Calcium gluconate side effects

Calcium Gluconate

Generic Name: calcium gluconate (oral/injection) (KAL see um GLUE koe nate)
Brand Names:

Medically reviewed by P. Thornton, DipPharm Last updated on Jul 2, 2019.

What is calcium gluconate?

Calcium is a mineral that is found naturally in foods. Calcium is necessary for many normal functions of the body, especially bone formation and maintenance.

Calcium gluconate is used to prevent or to treat calcium deficiencies.

Calcium gluconate may also be used for purposes not listed in this medication guide.

Important Information

Do not take calcium gluconate or antacids that contain calcium without first asking your doctor if you also take other medicines. Calcium can make it harder for your body to absorb certain medicines. Calcium gluconate works best if you take it with food.

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

To make sure calcium gluconate is safe for you, tell your doctor if you have ever had:

  • heart problems;

  • kidney disease;

  • kidney stones;

  • cancer;

  • a parathyroid gland disorder; or

  • high levels of calcium in your blood.

Tell your doctor if you are pregnant or breastfeeding. Your dose needs may be different during pregnancy or while you are nursing.

How should I use calcium gluconate?

Use calcium gluconate exactly as directed on the label, or as prescribed by your doctor.

Calcium gluconate oral is taken by mouth. Check the label on your brand of this medicine to see if it should be taken with or without food.

Take calcium gluconate oral with plenty of water.

Calcium gluconate injection is given as an infusion into a vein. A healthcare provider will give you this injection.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when this medicine is injected.

Calcium gluconate may be only part of a complete program of treatment that also includes dietary changes. Learn about the foods that contain calcium.

Your dose may need to be adjusted as you make changes to your diet. Follow your doctor’s instructions very closely.

Store at room temperature away from moisture and heat.

Calcium gluconate dosing information

Usual Adult Dose for Hypocalcemia:

Intravenous:
500 to 2000 mg (5 to 20 mL) IV one time at a rate not to exceed 0.5 to 2 mL/min. The dose may be increased as needed. The usual daily dosage ranges from 1000 to 15,000 mg (10 to 150 mL) in divided doses or as a continuous infusion. Doses may be repeated every 1 to 3 days as needed and tolerated to normalize the serum calcium level.
Oral:
500 to 2000 mg orally 2 to 4 times a day.

Usual Adult Dose for Hypermagnesemia:

1000 to 2000 mg (10 to 20 mL) IV one time at a rate not to exceed 0.5 to 2 mL/min. This dose may be repeated as necessary in severe cases of hypermagnesemia (where discontinuation of exogenous magnesium is inadequate) to temporarily reverse many of the toxic effects of magnesium in the central nervous system.

Usual Adult Dose for Hyperkalemia:

500 to 3000 mg (5 to 30 mL) IV one time at a rate not to exceed 0.5 to 2 mL/min. This dose may be repeated as necessary in cases of extreme hyperkalemia cardiotoxicity when P waves are absent, the QRS complexes are widened, and when continuous ECG monitoring is available. The use of calcium does not reduce the serum potassium level, but counteracts the effects of hyperkalemia on cardiac excitability.

Usual Adult Dose for Exchange Transfusion:

300 mg (3 mL) IV one time with each 100 mL of citrated blood at a rate not to exceed 0.5 to 2 mL/min.

Usual Adult Dose for Osteoporosis:

1000 to 1500 mg/day orally in divided doses.

Usual Pediatric Dose for Hypocalcemia:

