Calcium gluconate

Generic name
Calcium gluconate
Brand name
ATC Code
B05XA19
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Calcium gluconate

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

Interactions
PK
Renal impairment
References

Pharmacokinetics in children

No information

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

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

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Acute hypocalcaemia; convulsions resulting from hyperphosphataemia/hypocalcaemia
  • Intravenous
    • Term neonate
      [4]
      • Elemental Ca: 0.45 mmol/kg/dose in 30 minutes.

      • Administer under ECG monitoring

    • 1 month up to 18 years
      [4]
      • Elemental Ca: 0.023 - 0.225 mmol/kg/dose, once only.
    • 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

    • 1 month up to 18 years
      • Elemental calcium (Ca2+) 0.023 - 0.225 mmol/kg/dose, once only.
        Corresponding to: 
        -          Elemental calcium (Ca2+): 0,9 – 9 MG/kg/dose once
        - Calciumgluconate: 10-100 MG/kg/dose once

        .
Calcium deficiency
  • Oral
    • ≥ 2 years
      [5]
      • 500 mg/dose 2-3x daily.
    • ≥ 2 years
      • 500 mg/dose 2-3x daily.
Maintenance requirement for calcium in TPN
  • Intravenous
    • Premature infants Gestational age < 37 weeks
      [6]

      • 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
      [6]
      • 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
      [6]
      • 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.

    • 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
      • 0.25 - 0.4 mmol/kg/day, continuous infusion.

      • = 10-16 mg/kg/day
        Depending on the calcium level.
Hyperkalaemia
  • Intravenous
    • 1 month up to 18 years
      • 0.5 ml/kg/dose in 1 dose. Max: 20 ml/dose.  
        • 0.12 mmol = 0.5 ml of 10% calcium gluconate
        • slow IV injection over 5-10 minutes 
        .
    • Term neonate
      • 0.5 ml/kg/dose in 1 dose. Max: 20 ml/dose.  
        • 0.12 mmol = 0.5 ml of 10% calcium gluconate
        • slow IV injection over 5–10 minutes
        .

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.

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

Side effects

No information is present at this moment.

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].

Interactions

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

I.V. SOLUTION ADDITIVES

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

Electrolyte solutions
B05XA07
B05XA14
B05XA31
B05XA06
Amino acids
B05XB01
Vitamins
B05XC
VITAMINS
B05XC

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
  7. S. Smith, Advanced Paediatric Life Support 7th edition, Wiley-Blackwell, 2023

Changes

Therapeutic Drug Monitoring


Overdose