decreases effects of clevidipine by pharmacodynamic antagonism. Use Caution/Monitor.
- deferiprone
calcium chloride decreases levels of deferiprone by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Deferiprone may bind polyvalent cations (eg, iron, aluminum, and zinc), separate administration by at least 4 hr between deferiprone and other medications (eg, antacids), or supplements containing these polyvalent cations.
- delafloxacin
calcium chloride will decrease the level or effect of delafloxacin by cation binding in GI tract. Modify Therapy/Monitor Closely. Oral delafloxacin form chelates with alkaline earth and transition metal cations. Administer oral delafloxacin at least 2 hr before or 6 hr after these agents.
- digoxin
calcium chloride increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor.
- diltiazem
calcium chloride decreases effects of diltiazem by pharmacodynamic antagonism. Use Caution/Monitor.
- esmolol
calcium chloride decreases effects of esmolol by unspecified interaction mechanism. Use Caution/Monitor.
- estramustine
calcium chloride decreases levels of estramustine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Patients should take estramustine with water at least 1h before or 2h after meals.
- etidronate
calcium chloride decreases levels of etidronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 30 minutes.
- felodipine
calcium chloride decreases effects of felodipine by pharmacodynamic antagonism. Use Caution/Monitor.
- fleroxacin
calcium chloride, fleroxacin. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- gemifloxacin
calcium chloride, gemifloxacin. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- ibandronate
calcium chloride decreases levels of ibandronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 30 minutes.
- isradipine
calcium chloride decreases effects of isradipine by pharmacodynamic antagonism. Use Caution/Monitor.
- labetalol
calcium chloride decreases effects of labetalol by unspecified interaction mechanism. Use Caution/Monitor.
- levofloxacin
calcium chloride, levofloxacin. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- levothyroxine
calcium chloride decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- metoprolol
calcium chloride decreases effects of metoprolol by unspecified interaction mechanism. Use Caution/Monitor.
- moxifloxacin
calcium chloride, moxifloxacin. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- nadolol
calcium chloride decreases effects of nadolol by unspecified interaction mechanism. Use Caution/Monitor.
- nebivolol
calcium chloride decreases effects of nebivolol by unspecified interaction mechanism. Use Caution/Monitor.
- nicardipine
calcium chloride decreases effects of nicardipine by pharmacodynamic antagonism. Use Caution/Monitor.
- nifedipine
calcium chloride decreases effects of nifedipine by pharmacodynamic antagonism. Use Caution/Monitor.
- nisoldipine
calcium chloride decreases effects of nisoldipine by pharmacodynamic antagonism. Use Caution/Monitor.
- ofloxacin
calcium chloride, ofloxacin. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- omadacycline
calcium chloride will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
- pamidronate
calcium chloride decreases levels of pamidronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 30 minutes.
- penbutolol
calcium chloride decreases effects of penbutolol by unspecified interaction mechanism. Use Caution/Monitor.
- pindolol
calcium chloride decreases effects of pindolol by unspecified interaction mechanism. Use Caution/Monitor.
- propranolol
calcium chloride decreases effects of propranolol by unspecified interaction mechanism. Use Caution/Monitor.
- rilpivirine
calcium chloride decreases levels of rilpivirine by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Coadministration of antacids with rilpivirine may cause significant decreases in rilpivirine plasma concentrations because of increased gastric pH. If antacids must be administered, they should given at least 2 hr before or at least 4 hr after rilpivirine.
- risedronate
calcium chloride decreases levels of risedronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 30 minutes.
- sarecycline
calcium chloride will decrease the level or effect of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of calcium chloride by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of calcium chloride by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sotalol
calcium chloride decreases effects of sotalol by unspecified interaction mechanism. Use Caution/Monitor.
- squill
calcium chloride increases toxicity of squill by unspecified interaction mechanism. Use Caution/Monitor.
