Calcium gluconate, 100 mg/ml 10 ml 10 pcs

Pharmacological group: regulator of calcium-phosphorus metabolism.

Pharmacodynamics:

Calcium drug compensates the lack of calcium ions required for the transmission of nerve impulses, reduction of skeletal and smooth muscles, myocardial activity, bone formation, blood clotting.

Pharmacokinetics:

After parenteral administration with the bloodstream is evenly distributed in all tissues and organs. In blood plasma about 45% of calcium ions are in complex with proteins. It passes through the placental barrier and enters breast milk. It is eliminated from the body mainly by the kidneys.

Indications

Illnesses accompanied by hypocalcemia, increased permeability of cell membranes, impaired nerve impulse conducting in muscle tissue.

– Hypoparathyreosis (latent tetany, osteoporosis), disorders of vitamin D metabolism: rickets (spasmophilia, osteomalacia), hyperphosphatemia in patients with chronic renal insufficiency.

– Increased demand for calcium ions (pregnancy, breastfeeding, period of intense growth), insufficient content of calcium ions in food, disorders of calcium metabolism (in the postmenopausal period).

– Increased excretion of calcium ions (prolonged bed rest, chronic diarrhea, secondary hypocalcemia due to prolonged use of diuretics and antiepileptic drugs, glucocorticosteroids).

– Bleeding of various etiologies.

– Allergic diseases (serum sickness, urticaria, febrile syndrome, itching dermatosis(s), reactions to the administration of drugs and food intake, angioedema); bronchial asthma, dystrophic alimentary edema, pulmonary tuberculosis, rachitis, osteomalacia, lead colic; eclampsia.

– Hyperkalemic form of paroxysmal myoplegia.

Active ingredient

Calcium gluconate

Composition

Active ingredient:

Calcium gluconate – 100.0 mg

Excipients:

succinic acid – 5.0 mg,

sodium hydroxide solution 1 M – to pH 6.0 – 7.5,

water for injection – to 1.0 ml.

How to take, the dosage

Serum calcium concentration should be monitored during treatment. The drug is administered deeply intramuscularly, or intravenously slowly (within 2-3 minutes), or dropwise to avoid the possibility of local irritation or necrosis in case the drug enters the perivascular tissues.

Due to the risk of local irritation intramuscular injections should be performed only if intravenous injection is not possible. Intramuscular injections should be made deep enough into a muscle, preferably into gluteal area.

Adults: intramuscularly, slowly intravenously (2 – 3 min) or by drip 5-10 ml of 10% solution daily, every other day or every two days (depending on the disease and clinical condition of the patient). The subsequent doses are determined in accordance with calcium concentration in blood serum.

Children under 18 years old: The dose and method of administration depend on the degree of hypocalcemia, the nature and severity of symptoms.

For children depending on the age the drug is administered in the following dosages: up to 6 months – 0.1-1 ml, 7-12 months – 1-1.5 ml, 1-3 years – 1.5-2 ml, 4-6 years – 2-2.5 ml, 7-14 years – 3-5 ml, over 14 years – as for adults. The drug is administered every 2-3 days.

It is not recommended to administer the drug intramuscularly to children due to possible development of necrosis.

Only slow intravenous injection or intravenous infusion after dilution is recommended in order to achieve sufficiently low rates of administration and to avoid possible local irritation or necrosis if the drug accidentally gets into perivascular tissues.

For intravenous infusion the drug is diluted 1:10 to 10 mg/ml with the following solutions for infusion: 0.9% sodium chloride solution or 5% glucose solution. The rate of intravenous injection should not exceed 50 mg of calcium gluconate per minute.

The solution is warmed to body temperature before injection. Syringe for calcium gluconate injection should not contain residual ethanol (to avoid precipitation of calcium gluconate).

Interaction

Pharmaceutically incompatible with ethanol, carbonates, salicylates, sulfates (forms insoluble or hardly soluble calcium salts). It forms insoluble complexes with tetracycline-type antibiotics (decreases antibacterial effect).

