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Drug Details

Calcium Chloride Infusion

• Drug Class Description
  Calcium supplements.
• Generic Name
  Generic - cardiovascular system
• Presentation
  Sterile solution for slow intravenous injection.
• Description
  Calcium Chloride Dihydrate BP 13.4% w/v
• Indications
  Calcium Chloride Sterile Solution is indicated for the treatment of acute hypocalcaemia where there is a requirement for the rapid replacement of calcium, e.g. severe hypocalcaemic tetany or hypoparathyroidism, or where the oral route is inappropriate due to malabsorption.
• Adult Dosage
  

  Route of Administration: Slow intravenous injection.

  Adults

  A typical dose is 2.25 to 4.5 mmol of calcium given by slow intravenous injection not exceeding 1 ml per minute and repeated as necessary.

• Child Dosage
  

  The cause of the hypocalcaemia must be fully assessed before starting therapy including dietary review, measurement of vitamin D and PTH, together with regular serum calcium and phosphate levels. For children with hypocalcaemic tetany a dosage of 0.25 to 0.35 mmol/kg of calcium given by slow intravenous injection may be given, repeated every six to eight hours until a response is seen. For other hypocalcaemia conditions initial doses of 0.5 to 3.5 mmol of calcium may be given to elevate serum calcium concentrations.

  Infants

  Calcium chloride has been given to infants at doses of under 0.5 mmol of calcium, but calcium gluconate is usually preferred due to the irritancy of calcium chloride

• Contra Indications
  

  Parenteral calcium therapy is contraindicated in patients receiving cardiac glycosides. Unsuitable for the treatment of hypocalcaemia caused by renal insufficiencies.

  Must not be given intramuscularly and subcutaneously as severe necrosis and sloughing may occur.

• Special Precautions
  

  Calcium chloride can cause gastro-intestinal irritation due to the stimulatory effects of calcium on gastric acid production. However, the effect would be most likely with oral administration.

  Close monitoring of serum calcium levels is essential following IV administration of calcium.

  Calcium salts should be used with caution in patients with impaired renal function, cardiac disease or sarcoidosis.

  Because it is acidifying, calcium chloride should be used cautiously in patients with respiratory acidosis or respiratory failure.

• Interactions
  

  Calcium salts reduce the absorption of a number of drugs such as bisphosphonates, fluoride, some fluoroquinolones and tetracyclines; administration should be separated by at least 3 hours.

  Calcium chloride infusion reduces the cardiotonic effects of dobutamine.

  The effects of digitalis can be increased by increases in blood calcium levels, and the administration of intravenous calcium may result in the development of potentially life-threatening digitalis induced heart arrhythmias.

  Thiazide diuretics decrease urinary calcium excretion, and caution is required if such drugs are administered with both calcium chloride and other calcium-containing preparations.

• Adverse Drug Reactions
  

  Rapid intravenous injection may cause vasodilation, decreased blood pressure, bradycardia and arrhythmias.

  The patient may complain of tingling sensations, a chalky 'calcium' taste and a sense of oppression or 'heat wave'.

  Irritation can occur after intravenous injection. Extravasation can cause burning, necrosis and sloughing of tissue, cellulitis and soft tissue calcification.