Neonatal:
Recommended daily allowance (RDA): (Dosage is in terms of elemental calcium):
Oral: 400 mg/day
Daily maintenance calcium:
IV: 3 to 4 mEq/kg/day
Cardiac arrest in the presence of hyperkalemia or hypocalcemia, magnesium toxicity, or calcium antagonist toxicity: Dosage expressed in mg of calcium gluconate: IV or intraosseous IO:
60 to 100 mg/kg/dose; may repeat in 10 minutes if necessary. If effective, consider IV infusion.
Hypocalcemia (dose depends on clinical condition and serum calcium level):
IV: (Dose expressed in mg of calcium gluconate):
200 to 800 mg/kg/day as a continuous infusion or in 4 divided doses
Oral: (Dosage expressed in mg of elemental calcium):
50 to 150 mg/kg/day in 4 to 6 divided doses
Do not exceed 1 g/day
Dose expressed in mg of calcium gluconate:
500 to 1500 mg/kg/day in 4 to 6 divided doses
Hypocalcemia secondary to citrated blood infusion:
IV:
Give 0.45 mEq elemental calcium for each 100 mL citrated blood infused
Tetany: (Dose expressed in mg of calcium gluconate):
IV: 100 to 200 mg/kg/dose over 5 to 10 minutes; may repeat after 6 hours or follow with an infusion with a maximum dose of 500 mg/kg/day
Dosing: Usual
Adequate intake (AI): (Dosage is in terms of elemental calcium):
Oral:
1 to 6 months: 210 mg/day
7 to 12 months: 270 mg/day
1 to 3 years: 500 mg/day
4 to 8 years: 800 mg/day
9 to 18 years: 1300 mg/day
Recommended daily allowance (RDA): (Dosage is in terms of elemental calcium):
Oral:
1 to 6 months: 400 mg/day
6 to 12 months: 600 mg/day
1 to 10 years: 800 mg/day
11 to 24 years: 1200 mg/day
Hypocalcemia (dose depends on clinical condition and serum calcium level):
Oral: (Dose expressed in mg of elemental calcium):
Children: 45 to 65 mg/kg/day in 4 divided doses
Dose expressed in mg of calcium gluconate:
Infants and Children: 500 to 725 mg/kg/day in 3 to 4 divided doses
Hypocalcemia (dose depends on clinical condition and serum calcium level):
IV: (Dose expressed in mg of calcium gluconate):
Infants and Children: 200 to 500 mg/kg/day as a continuous infusion or in 4 divided doses
Cardiac arrest in the presence of hyperkalemia or hypocalcemia, magnesium toxicity, or calcium antagonist toxicity:
IV, IO: (Dosage expressed in mg of calcium gluconate):
Infants and Children: 60 to 100 mg/kg/dose (maximum: 3 g/dose); may repeat in 10 minutes if necessary; if effective, consider IV infusion.
Hypocalcemia secondary to citrated blood infusion:
IV: Give 0.45 mEq elemental calcium for each 100 mL citrated blood infused
Tetany:
IV: (Dose expressed in mg of calcium gluconate):
Infants and Children: 100 to 200 mg/kg/dose; over 5 to 10 minutes; may repeat after 6 hours or follow with an infusion with a maximum dose of 500 mg/kg/day.
Daily maintenance calcium:
IV:
Infants and Children 25 kg and less: 1 to 2 mEq/kg/day
Children 25 to 45 kg: 0.5 to 1.5 mEq/kg/day
Children greater than 45 kg: 0.2 to 0.3 mEq/kg/day or 10 to 20 mEq/day

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using calcium gluconate?

Follow your healthcare provider’s instructions about any restrictions on food, beverages, or activity.

Calcium gluconate side effects

Get emergency medical help if you have signs of an allergic reaction to calcium gluconate: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • little or no urinating;

  • swelling, rapid weight gain;

  • a light-headed feeling, like you might pass out;

  • slow or irregular heartbeats; or

  • high levels of calcium in your blood–nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, confusion, lack of energy, or feeling tired.

Common calcium gluconate side effects may include:

  • warmth, tingling, or a heavy feeling;

  • a chalky taste in your mouth;

  • upset stomach, gas; or

  • constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect calcium gluconate?

Calcium can make it harder for your body to absorb certain medicines. If you take other medications, take them at least 2 hours before or 4 or 6 hours after you take calcium gluconate.

Tell your doctor about all your current medicines. Many drugs can interact with calcium gluconate, especially:

  • baloxavir marboxil (Xofluza);

  • digoxin (digitalis);

  • an antibiotic; or

  • other forms of calcium.

This list is not complete and many other drugs may interact with calcium gluconate. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use calcium gluconate only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 6.01.

Medical Disclaimer

Therapeutic action

– Calcium therapy
– Antidote to magnesium sulfate

Indications

– Severe hypocalcaemia (hypocalcaemic tetany, neonatal hypocalcaemia, etc.)
– Symptomatic hypermagnesaemia due to excessive doses of magnesium sulfate

Forms and strengths, route of administration

Dosage

– Severe hypocalcaemia
Neonate: 2 ml/kg of a 10% solution by IV infusion over 30 minutes followed by 4 ml/kg of a 10% solution administered by continuous infusion over 24 hours
Adult: 10 ml by slow IV injection (over at least 5 minutes), either repeated as required, or followed by continuous infusion of 40 ml of a 10% solution over 24 hours
Change to oral route as soon as possible.

