Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 100mg/mL (10%)
tablet
- 50mg
- 500mg
- 650mg
capsule
- 500mg
Calcium Supplementation
19-50 years old: 1000 mg/day PO divided q8-12hr, preferably 1-2 hours after meals
>50 years old: 1200 mg/day PO divided q8-12hr, preferably 1-2 hours after meals
Pregnant or breastfeeding patient: 1000/day PO divided q8-12hr, preferably 1-2 hours after meals
Dosing considerations
- Dietary reference intakes are expressed as elemental calcium
Hypocalcemia
Treatment of conditions arising from calcium deficiency (eg, hypocalcemic tetany, hypoparathyroidism)
Mild (ionized calcium 1-1.2 mmol/L)
- Management of non-life-threatening symptoms
- PO: 1-3 g/day in divided doses; oral repletion may be considered and administered on outpatient basis
- IV: 1-2 g over 2 hours
Severe (ionized calcium <1 mmol/L)
- Without seizure or tetany: 0.5 mg/kg/hr IV; may be increased to 2 mg/kg/hr; not to exceed 3-4 g IV over 4 hours
- Hypocalcemic tetany: 100-300 mg elemental calcium (~3 g calcium gluconate) IV over 5-10 minutes, followed by continuous IV infusion at 0.5 mg/kg/hr (may be increased to 2 mg/kg/hr)
- Monitor serum calcium q4-6hr to maintain serum calcium levels
Cardiac Arrest (Off-label)
Management of cardiac arrest only in presence of hyperkalemia, hypocalcemia, or hypermagnesemia (routine use for cardiac arrest not recommended, because it yields no improvement in survival)
1.5-3 g IV over 2-5 minutes
Hydrofluoric Acid Burn (Off-label)
Immediately irrigate skin with tap water; lavage should occur immediately at hydrofluoric acid burn site for 15-30 min
After irrigation, apply calcium gluconate 2.5-5% gel to the affected area q30min initially, then q4hr afterwards for ~3-4 days
If gel is unavailable, calcium gluconate gel can be made with a water-soluble lubricant (eg, K-Y Jelly), added to calcium gluconate solution or calcium gluconate powder (75 mL water-soluble lubricant plus 25 mL of 10% calcium gluconate or 100 mL of water-soluble lubricant plus 2.5 g of calcium gluconate) (Mckee 2014)
SC: 10% calcium gluconate, no more than 0.5 mL/cm² of skin; do not use in digits
If topical and/or SC do not work, consider intra-arterial
Intra-arterial calcium infusion for moderate to severe burns: Infuse 10 mL 10% calcium gluconate mixed with 40-50 mL D5W over 4 hours, repeating as needed (need to indicate with high-pressure pump)
Calcium Channel Blocker Overdose (Off-label)
60-120 mg/kg/hr IV or 60 mg/kg IV over 5 minutes every 10-20 minutes PRN up to 3-4 doses; not to exceed 3-4 g/dose
Hyperkalemia (Off-label)
1.5-3 g IV infused over 2-5 minutes
Hypermagnesemia (Off-label)
1.5-3 g IV infused over 2-5 minutes
Dosage Forms & Strengths
injectable solution
- 100mg/mL (10%)
tablet
- 50mg
- 500mg
- 650mg
Calcium Supplementation
0-6 months old: 210 mg/day PO divided q8-12hr, preferably 1-2 hours after meals
7-12 months old: 270 mg/day PO divided q8-12hr, preferably 1-2 hours after meals
1-3 years old: 500 mg/day PO divided q8-12hr, preferably 1-2 hours after meals
4-8 years old: 800 mg/day PO divided q8-12hr, preferably 1-2 hours after meals
9-18 years old: 1300 mg/day PO divided q8-12hr, preferably 1-2 hours after meals
Dosing considerations
- Dietary reference intakes are expressed as elemental calcium
Hypocalcemia
Treatment of conditions arising from calcium deficiency (eg, hypocalcemic tetany, hypoparathyroidism)
Mild
- Neonates: 500-1500 mg/kg/day PO divided q4-6hr
- Infants/children: 500-725 mg/kg/day PO divided q6-8hr
Severe
- Neonates: 200-800 mg/kg/day IV by continuous infusion or divided q6hr as intermittent infusions
- Infants/children: 200-500 mg/kg/day IV by continuous infusion or divided q6hr as intermittent infusions
Hypocalcemic tetany
- 100-200 mg/kg IV over 10 minutes; may be repeated after 6 hours, or initiate continuous infusion not to exceed 500 mg/kg/day
Interactions
Interaction Checker
No Results
Contraindicated
Serious
Significant - Monitor Closely
Minor
Contraindicated (1)
- ceftriaxone
ceftriaxone, calcium gluconate. Other (see comment). Contraindicated. Comment: Do not use ANY calcium containing solutions (including Ringer or Harmann) in combination with IV ceftriaxone; risk of potentially fatal particulate precipitation in lungs, kidneys. Separate by at least 48 hrs.