Decreases the effect of calcium channel blockers (intravenous injection of calcium gluconate before or after verapamil decreases its hypotensive effect).

Simultaneous use with quinidine may slow intraventricular conduction and increase quinidine toxicity.

Parenteral use of calcium gluconate is not recommended during cardiac glycosides treatment (cardiotoxic effect of cardiac glycosides may increase).

In combination with thiazide diuretics may increase hypercalcemia.

Decreases the effect of calcitonin in hypercalcemia. Decreases the bioavailability of phenytoin.

Special Instructions

The drug is heated to body temperature before injection.

When administered intravenously there may be a feeling of heat throughout the body, which quickly disappears.

During treatment the serum calcium concentration should be carefully monitored.

Due to the risk of local irritation intramuscular injections should be performed only if intravenous injection is not possible. Intramuscular injections should be performed deep into the muscle, preferably into the gluteal area.

For obese patients, a longer needle should be selected to safely inject into the muscle rather than into the fatty tissue. If repeated injections are necessary, the injection site should be changed each time.

When administering calcium gluconate intravenously, in exceptional cases, patients receiving cardiac glycosides need cardiac monitoring and conditions for emergency treatment of cardiac complications such as severe arrhythmias should be provided.

Calcium salts should be used with caution and only after careful indication in patients with nephrocalcinosis, heart disease, in elderly patients. Impaired renal function may be associated with hypercalcemia and secondary hyperparathyroidism.

Therefore, in patients with impaired renal function parenteral administration of calcium should be administered only after careful determination of indications, and the calcium-phosphate balance should be controlled.

In patients with insignificant hypercalciuria, decreased glomerular filtration or with nephrourolithiasis in past history the treatment should be performed under control of urinary calcium ions concentration.

To reduce the risk of nephrourolithiasis development, abundant drinking is recommended.

Effect on the ability to drive and operate machinery
The drug does not affect the concentration and speed of psychomotor reactions when driving a car and engaging in potentially dangerous activities.

Contraindications

Hypersensitivity to the drug components, hypercalcemia (calcium concentration should not exceed 12 mg% or 6 mEq/L), hypercalciuria, nephrolithiasis (calcium), sarcoidosis, simultaneous use of cardiac glycosides (risk of arrhythmias).

With caution: dehydration, electrolyte disorders (risk of hypercalcemia), diarrhea, malabsorption syndrome, calcium nephrourolithiasis (history), moderate chronic renal failure, chronic heart failure, common atherosclerosis, hypercoagulation, for injection in children (risk of necrosis).

Side effects

When administered intramuscularly and intravenously, nausea, vomiting, diarrhea, bradycardia may occur. When administered intravenously, burning in the mouth, fever may be observed; when administered intravenously, blood pressure may decrease, arrhythmia, fainting, cardiac arrest may occur. In intramuscular injection, necroses may form at the injection site.

Overdose

Development of hypercalcemia (symptoms: drowsiness, weakness, anorexia, abdominal pain, vomiting, nausea, constipation, polydipsia, polyuria, increased fatigue, irritability, depression, dehydration, possible cardiac rhythm disturbance, myalgia, arthralgia, arterial hypertension). Severe hypercalcemia (calcium over 3.4 mmol/l) is life threatening and requires immediate infusion therapy.

Treatment: drug withdrawal; in severe cases – parenteral calcitonin in dose of 5-10 IU/kg of body weight per day (diluted in 500 ml of sterile 0.9% physiological sodium chloride solution), intravenously by drip for 6 hours.

Slow intravenous infusion 2-4 times a day is possible.

Pregnancy use

It is possible to use during pregnancy and breastfeeding by indication and under strict control of serum calcium concentration, because hypercalcemia negatively affects the fetus and child.

When taking calcium preparations during breastfeeding, its penetration into the breast milk is possible.

Similarities

Calcium gluconate, Calcium gluconate Renewal, Calcium gluconate-SOLOPHARM