– Magnesium sulfate intoxication
Adult: 10 ml of a 10% solution by slow IV injection (over at least 5 minutes), to be repeated once if necessary

Duration

– According to clinical response and plasma-calcium levels

Contra-indications, adverse effects, precautions

– Do not administer to patients with severe renal disease or patients receiving cardiac glycosides.
– Do not administer by IM or SC route (pain and risk of tissue necrosis or abscess formation at injection site, especially in infants and children).
– May cause:
• tingling sensations, warm flushes, dizziness;
• tissue necrosis in the event of extravasation;
• hypercalcaemia in the event of too rapid IV injection or overtreatment. First signs of hypercalcaemia include nausea, vomiting, thirst and polyuria. In severe cases, hypo tension, bradycardia, arrhythmia, syncope and cardiac arrest may develop.
– Hypercalcaemia can be confirmed by monitoring of serum-calcium levels and ECG changes. Do not use in prolonged treatment if plasma-calcium levels cannot be monitored.
– The patient should be placed in the horizontal position prior to injection and should remain lying down for 30 to 60 minutes.
– Pregnancy: no contra-indication
– Breast-feeding: no contra-indication

Remarks

– Calcium gluconate is also administered as adjunctive therapy in insect bites or stings (black widow spider, scorpions) for the management of muscle pain and spasms. Several doses at 4-h intervals may be necessary.
– 1 g of calcium gluconate (2.2 mmol or 4.5 mEq) is equivalent to 89 mg of calcium.
– Calcium gluconate is incompatible with many drugs: do not mix with other drugs in the same syringe or infusion fluid.
– Do not use if the solution appears cloudy or particles are visible (calcium gluconate precipitate).
– Storage: below 25 °C –

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 10/25/2016

Calcium gluconate is the calcium salt of gluconic acid, an intravenous medication used to treat conditions arising from calcium deficiencies such as hypocalcemic tetany, hypocalcemia related to hypoparathyrodism, and hypocalcemia due to rapid growth or pregnancy. Calcium gluconate is available in generic form. Side effects of calcium gluconate include:

  • nausea,
  • vomiting,
  • decreased appetite,
  • constipation,
  • dry mouth,
  • increased thirst,
  • increased urination,
  • tingling sensations,
  • hot flashes, and
  • a chalky taste following intravenous administration.

The usual dosage of calcium gluconate in adults is 500 mg – 2 grams (5-20 mL); in children 200-500 mg (2-5 mL); and in infants not more than 200 mg (not more than 2 mL). Calcium gluconate may interact with digoxin, antacids or other calcium supplements, calcitriol or vitamin D supplements, doxycycline, minocycline, or tetracycline. Tell your doctor all medications and supplements you use. It is also known whether calcium gluconate can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Calcium gluconate should be given to a pregnant woman only if clearly needed. It is also not known whether this drug is excreted in human milk. Tell your doctor if you are pregnant or become pregnant, or are breastfeeding, while using calcium gluconate dose. Your dose needs may be different during pregnancy or while you are breastfeeding.

Our Calcium gluconate Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Calcium gluconate Side Effects

Medically reviewed by Drugs.com. Last updated on Sep 21, 2019.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Interactions
  • More

For the Consumer

Applies to calcium gluconate: oral capsule, oral tablet

Other dosage forms:

  • intravenous solution

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of high calcium levels like weakness, confusion, feeling tired, headache, upset stomach and throwing up, constipation, or bone pain.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Constipation.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

For Healthcare Professionals

Applies to calcium gluconate: compounding powder, injectable solution, intravenous solution, oral tablet

Cardiovascular

Frequency not reported: Arrhythmias with concomitant cardiac glycoside use, hypotension, bradycardia, cardiac arrhythmias

Postmarketing reports: Vasodilation, cardiac arrest

Local

Frequency not reported: Tissue necrosis, calcinosis

Postmarketing reports: Local soft tissue inflammation, calcification due to extravasation