- strontium ranelate
calcium chloride decreases levels of strontium ranelate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Applies to oral form of calcium. Separate by 2 hr.
- tiludronate
calcium chloride decreases levels of tiludronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 30 minutes.
- timolol
calcium chloride decreases effects of timolol by unspecified interaction mechanism. Use Caution/Monitor.
- verapamil
calcium chloride decreases effects of verapamil by pharmacodynamic antagonism. Use Caution/Monitor.
- vitamin D
vitamin D, calcium chloride. Other (see comment). Use Caution/Monitor. Comment: The concurrent use of vitamin D with calcium salts is generally beneficial; in some patients this combination may result in hypercalcemia.
- zoledronic acid
calcium chloride decreases levels of zoledronic acid by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 30 minutes.
Minor (50)
- amikacin
amikacin decreases levels of calcium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- amiloride
amiloride decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.
- bendroflumethiazide
bendroflumethiazide increases levels of calcium chloride by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- budesonide
budesonide decreases levels of calcium chloride by increasing elimination. Minor/Significance Unknown.
- bumetanide
bumetanide decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.
- caffeine
caffeine decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.
- calcitriol topical
calcitriol topical increases levels of calcium chloride by pharmacodynamic synergism. Minor/Significance Unknown. Topical calcitriol may lead to hypercalcemia.
- carbonyl iron
calcium chloride decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
carbonyl iron increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - chlorothiazide
chlorothiazide increases levels of calcium chloride by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- chlorthalidone
chlorthalidone increases levels of calcium chloride by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- cortisone
cortisone decreases levels of calcium chloride by increasing elimination. Minor/Significance Unknown.
- cyclopenthiazide
cyclopenthiazide increases levels of calcium chloride by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- deflazacort
deflazacort decreases levels of calcium chloride by increasing elimination. Minor/Significance Unknown.
- dexamethasone
dexamethasone decreases levels of calcium chloride by increasing elimination. Minor/Significance Unknown.
- drospirenone
drospirenone decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.
- ethacrynic acid
ethacrynic acid decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.
- ferric maltol
ferric maltol increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
calcium chloride decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - ferrous fumarate
calcium chloride decreases levels of ferrous fumarate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
ferrous fumarate increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - ferrous gluconate
ferrous gluconate increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
calcium chloride decreases levels of ferrous gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - ferrous sulfate
ferrous sulfate increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- fludrocortisone
fludrocortisone decreases levels of calcium chloride by increasing elimination. Minor/Significance Unknown.
- furosemide
furosemide decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.
- gentamicin
gentamicin decreases levels of calcium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- hydrochlorothiazide
hydrochlorothiazide increases levels of calcium chloride by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- hydrocortisone
hydrocortisone decreases levels of calcium chloride by increasing elimination. Minor/Significance Unknown.
- indapamide
indapamide increases levels of calcium chloride by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- iron dextran complex
calcium chloride decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
iron dextran complex increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - iron sucrose
calcium chloride decreases levels of iron sucrose by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
iron sucrose increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - isoniazid
isoniazid decreases levels of calcium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- isotretinoin
isotretinoin increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- lily of the valley
calcium chloride increases effects of lily of the valley by unspecified interaction mechanism. Minor/Significance Unknown.
- manganese
calcium chloride, manganese. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Separate by 2 hours.
- methyclothiazide
methyclothiazide increases levels of calcium chloride by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- methylprednisolone
methylprednisolone decreases levels of calcium chloride by increasing elimination. Minor/Significance Unknown.
- metolazone
metolazone increases levels of calcium chloride by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- neomycin PO
neomycin PO decreases levels of calcium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- paromomycin
paromomycin decreases levels of calcium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- polysaccharide iron
calcium chloride decreases levels of polysaccharide iron by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
polysaccharide iron increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - prednisolone
prednisolone decreases levels of calcium chloride by increasing elimination. Minor/Significance Unknown.
