Data from FDA - Curated by Toby Galbraith - Last updated 12 July 2017

Indication(s)

INDICATIONS AND USAGE Calcium Chloride is indicated in the immediate treatment of hypocalcemic tetany. Other therapy, such as parathyroid hormone or vitamin D, may be indicated according to the etiology of the tetany. It is also important to institute oral calcium therapy as soon as practicable. Calcium salts have been used as adjunctive therapy in a number of conditions, including the following: Insect bites or stings, such as Black Widow Spider bites. Sensitivity reactions, particularly when characterized by urticaria. As an aid in the treatment of depression due to overdosage of magnesium sulfate. As an aid in the management of the acute symptoms in lead colic. In cardiac resuscitation, particularly after open heart surgery, calcium chloride has been used when epinephrine has failed to improve weak or ineffective myocardial contractions.

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Advisory information

contraindications
CONTRAINDICATIONS In cardiac resuscitation, the use of calcium chloride is contraindicated in the presence of ventricular fibrillation. If neonates are required, or expected to require, treatment with calcium-containing IV solutions, including continuous calcium-containing infusions such as parenteral nutrition, ceftriaxone sodium injection is contraindicated because of the risk of precipitation of ceftriaxone-calcium. A small number of cases of fatal outcomes in which a crystalline material was observed in the lungs and kidneys at autopsy have been reported in neonates receiving calcium containing fluids and ceftriaxone. In some of these cases, the same intravenous infusion line was used for both calcium-containing fluids and ceftriaxone and in some a precipitate was observed in the intravenous infusion line. At least one fatality has been reported in a neonate in whom calcium-containing fluids and ceftriaxone were administered at different time points via different intravenous lines; no crystalline material was observed at autopsy in this neonate. There have been no similar reports in patients other than neonates.
Special warnings and precautions
PRECAUTIONS To avoid undesirable reactions that may follow intravenous administration of calcium chloride, the rate of injection should not exceed 0.5 mL to 1 mL per minute. Because of the danger involved in the simultaneous use of calcium salts and drugs of the digitalis group, a digitalized patient should not receive an intravenous injection of a calcium compound unless the indications are clearly defined. Interaction with Calcium-Containing Products: Do not use diluents containing calcium to reconstitute ceftriaxone vials or to further dilute a reconstituted vial for IV administration because a precipitate can form. Precipitation of ceftriaxone-calcium can also occur when calcium-containing solutions are mixed with ceftriaxone in the same IV administration line. Calcium-containing IV solutions, including continuous calcium-containing infusions such as parenteral nutrition must not be administered simultaneously with ceftriaxone via a Y-site. However, in patients other than neonates, calcium-containing solutions and ceftriaxone may be administered sequentially of one another if the infusion lines are thoroughly flushed between infusions with a compatible fluid. In vitro studies using adult and neonatal plasma from umbilical cord blood demonstrated that neonates have an increased risk of precipitation of ceftriaxone-calcium. There have been no reports of an interaction between oral calcium-containing products and ceftriaxone or interaction between calcium-containing products (IV or oral) and intramuscular ceftriaxone. PREGNANCY Safety for use in pregnancy has not been established. Use of calcium chloride in women of childbearing potential requires that anticipated benefits be weighed against possible hazards.

Usage information

Dosing and administration
DOSAGE AND ADMINISTRATION The usual adult dose of this preparation varies from 5 to 10 mL at intervals of 1 to 3 days. In cardiac resuscitation, the usual dose is 2 to 4 mL injected into the ventricular cavity. Care should be taken to avoid injection into the cardiac muscle. Parenteral drug products should be inspected visually for particulate matter and discoloration, whenever solution and container permit. TREATMENT OF OVERDOSAGE Inadvertent systemic overloading with calcium ion can produce an acute hypercalcemic syndrome. The syndrome is characterized by weakness, lethargy, intractable nausea and vomiting, coma, and sudden death, and a markedly elevated plasma calcium level. It is suggested that details of treatment of this problem be obtained by reference to Harrison’s Principles of Internal Medicine Sixth Edition, pg. 475, column 2, “Acute Hypercalcemic Syndrome”. Store at 20°-25°C (68°-77°F); excursions permitted to 15°-30°C (59°-86°F) (See USP Controlled Room Temperature).

More information

Category Value
Agency product number M4I0D6VV5M
Orphan designation No
Product NDC 0517-2710
Date Last Revised 26-06-2017
Type HUMAN PRESCRIPTION DRUG
Marketing authorisation holder American Regent, Inc.