Calcium chloride
See critical care quick reference for drug doses by weight.
General
- Type: Mineral, Antidote
- Dosage Forms: injectable solution
- Dosage Strengths: 100 mg/mL
- Routes of Administration: IV
- Common Trade Names:
Adult Dosing
- Hypocalcemia (emergent): 500-1000 mg IV over 5-10 minutes, repeat as needed
- Arrhythmias (emergent): 500-1000 mg IV over 5-10 minutes, repeat as needed
- Hypermagnesemia: 500-1000 mg IV over 2-5 minutes, repeat if CNS depression persists
- Calcium channel blocker toxicity: 1-2 g IV infused over 10-20 min; repeat every 20 minutes PRN up to 5 doses
- Beta-blocker toxicity (Refractory to glucagon/vasopressors): 1g IV bolus
- Hyperkalemia: 1g IV
- Cardiac Arrest: 1g IV (not recommended for routine use[1])
Pediatric Dosing
See critical care quick reference for drug doses by weight.
Special Populations
- Pregnancy Rating: C
- Lactation: Infant risk cannot be ruled out
- Renal Dosing: base dosing on serum Ca if CrCl <25, may need reduced dose if on HD
- Hepatic dosing: No adjustment
Contraindications
- Allergy to class/drug
- Current use of ceftriaxone sodium injection in neonates
- Ventricular fibrillation
- Do NOT administer for IM or subq
- Administer through central venous access except in cases of cardiac arrest
- High risk of extravasation and tissue necrosis
Adverse Reactions
Serious
- Vasodilation
- Tissue necrosis (if extravasated)
Common
- Burning sensation
Pharmacology
- Half-life:
- Metabolism:
- Excretion: Renal, fecal
Mechanism of Action
- Cofoactor in many enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Beta-blocker toxicity | 1-3 g IV (10-20 mL 10% solution) | Calcium supplementation | IV | Adult |
| Calcium channel blocker toxicity | 1-3 g IV bolus (10-20 mL 10% solution), then 1 g IV q5min to BP effect; drip 10-50 mg/kg/hr | Calcium supplementation (preferred, 3x calcium vs gluconate) | IV/IV drip | Adult |
| Hypermagnesemia | 5-10mL of 10% solution | Antagonize cardiac/respiratory effects of hypermagnesemia | IV | Adult |
| Hypocalcemia | 10mL of 10% solution | Symptomatic hypocalcemia (alternative to calcium gluconate) | IV | Adult |
See Also
References
- ↑ Neumar RW, Otto CW, Link MS, et al. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):729-767. doi: 10.1161/CIRCULATIONAHA.110.970988. [PubMed 20956224]