Serious (7)
- baloxavir marboxil
calcium gluconate 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 gluconate, 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 gluconate, 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 gluconate 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 gluconate, 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 gluconate, 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 gluconate, 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 (54)
- acebutolol
calcium gluconate decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.
- alendronate
calcium gluconate 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 gluconate decreases effects of amlodipine by pharmacodynamic antagonism. Use Caution/Monitor.
- atenolol
calcium gluconate decreases effects of atenolol by unspecified interaction mechanism. Use Caution/Monitor.
- betaxolol
calcium gluconate decreases effects of betaxolol by unspecified interaction mechanism. Use Caution/Monitor.
- bisoprolol
calcium gluconate decreases effects of bisoprolol by unspecified interaction mechanism. Use Caution/Monitor.
- carvedilol
calcium gluconate decreases effects of carvedilol by unspecified interaction mechanism. Use Caution/Monitor.
- celiprolol
calcium gluconate decreases effects of celiprolol by unspecified interaction mechanism. Use Caution/Monitor.
- ciprofloxacin
calcium gluconate 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 gluconate decreases effects of clevidipine by pharmacodynamic antagonism. Use Caution/Monitor.
- deferiprone
calcium gluconate 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 gluconate 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 gluconate increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor.
- diltiazem
calcium gluconate decreases effects of diltiazem by pharmacodynamic antagonism. Use Caution/Monitor.
- esmolol
calcium gluconate decreases effects of esmolol by unspecified interaction mechanism. Use Caution/Monitor.
- estramustine
calcium gluconate 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 gluconate 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 gluconate decreases effects of felodipine by pharmacodynamic antagonism. Use Caution/Monitor.
- fleroxacin
calcium gluconate, 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 gluconate, 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 gluconate 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 gluconate decreases effects of isradipine by pharmacodynamic antagonism. Use Caution/Monitor.
- labetalol
calcium gluconate decreases effects of labetalol by unspecified interaction mechanism. Use Caution/Monitor.
- levofloxacin
calcium gluconate, 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 gluconate decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate administration by 4 hours.
- metoprolol
calcium gluconate decreases effects of metoprolol by unspecified interaction mechanism. Use Caution/Monitor.
- moxifloxacin
calcium gluconate, 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 gluconate decreases effects of nadolol by unspecified interaction mechanism. Use Caution/Monitor.
- nebivolol
calcium gluconate decreases effects of nebivolol by unspecified interaction mechanism. Use Caution/Monitor.
- nicardipine
calcium gluconate decreases effects of nicardipine by pharmacodynamic antagonism. Use Caution/Monitor.
- nifedipine
calcium gluconate decreases effects of nifedipine by pharmacodynamic antagonism. Use Caution/Monitor.
- nisoldipine
calcium gluconate decreases effects of nisoldipine by pharmacodynamic antagonism. Use Caution/Monitor.
- ofloxacin
calcium gluconate, 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 gluconate 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.
- palopegteriparatide
calcium gluconate, palopegteriparatide. Other (see comment). Use Caution/Monitor. Comment: Drugs that affect serum calcium may alter palopegteriparaatide therapeutic response. Measure serum calcium more frequently if coadministered, particularly after these drugs are initiated, discontinued, or dose-adjusted.
