calcium gluconate
Indication
- Treatment of neonatal hypocalcemia
- Treatment of symptomatic hyperkalemia
Dosage Guidelines
- Hypocalcemia:
Initial: 50-100 mg/kg/dose IV
Maintenance: 50-200 mg/kg/dose IV q6 hours or 8-30 mg/kg/hr IV continuous
- Hyperkalemia: 50 mg/kg/dose IV (over 5-10 minutes)
Administration
- SLOW IV direct by MD/NP or under direct supervision by MD/NP not to exceed 100 mg/minute
- IV intermittent slow infusion over 30 minutes
- IV continuous infusion
To make 50 mL of a 20 mg/mL solution:
- Administer at a rate not exceeding 100 mg/min (5 mL/min of the 20 mg/mL concentration)
- Central Line Prefered
- Avoid scalp veins and ensure line patency
Adverse Effects
- Severe necrosis and tissue sloughing may occur due to extravasation
- Hypercalcemia and cardiac arrhythmias or arrest with rapid bolus infusion
Comments
- Monitor for bradycardia and arrythmias when giving IV bolus
- Incompatible with many medications including sodium bicarbonate (because of precipitation); consult Pharmacist for compatibility with other medications
- Avoid extravasation: for calcium burns consider using hyaluronidase
Supplied As
1 g vial (100 mg/mL)
20 mg/mL IV syringe prepared by Pharmacy
At LHSC, standard concentration reference charts are available on the NICU Intranet site
References
LexiComp Sick Kids, LexiComp Pediatric and Neonatal, Neofax