Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Calcium gluconate

Generic name
Calcium gluconate
Brand name
ATC Code
B05XA19

Pharmacokinetics in children

No information

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dose recommendation of formulary compared to licensed use (on-label versus off-label)

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Available formulations

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Dosages

Acute hypocalcaemia; convulsions resulting from hyperphosphataemia/hypocalcaemia
  • Intravenous
    • Term neonate
      • Elemental calcium (Ca2+): 0.45 mmol/kg/dose in 30 minutes.
        Corresponding to: 
        -          Elemental calcium (Ca 2+): 18  MG/kg/dose
        - Calciumgluconate: 200 MG/kg/dose

        .

      • Administer under ECG monitoring
Maintenance requirement for calcium in TPN
  • Intravenous
    • 1 year up to 18 years
      • 0.25 - 0.4 mmol/kg/day, continuous infusion.

      • = 10-16 mg/kg/day
        Depending on the calcium level.

    • Premature infants Gestational age < 37 weeks

      • During the first days after birth: 0,8-2 mmol/kg/day (= 32-80 mg/kg/day)
        Growing premature neonate: 1,6-3,5 mmol/kg/day (= 64-140 mg/kg/day)

    • Full-term neonates and children 0 months up to 7 months
      • 0.8 - 1.5 mmol/kg/day, continuous infusion.

      • = 32-60 mg/kg/day
        Depending on the calcium level.

    • 7 months up to 1 year
      • 0.5 mmol/kg/day, continuous infusion.

      • = 20 mg/kg/day
        Depending on the calcium level.

    • 1 year up to 18 years
      [6]
      • 0.25 - 0.4 mmol/kg/day, continuous infusion.

      • = 10-16 mg/kg/day
        Depending on the calcium level.
Calcium deficiency
  • Oral
    • ≥ 2 years
      • 500 mg/dose 2-3x daily.

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Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects

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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Be aware of the possibility of a reaction with phosphate in TPN. Be aware of the possibility of hypomagnesaemia, either pre-existing or resulting from the calcium administered.

Only slow intravenous injection or infusion (both after dilution), to achieve sufficiently slow delivery rates and to avoid tissue irritation or necrosis due to accidental extravasation. The intravenous rate should not exceed 5 ml per minute of 1:10 diluted calcium gluconate 10% solution in children and adolescents. Avoid intramuscular injections in pediatric patients [SmPC].

Cases of serious reactions because of calcium ceftriaxone precipitates in the lungs and kidneys after intravenous administration in (premature) neonates less than one month old have been reported [SmPC].

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Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

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References

  1. Rademaker C.M.A. et al, Geneesmiddelen-Formularium voor Kinderen, 2007
  2. Noordam C et al, Werkboek Kinderendocrinologie, digitale publicatie op www.nvk.nl (alleen leden), 2010
  3. Kamps WA et al, Werkboek ondersteundende behandeling kinderoncologie, VU Uitgeverij, 2005
  4. B. Braun Melsungen AG, SmPC Calciumgluconaat (RVG 32248) 22-10-2015, www.geneesmiddeleninformatiebank.nl
  5. TEVA, SmPC (RVG 52036) 11-04-2016, www.geneesmiddelinformatiebank.nl
  6. Mihatsch W, et al, ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Calcium, phosphorus and magnesium, Clinical Nutrition, 2018, 37, 2360-2365

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Changes

Changes