- prednisone
prednisone decreases levels of calcium chloride by increasing elimination. Minor/Significance Unknown.
- rose hips
calcium chloride decreases levels of rose hips by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
rose hips increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - shark cartilage
calcium chloride, shark cartilage. pharmacodynamic synergism. Minor/Significance Unknown. May lead to hypercalcemia (theoretical).
- sodium polystyrene sulfonate
sodium polystyrene sulfonate increases levels of calcium chloride by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis.
- spironolactone
spironolactone decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.
- streptomycin
streptomycin decreases levels of calcium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- teriparatide
teriparatide increases levels of calcium chloride by pharmacodynamic synergism. Minor/Significance Unknown.
- tobramycin
tobramycin decreases levels of calcium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- torsemide
torsemide decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension decreases levels of calcium chloride by increasing elimination. Minor/Significance Unknown.
- triamterene
triamterene decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.
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
Warnings
Contraindications
Ventricular fibrillation
Asystole and electromechanical dissociations
Newborns up to 28 days if they require or expected to require ceftriaxone IV, regardless of whether product would be received at different times or through separate IV lines
Cautions
Use caution in hepatic impairment, sarcoidosis, CV disease, acidosis, cor pulmonale
Use in patients with renal impairment may increase risk of higher calcium-phosphorus product
PALS no longer recommends Ca for pediatric cardiac arrest
Life-threatening cardiac arrhythmias may occur in severe hypokalemia
Product is irritating to veins; must not be injected into tissues, as severe necrosis and sloughing may occur; take great care to avoid extravasation or accidental injection into perivascular tissues
Because of additive effect, administer calcium very cautiously to patients who are digitalized or who are taking effective doses of digitalis or digitalis-like preparations
Administer injections 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; if injected into the ventricular cavity in cardiac resuscitation, it must not be injected into the myocardial tissue
Tissues necrosis and calcinosis
- Administration of calcium chloride injection in patients with local trauma may result in calcinosis cutis due to transient increase in local calcium concentration; calcinosis cutis can occur with or without extravasation of calcium chloride injection, is characterized by abnormal dermal deposits of calcium salts, and clinically manifests as papules, plaques, or nodules that may be associated with erythema, swelling, or induration
- Tissue necrosis, ulceration, and secondary infection are the most serious complications; to minimize risk of tissue necrosis, ulceration and calcinosis, administer calcium chloride injection slowly through a small needle into large vein
- Avoid extravasation or accidental injection into perivascular tissues; should perivascular infiltration occur, immediately discontinue intravenous administration at that site and treat as needed
Aluminum toxicity
- Calcium chloride injection contains aluminum that may be toxic; aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired
- Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum
- Research indicates that patients with impaired kidney function, including premature (preterm) neonates and preterm infants, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day can accumulate aluminum at levels associated with central nervous system and bone toxicity; tissue loading may occur at even lower amounts of aluminum
- Exposure to aluminum from calcium chloride injection at recommended dose is not more than 10 mcg; when prescribing calcium chloride injection in patients receiving parenteral nutrition solutions, limit total daily patient exposure to aluminum to no more than 5 mcg/kg/day
End-organ damage due to intravascular-calcium precipitates
- Use is contraindicated in newborns if they require (or are expected to require) ceftriaxone intravenous treatment because of the risk of precipitation of ceftriaxone-calcium
- In pediatric patients older than 28 days of age, calcium chloride Injection and ceftriaxone intravenous solutions may be administered sequentially one after another if infusion lines at different sites are used, infusion lines are replaced, or infusion lines are thoroughly flushed between infusions with physiological salt solution to avoid precipitation
