Dosing and uses of CaCl or CaCl(2) (calcium chloride)
Adult dosage forms and strengths
injectable solution
- 100mg/mL
Hypocalcemia, Emergency Treatment
500-1000 mg IV over 5-10 minutes; may repeat as necessary
Arrhythmias, Emergent
Indicated for arrhythmias associated with hypocalcemia, hyperkalemia, or hypermagnesemia
500-1000 mg IV over 5-10 minutes
Hypermagnesemia
500-1000 mg IV over 2-5 minutes; observe the patient for signs of recovery; may repeat if CNS depression persists
Calcium Channel Blocker Overdose
1-2 g IV infused over 10-20 min; may repeat every 20 minutes prn up to 5 doses
Beta-blocker Overdose, Refractory to Glucagon & High Dose Vasopressor
1000 mg IV bolus via central line
Other Information
1 g (10 mL) vials of calcium chloride 10% solution contain 273 mg (13.6 mEq) elemental calcium
Pediatric dosage forms and strengths
injectable solution
- 100 mg/mL
Hypocalcemia, Emergency Treatment
Infants: <75 mg (20 mg elemental Ca) IV; may repeat as necessary
Children: 75-519 mg (20-140 mg elemental Ca) IV, may repeat as necessary
Hypocalcemic Tetany
Neonates: 171 mg/kg/day IV in divided doses
Infants and Children: 10 mg/kg IV over 5-10 min TID/QID; alternatively, may administer 35-50 mg/kg IV TID/QId
Other Information
(Not recommended) Cardiac Arrest: 20 mg/kg IV push every 10 minutes as necessary
Other Indications & Uses
Medullary thyroid cancer diagnosis
CaCl or CaCl(2) (calcium chloride) adverse (side) effects
Frequency not defined
Erythema
Hypomagnesemia
Hypophosphatemia
Hypotension
Hypercalcemia
Nausea
Tissue necrosis at injection site
Vasodilation
Weakness
Renal calculi
Hot flashes
Serum amylase increased
Tingling sensations
Rapid Administration
Arrhythmia
Bradycardia
Calcium taste
Sense of heat waves
Ventricular fibrillation
Warnings
Contraindications
VFib during CPR, hypercalcemia, risk for digitalis toxicity, hypophosphatemia, renal calculi
IM or SC administration
Pulseless ventricular tachycardia
Cautions
Hepatic impairment, sarcoidosis, CV disease, renal disease, acidosis, cor pulmonale, digitalized patients
Not recommended in treatment of asystole and electromechanical dissociation
PALS no longer recommends Ca for pediatric cardiac arrest
Life-threatening cardiac arrhythmias may occur in severe hypokalemia
Pregnancy and lactation
Pregnancy category: C
Lactation: As a component of human milk calcium enters milk. Use caution.
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of CaCl or CaCl(2) (calcium chloride)
Mechanism of action
Bone mineral component; cofoactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways
Pharmacokinetics
Excretion: feces (80%) and urine (20%)
Administration
IV Administration
1 g (10 mL) vials of calcium chloride 10% solution contain 273 mg (13.6 mEq/mL) elemental calcium
If time permits warm solution to body temp
Infuse IV at <45-90 mg/kg/hr (0.6-1.2 mEq/kg/hour)
Stop infusion if patient experiences pain or discomfort
Following injection patient should remain recumbent for a short time
