Department of Medicine, MTI, Khyber Teaching Hospital

Adult IV Medication Monograph

Calcium Gluconate 10%

Emergency medication
Drug Class Calcium supplement
Available dosage form Injection form - 10ml (Calcium Gluconate – 10%)

Usual Dosing 1. Acute hypocalcaemia: 10-20ml (2.2-4.4mmol)

2. Fluoride or lead poisoning: 0.3ml/kg (0.07mmol/kg)
3. Cardiac resuscitation: 7-15ml (1.54-3.3mmol).

Dilution & Preparation 1. Calcium Gluconate Injection can be diluted with glucose 5% or
sodium chloride 0.9%.

2. It should not be administered at dose more than 2ml/min (10%

calcium gluconate) .

3. For continuous intravenous infusion, dilute 100 mL of calcium

gluconate 10% in 1 litre of glucose 5% or sodium chloride
0.9% and give at an initial rate of 50 mL/hour adjusted
according to response.

Administration Intravenous

Dosage adjustment Renal impairement: Use with caution.

Incompatibility
1. Calcium salts can form complexes with many drugs like
amphotericin, ceftriaxone, dobutamine hydrochloride,
prochlorperazine, and tetracyclines.
2. Dilution into a solution containing bicarbonate, phosphate or
sulfate should be avoided.

Monitoring Monitoring should include heart rate or ECG.

Contraindications & Contraindications:
1. Hypersensitivity
Precautions
2. Patients with severe renal failure;
3. Patients with hypercalcemia.
4. Patients receiving cardiac glycosides.
5. Co-administration with ceftriaxone.
6. Repeated or prolonged treatment, including as an intravenous
infusion, in those with impaired renal function.

Precautions:
1. In patients receiving ceftriaxone, it can be administered
sequentially one after another if infusion lines at different sites
are used to avoid precipitation.
2. It should be administered slowly to minimise peripheral
vasodilation and cardiac depression.
3. The infusion site must be monitored regularly to ensure
extravasation injury has not occurred.
 Department of Medicine, MTI, Khyber Teaching Hospital
Adult IV Medication Monograph

4. Calcium may antagonise the effect of calcium antagonists

(calcium channel blockers).
Clinical considerations 1. Hypocalcemic tetany
2. Cardiac resuscitation
3. Acute colic of lead poisoning
4. Acute fluoride poisoning
5. Prevention of hypocalcemia after mass transfusion/exchange
transfusion.
Adverse Effects They are mostly because of intravenous overdose or too rapid
intravenous injection.
1. Bradycardia, cardiac arrhythmia.
2. Hypotension, vasodilatation, circulatory collapse (possibly
fatal), flushing, mainly after too rapid injection.
3. Nausea, vomiting.
4. Heat sensations, sweating.
5. Calcinosis cutis. Reddening of skin, burning sensation or pain
during intravenous injection may indicate accidental
perivascular injection, which may lead to tissue necrosis.

Pregnancy and Breast 1. Calcium Gluconate Injection BP should not be used during
pregnancy unless clearly indicated.
Feeding
2. The administered dose should be carefully calculated, as
hypercalcemia may be deletrorious for the fetus.
3. Calcium is excreted in breast milk. A decision must be made
whether to discontinue breast-feeding or to discontinue/abstain
from Calcium Gluconate Injection BP therapy taking into
account the benefit of breast feeding for the child and the
benefit of therapy for the woman.