- Do not mix or administer calcium chloride injection simultaneously with ceftriaxone, even if using different infusion lines or different infusion sites as it can lead to precipitation of ceftriaxone-calcium
- Calcium Chloride Injection contains aluminum that may be associated with central nervous system and bone toxicity; because of immature renal function, preterm infants receiving prolonged parenteral nutrition treatment with calcium chloride injection may be at higher risk of aluminum toxicity
Drug interactions overview
- Rapid injection of calcium chloride injection may cause vasodilation, decreased blood pressure, bradycardia, arrhythmias, syncope, and cardiac arrest; it is particularly important to prevent a high concentration of calcium from reaching the heart because of risk of syncope; too rapid an injection exceeding 1 mL/minute may lead to hypotension and cardiac syncope
- Arrhythmias may occur if this medication and digoxin are administered together; hypercalcemia resulting from overdose of calcium chloride injection increases risk of digoxin toxicity; avoid use of this medication in patients receiving digoxin; if concomitant therapy necessary, closely monitor ECG and calcium levels
- Concomitant use of calcium chloride injection and calcium channel blockers may reduce response to calcium channel blockers; avoid concomitant use; if concomitant use unavoidable, monitor blood pressure closely during administration of calcium chloride injection
Pregnancy & Lactation
Pregnancy
Administration of this medication for the treatment of acute symptomatic hypocalcemia during pregnancy not expected to cause major birth defects, miscarriage, or adverse maternal or fetal outcomes; there are risks to mother and fetus associated with development of hypocalcemia during pregnancy
Maternal hypocalcemia can result in an increased rate of spontaneous abortion, premature and dysfunctional labor, and possibly preeclampsia
Infants born to mothers with hypocalcemia can develop fetal and neonatal hyperparathyroidism, which in turn can cause fetal and neonatal skeletal demineralization, subperiosteal bone resorption, osteitis fibrosa cystica, and neonatal seizures
Animal data
- Animal reproduction studies have not been conducted
Lactation
Calcium is present in human milk; administration of approved recommended dose to mother is not expected to cause harm to a breastfed infant
There is no information on effects of this medication on breastfed infant or on milk production
The developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for this medication and any potential adverse effects on breastfed infant from this medication or from underlying maternal condition
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.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%)
Administration
IV Incompatibilities
Do not infuse calcium chloride in the same IV line as phosphate-containing solutions
IV Administration
Not for IM or SC administration
Administration via a central or deep vein is preferred
Visually inspect product for particulate matter and discoloration before administration
Vial
- 1 g (10 mL) vials of calcium chloride 10% solution contain 27 mg/mL (1.4 mEq/mL) elemental calcium Do not exceed 100 mg/minute except in emergency situations
- If time permits, warm solution to body temp
- For intermittent IV infusion, infuse diluted solution over 1 hr or no >45-90 mg/kg/hour (0.6-1.2 mEq/kg/hour)
- Do not use small hand or foot veins for IV administration (severe necrosis and sloughing may occur)
- Refer to institutional protocol
- Stop infusion if patient experiences pain or discomfort
- Following injection patient should remain recumbent for a short time
Prefilled syringe
- Prefilled 1 g (10 mL) syringe contains 27 mg or 1.4 mEq of elemental calcium per mL
- Slow IV injection (not to exceed 1 mL/min), preferably in a central or deep vein
Storage
Vial: Store at 20-25ºC (68-77ºF); excursions permitted to 15-30ºC (59-86ºF)
Syringe: Store at 20-25ºC (68-77ºF)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| calcium chloride intravenous - | 100 mg/mL (10 %) solution |  | |
| calcium chloride intravenous - | 100 mg/mL (10 %) solution |  | |
| calcium chloride intravenous - | 100 mg/mL (10 %) solution |  | |
| calcium chloride intravenous - | 100 mg/mL (10 %) vial |  | |
| calcium chloride intravenous - | 100 mg/mL (10 %) solution |  | |
| calcium chloride intravenous - | 100 mg/mL (10 %) solution |  | |
| calcium chloride intravenous - | 100 mg/mL (10 %) vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
calcium chloride intravenous
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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