Calcium Gluconate
Calcium Gluconate Prescribing Information
Calcium Gluconate Injection is indicated for pediatric and adult patients for the treatment of acute symptomatic hypocalcemia.
The safety of Calcium Gluconate Injection for long term use has not been established.
Measure serum calcium every 4 to 6 hours during intermittent infusions with Calcium Gluconate Injection and measure serum calcium every 1 to 4 hours during continuous infusion.
Calcium Gluconate Injection is a clear, colorless to slightly yellow, solution available in the following:
- Pharmacy bulk package: 10,000 mg per 100 mL (100 mg per mL)
Each mL of Calcium Gluconate Injection contains 9.3 mg (0.465 mEq) of elemental calcium.
Hepatic function does not impact the availability of ionized calcium after calcium gluconate intravenous administration. Dose adjustment in hepatically impaired patients may not be necessary.
Calcium Gluconate Injection is contraindicated in:
- Hypercalcemia
- Neonates (28 days of age or younger) receiving ceftriaxone [see Warnings and Precautions ()]
5.2 End-Organ Damage due to Intravascular Ceftriaxone-Calcium PrecipitatesConcomitant use of ceftriaxone and Calcium Gluconate Injection is contraindicated in neonates (28 days of age or younger) due to cases of fatal outcomes in neonates in which a crystalline material was observed in the lungs and kidneys at autopsy after ceftriaxone and calcium were administrated simultaneously through the same intravenous line. Concomitant administration can lead to the formation of ceftriaxone calcium precipitates that may act as emboli, resulting in vascular spasm or infarction
[see Contraindications ].In patients older than 28 days of age, ceftriaxone and Calcium Gluconate Injection may be administered sequentially, provided the infusion lines are thoroughly flushed between infusions with a compatible fluid. Do not administer Ceftriaxone simultaneously with Calcium Gluconate Injection via a Y-site in any age group.
Calcium Gluconate Injection contains aluminum, up to 400 mcg per liter, 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 neonates, who receive parenteral levels of aluminum at greater than 4 mcg/kg/day to 5 mcg/kg/day accumulate aluminum levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.