Adult Dosing

Cardiac resuscitation

• 500-1000 mg (5-10ml) IV, may be repeated as necessary
• 200-800 mg (2-8 mL) intracardiac into ventricular cavity
• Administer into the ventricular cavity, not into the heart muscle

Hypocalcemic Disorders

• 500 mg-1 g (5-10 mL) IV q1-3 days; depending upon the response or serum calcium levels, dose may be repeated

Magnesium Intoxication

• Initial dose: 500 mg (5 mL) IV; monitor patient for the signs of recovery and adjust subsequent doses accordingly

Hyperkalemic ECG disturbances

• Adjust dose by constant monitoring of ECG changes

Note:

• Inject slowly at the rate of 1 mL/min, preferably in a central or deep vein
• 10% (100 mg/mL) calcium chloride = 27 (1.4 mEq) elemental calcium

Calcium Channel Blocker Overdose [Non-FDA Approved]

• 20 ml (2 g) bolus dose (over 5-10 min) followed by continuous infusion of 0.2 to 0.4 ml/kg per hour

Pediatric Dosing

Cardiac resuscitation

• 0.2 mL/kg intracardiac into ventricular cavity

Hypocalcemic Disorders

• 2.7-5.0 mg/kg hydrated calcium chloride or 0.027-0.05 mL/kg IV q4-6 hrs

Note:

• Inject slowly at the rate of 1 mL/min, preferably in a central or deep vein
• 10% (100 mg/mL) calcium chloride = 27 (1.4 mEq) elemental calcium

Calcium Channel Blocker Overdose [Non-FDA Approved]

• 0.2 ml/kg (20 mg/kg) bolus dose followed by continuous infusion of 0.2 to 0.4 ml/kg per hour

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment of hypocalcemia in conditions requiring a prompt increase in plasma calcium levels
• Hypocalcemia during exchange transfusion
• Adjuvant therapy in the management of acute symptoms in lead colic
• Treatment of magnesium intoxication
• Severe hyperkalemia
• Cardiac resuscitation, after open heart surgery

• Hypersensitivity to any of the ingredients of the product
• Cardiac resuscitation in the presence of ventricular fibrillation
• Hypercalcemia
• Digitalis toxicity
• Asystole
• Electromechanical dissociation
• Hypophosphatemia

• N/A

Renal Dose Adjustments

• Renal impairment: Use cautiously, dose adjustments not defined

Hepatic Dose Adjustments

• Hepatic impairment: Dose adjustments not defined

• Do not inject unless the solution is clear and the seal is intact
• Inject calcium chloride very slowly into a large vein as too rapid injection may cause hypotension and cardiac syncope
• As calcium chloride is an acidifying salt, it is usually undesirable in the treatment of hypocalcemia of renal insufficiency
• Do not administer calcium chloride injection into tissues, as it is irritating to veins and can cause severe necrosis and sloughing. Care should be taken to avoid extravasation or accidental injection into perivascular tissues
• Calcium chloride injection should be warmed to body temperature and should be injected slowly into a large vein to minimize venous irritation and avoid undesirable reactions
• In cardiac resuscitation inject calcium chloride into the ventricular cavity. Care must be taken to avoid injecting into the myocardial tissue. Prevent high concentration of calcium from reaching the heart as it may cause cardiac syncope
• Caution should be exercised in patients taking digitalis or digitalis-like preparations

Cautions: Use cautiously in

• Renal impairment
• Renal calculi
• Cardiac diseases
• Respiratory acidosis
• Respiratory failure
• Sarcoidosis
• Hyperparathyroidism

Pregnancy Category:C

Breastfeeding: Safe

• NEURO: Tingling sensations, dizziness
• CV: Peripheral vasodilation, flushing, hypotension, cardiac syncope, arrhythmias, bradycardia
• GI: Calcium taste, constipation
• METABOLIC: Hypercalcemia, hypomagnesemia
• LOCAL: Burning sensation, necrosis, sloughing
• GU: Nephrolithiasis
• MISC: Sensation of heat waves

• Mineral; essential for the functional integrity of the nervous and muscular systems, for normal cardiac function and is involved in the mechanism of blood coagulation
• Metabolism: other
• Excreted 80% in feces and 20% in urine
• Half-life: Unknown

US Trade Name(s)

• Only generic available

US Availability

calcium chloride (generic)

• INJ: 100mg/ml (10 mL prefilled syringe)

Canadian Trade Name(s)

• Calciject

Canadian Availability

calcium chloride (generic)

• INJ: 100 mg/mL

Calciject

• INJ: 100 mg/mL

UK Trade Name(s)

• Only generic available

UK Availability

calcium chloride (generic)

• INJ: 100mg/ml (10 mL vial)

Australian Trade Name(s)

• Only generic available

Australian Availability

calcium chloride (generic)

• INJ: 100mg/ml (10 mL prefilled syringe)

[Outline]

Nutrition/Electrolytes

Minerals & Electrolytes