Other

Frequency not reported: End-organ damage (due to ceftriaxone-calcium precipitates), aluminum toxicity

Nervous system

Postmarketing reports: Syncope

1. “Product Information. Calcium Gluconate (calcium gluconate).” Fresenius Kabi USA, LLC, Lake Zurich, IL.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer

More about calcium gluconate

  • During Pregnancy
  • Dosage Information
  • Drug Images
  • Drug Interactions
  • Compare Alternatives
  • Pricing & Coupons
  • En Español
  • Drug class: minerals and electrolytes
  • FDA Alerts (5)

Consumer resources

  • Calcium gluconate
  • Calcium Gluconate Capsules and Tablets
  • Calcium Gluconate Injection

Other brands: Cal-GLU

Professional resources

  • Calcium Gluconate (Wolters Kluwer)
  • … +1 more

Related treatment guides

  • Hypermagnesemia
  • Exchange Transfusion
  • Hyperkalemia
  • Hypocalcemia
  • Osteoporosis

Zoledronic Acid Injection

Before receiving zoledronic acid injection,

  • tell your doctor and pharmacist if you are allergic to zoledronic acid or any other medications, or any of the ingredients in zoledronic acid injection. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
  • you should know that zoledronic acid injection is available under the brand names Zometa and Reclast. You should only be treated with one of these products at a time.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: aminoglycoside antibiotics such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Neo-Rx, Neo-Fradin), paromomycin (Humatin), streptomycin, and tobramycin (Tobi, Nebcin); aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); cancer chemotherapy medications; digoxin (Lanoxin, in Digitek); diuretics (‘water pills’) such as bumetanide (Bumex), ethacrynic acid (Edecrin), and furosemide (Lasix); and oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone). Many other medications may interact with zoledronic acid, so tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had kidney disease or if you have a dry mouth, dark urine, decreased sweating, dry skin, and other signs of dehydration or recently have had diarrhea, vomiting, fever, infection, excessive sweating, or have been unable to drink enough fluids. Your doctor will wait until you are no longer dehydrated before giving you zoledronic acid injection or if you have certain types of kidney disease may not prescribe this treatment for you. Also tell your doctor if you have ever had a low level of calcium in your blood. Your doctor will probably check the level of calcium in your blood before you begin treatment and may not prescribe this medication if the level is too low.
  • tell your doctor if you have been treated with zoledronic acid or other bisphosphonates (Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax+D, Reclast, Skelid, and Zometa) in the past; if you have ever had surgery on your parathyroid gland (small gland in the neck) or thyroid gland or surgery to remove sections of your small intestine; and if you have or have ever had heart failure (condition in which the heart cannot pump enough blood to other parts of the body); anemia (condition in which red blood cells cannot bring enough oxygen to other parts of the body); any condition that stops your blood from clotting normally; low levels of calcium, magnesium, or potassium in your blood; any condition that prevents your body from absorbing nutrients from food; or problems with your mouth, teeth, or gums; an infection, especially in your mouth; asthma or wheezing, especially if it is made worse by taking aspirin; or parathyroid or liver disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. You should use a reliable method of birth control to prevent pregnancy while you are receiving zoledronic acid. If you become pregnant while receiving zoledronic acid, call your doctor. Zoledronic acid may harm the fetus. Talk to your doctor if you plan to become pregnant at any time in the future because zoledronic acid may remain in your body for years after you stop receiving it.
  • you should know that zoledronic acid injection may cause severe bone, muscle, or joint pain. You may begin to feel this pain within daysor months after you first receive zoledronic acid injection. Although this type of pain may begin after you have received zoledronic acid injection for some time, it is important for you and your doctor to realize that it may be caused by zoledronic acid. Call your doctor right away if you experience severe pain at any time during your treatment with zoledronic acid injection. Your doctor may stop giving you zoledronic acid injection and your pain may go away after you stop treatment with this medication.
  • you should know that zoledronic acid may cause osteonecrosis of the jaw (ONJ, a serious condition of the jaw bone), especially if you have dental surgery or treatment while you are using the medication. A dentist should examine your teeth and perform any needed treatments, including cleaning, before you start to use zoledronic acid. Be sure to brush your teeth and clean your mouth properly while you are using zoledronic acid. Talk to your doctor before having any dental treatments while you are using this medication.

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