- pamidronate
calcium gluconate 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 gluconate decreases effects of penbutolol by unspecified interaction mechanism. Use Caution/Monitor.
- pindolol
calcium gluconate decreases effects of pindolol by unspecified interaction mechanism. Use Caution/Monitor.
- potassium phosphates, IV
calcium gluconate decreases effects of potassium phosphates, IV by cation binding in GI tract. Modify Therapy/Monitor Closely. Calcium decreases serum phosphate concentration by binding dietary phosphate. Use alternatives if available.
- propranolol
calcium gluconate decreases effects of propranolol by unspecified interaction mechanism. Use Caution/Monitor.
- rilpivirine
calcium gluconate 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 gluconate 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 gluconate 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 phosphates, IV
calcium gluconate decreases effects of sodium phosphates, IV by cation binding in GI tract. Modify Therapy/Monitor Closely. Calcium decreases serum phosphate concentration by binding dietary phosphate. Use alternatives if available.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of calcium gluconate 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 gluconate 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 gluconate decreases effects of sotalol by unspecified interaction mechanism. Use Caution/Monitor.
- squill
calcium gluconate increases toxicity of squill by unspecified interaction mechanism. Use Caution/Monitor.
- strontium ranelate
calcium gluconate 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 gluconate 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 gluconate decreases effects of timolol by unspecified interaction mechanism. Use Caution/Monitor.
- verapamil
calcium gluconate decreases effects of verapamil by pharmacodynamic antagonism. Use Caution/Monitor.
- vitamin D
vitamin D, calcium gluconate. 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 gluconate 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 gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- amiloride
amiloride decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.
- bendroflumethiazide
bendroflumethiazide increases levels of calcium gluconate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- budesonide
budesonide decreases levels of calcium gluconate by increasing elimination. Minor/Significance Unknown.
- bumetanide
bumetanide decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.
- caffeine
caffeine decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.
- calcitriol topical
calcitriol topical increases levels of calcium gluconate by pharmacodynamic synergism. Minor/Significance Unknown. Topical calcitriol may lead to hypercalcemia.
- carbonyl iron
calcium gluconate 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 gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - chlorothiazide
chlorothiazide increases levels of calcium gluconate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- chlorthalidone
chlorthalidone increases levels of calcium gluconate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- cortisone
cortisone decreases levels of calcium gluconate by increasing elimination. Minor/Significance Unknown.
- cyclopenthiazide
cyclopenthiazide increases levels of calcium gluconate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- deflazacort
deflazacort decreases levels of calcium gluconate by increasing elimination. Minor/Significance Unknown.
- dexamethasone
dexamethasone decreases levels of calcium gluconate by increasing elimination. Minor/Significance Unknown.
- drospirenone
drospirenone decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.
- ethacrynic acid
ethacrynic acid decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.
- ferric maltol
ferric maltol increases levels of calcium gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
calcium gluconate decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - ferrous fumarate
calcium gluconate 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 gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - ferrous gluconate
ferrous gluconate increases levels of calcium gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
calcium gluconate 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 gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- fludrocortisone
fludrocortisone decreases levels of calcium gluconate by increasing elimination. Minor/Significance Unknown.
- furosemide
furosemide decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.
- gentamicin
gentamicin decreases levels of calcium gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- hydrochlorothiazide
hydrochlorothiazide increases levels of calcium gluconate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- hydrocortisone
hydrocortisone decreases levels of calcium gluconate by increasing elimination. Minor/Significance Unknown.
- indapamide
indapamide increases levels of calcium gluconate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- iron dextran complex
calcium gluconate 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 gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - iron sucrose
calcium gluconate 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 gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - isoniazid
isoniazid decreases levels of calcium gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- isotretinoin
isotretinoin increases levels of calcium gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- lily of the valley
calcium gluconate increases effects of lily of the valley by unspecified interaction mechanism. Minor/Significance Unknown.
- manganese
calcium gluconate, 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 gluconate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- methylprednisolone
methylprednisolone decreases levels of calcium gluconate by increasing elimination. Minor/Significance Unknown.
- metolazone
metolazone increases levels of calcium gluconate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- neomycin PO
neomycin PO decreases levels of calcium gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- paromomycin
paromomycin decreases levels of calcium gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- polysaccharide iron
calcium gluconate 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 gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - prednisolone
prednisolone decreases levels of calcium gluconate by increasing elimination. Minor/Significance Unknown.
- prednisone
prednisone decreases levels of calcium gluconate by increasing elimination. Minor/Significance Unknown.
- rose hips
calcium gluconate 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 gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - shark cartilage
calcium gluconate, shark cartilage. pharmacodynamic synergism. Minor/Significance Unknown. May lead to hypercalcemia (theoretical).
- sodium polystyrene sulfonate
sodium polystyrene sulfonate increases levels of calcium gluconate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis.
- spironolactone
spironolactone decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.
- streptomycin
streptomycin decreases levels of calcium gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- teriparatide
teriparatide increases levels of calcium gluconate by pharmacodynamic synergism. Minor/Significance Unknown.
- tobramycin
tobramycin decreases levels of calcium gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- torsemide
torsemide decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension decreases levels of calcium gluconate by increasing elimination. Minor/Significance Unknown.
- triamterene
triamterene decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Bradycardia
Hypotension
Headache
Constipation
Diarrhea
Flatulence
Nausea
Vomiting
Hypomagnesemia
Hypophosphatemia
Extravasation necrosis
Warnings
Contraindications
Hypersensitivity
IM/SC administration
Ventricular fibrillation during CPR
Hypercalcemia
Digoxin poisonings
Sarcoidosis
Cautions
Hepatic or renal impairment, cardiovascular disease, acidosis, history of renal calculi
Cardiac arrest may occur
Calcium gluconate injection contains aluminum, up to 100 mcg per liter
Constipation, bloating, and gas may occur with oral administration
Use caution in patients with severe hyperphosphatemia
Adult and Pediatric Advanced Life Support programs no longer recommend routine calcium for CPR
Rapid IV infusion associated with hypotension, bradycardia, syncope, cardiac arrest, cardiac arrhythmias, sense of oppression or heat waves, tingling sensation, vasodilation
Pregnancy & Lactation
Pregnancy category: C
Lactation: Calcium enters human milk; use with 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.Pharmacology
Mechanism of Action
Bone mineral component; cofoactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways
Absorption
Oral absorption requires vitamin D; absorption is increased with acidic condition; therefore, administer 1-2 hr after meals
Distribution
Protein bound: ~45% (primarily to albumin)
Elimination
Excretion: Feces as unabsorbed calcium salt (80%), urine (20%)
Administration
1 g calcium gluconate salt contains 93 mg elemental calcium
Injectable 10% solution 10% contains 100 mg/mL (ie, elemental calcium 0.465 mEq/ mL or 9.3 mg/mL)
IV Compatibilities
Additive: Aminophylline, dopamine, heparin, hydrocortisone, lidocaine, norepinephrine, potassium chloride, sodium bicarbonate, vancomycin, verapamil, vitamins B and C
Y-site: Cefazolin, dobutamine, epinephrine, heparin, potassium chloride, vitamins B and C
Not specific: Erythromycin
IV Incompatibilities
Additive: Amphotericin B, dobutamine
Y-site: Ampicillin, sodium bicarbonate
Not specific: Clindamycin, tetracycline
IV Preparation
May be given diluted or undiluted
Solution may be diluted in NS, D5W (mix in up to 1000 mL), or 2/3-1/3
Store at room temperature
Do not mix in same bag or line with carbonates, phosphates, sulfates, and tartrates, because of precipitation
IV Administration
May administer IV push at rate of 50-100 mg/min (0.5-1 mL/min); rapid IV administration may produce arrhythmias, hypotension, myocardial infarction, or vasodilation
For intermittent IV infusion, maximum rate is 200 mg/min (2 mL/min)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| calcium gluconate intravenous - | 100 mg/mL (10%) vial |  | |
| calcium gluconate intravenous - | 100 mg/mL (10%) vial |  | |
| calcium gluconate intravenous - | 100 mg/mL (10%) vial |  | |
| calcium gluconate intravenous - | 100 mg/mL (10%) vial |  | |
| calcium gluconate intravenous - | 100 mg/mL (10%) vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
calcium gluconate oral
CALCIUM SUPPLEMENTS - ORAL
USES: This medication is used to prevent or treat low blood calcium levels in people who do not get enough calcium from their diets. It may be used to treat conditions caused by low calcium levels such as bone loss (osteoporosis), weak bones (osteomalacia/rickets), decreased activity of the parathyroid gland (hypoparathyroidism), and a certain muscle disease (latent tetany). It may also be used in certain patients to make sure they are getting enough calcium (such as women who are pregnant, nursing, or postmenopausal, people taking certain medications such as phenytoin, phenobarbital, or prednisone).Calcium plays a very important role in the body. It is necessary for normal functioning of nerves, cells, muscle, and bone. If there is not enough calcium in the blood, then the body will take calcium from bones, thereby weakening bones. Having the right amount of calcium is important for building and keeping strong bones.
HOW TO USE: Take this medication by mouth with food. If your product contains calcium citrate, then it may be taken with or without food. Follow all directions on the product package, or take as directed by your doctor. For best absorption, if your daily dose is more than 600 milligrams, then divide your dose and space it throughout the day. If you have any questions, ask your doctor or pharmacist.If you are using the chewable product, chew it well before swallowing.If you are using the effervescent tablet, allow the tablet to fully dissolve in a glass of water before drinking it. Do not chew or swallow the tablet whole.If you are using the liquid product or powder, measure the medication with a dose-measuring spoon or device to make sure you get the correct dose. Do not use a household spoon. If the liquid product is a suspension, shake the bottle well before each dose.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.If your doctor has recommended that you follow a special diet, it is very important to follow the diet to get the most benefit from this medication and to prevent serious side effects. Do not take other supplements/vitamins unless ordered by your doctor.If you think you may have a serious medical problem, get medical help right away.
SIDE EFFECTS: Constipation and upset stomach may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: nausea/vomiting, loss of appetite, unusual weight loss, mental/mood changes, bone/muscle pain, headache, increased thirst/urination, weakness, unusual tiredness.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or 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: Before taking calcium, tell your doctor or pharmacist if you have any allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.If you have any of the following health problems, consult your doctor or pharmacist before using this product: high calcium levels (hypercalcemia), kidney disease (including kidney stones), little or no stomach acid (achlorhydria), heart disease, disease of the pancreas, a certain lung disease (sarcoidosis), difficulty absorbing nutrition from food (malabsorption syndrome).Some sugar-free formulations of calcium may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to restrict your intake of aspartame (or phenylalanine), consult your doctor or pharmacist about using this drug safely.Tell your doctor if you are pregnant before using this medication.This medication passes into breast milk. Consult your doctor before breastfeeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: digoxin, cellulose sodium phosphate, certain phosphate binders (such as calcium acetate).Calcium can decrease the absorption of other drugs such as bisphosphonates (for example, alendronate), tetracycline antibiotics (such as doxycycline, minocycline), estramustine, levothyroxine, and quinolone antibiotics (such as ciprofloxacin, levofloxacin). Separate your doses of these medications as far as possible from your doses of calcium. Ask your doctor or pharmacist about how long you should wait between doses and for help finding a dosing schedule that will work with all your medications.Check the labels on all your prescription and nonprescription/herbal products (such as antacids, vitamins) because they may contain calcium. Ask your pharmacist about using those products safely.
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 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: nausea/vomiting, loss of appetite, mental/mood changes, headache, weakness, tiredness.
NOTES: Foods rich in calcium include: dairy products (such as milk, yogurt, cheese, ice cream), dark-green leafy vegetables (such as broccoli, spinach, bok choy), and calcium-fortified foods (such as orange juice).Vitamin D helps with the absorption of calcium. Foods rich in vitamin D include: fortified dairy products, eggs, sardines, cod liver oil, chicken livers, and fatty fish. Vitamin D is also made by the body as a result of exposure to the sun.Lab and/or medical tests (such as calcium levels) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.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.
Information last revised May 2024. Copyright(c) 2024 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
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
