Calcium Chloride

Calcium Chloride is a mineral indicated in the immediate treatment of hypocalcemic tetany (abnormally low levels of calcium in the body that cause muscle spasm). Calcium chloride injection is also used in cardiac resuscitation, arrhythmias, hypermagnesemia, calcium channel blocker overdose, and beta-blocker overdose.

Calcium Chloride is available under the following different brand or other names: CaCl and CaCl2.

Dosage Forms and Strengths

Injectable solution

• 100mg/mL

Dosage Considerations – Should be Given as Follows:

Hypocalcemia, Emergency Treatment

• Adults: 500-1000 mg intravenously (IV) over 5-10 minutes; may repeat as necessary
• Infants: less than 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

Arrhythmias, Emergent

• Indicated for arrhythmias associated with hypocalcemia, hyperkalemia, or hypermagnesemia
• 500-1000 mg intravenously (IV) over 5-10 minutes

Hypermagnesemia

• 500-1000 mg intravenously (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 intravenously (IV) infused over 10-20 min; may repeat every 20 minutes prn up to 5 doses

Beta-blocker Overdose, Refractory to Glucagon and High Dose Vasopressor

• 1000 mg intravenous (IV) bolus via central line

Hypocalcemic Tetany, Pediatric

• Neonates: 171 mg/kg/day intravenously (IV) in divided doses
• Infants and Children: 10 mg/kg intravenously (IV) over 5-10 min three to four times daily; alternatively, may administer 35-50 mg/kg IV three to four times daily

Other Indications and Uses

• Medullary thyroid cancer diagnosis

Other Information

• 1 g (10 mL) vials of calcium chloride 10% solution contain 273 mg (13.6 mEq) elemental calcium
• Pediatric: (Not recommended) Cardiac Arrest: 20 mg/kg intravenous (IV) push every 10 minutes as necessary

Side effects of Calcium Chloride include:

• Redness
• Low blood magnesium (hypomagnesemia)
• Low blood phosphates (hypophosphatemia)
• Low blood pressure (hypotension)
• High blood calcium (hypercalcemia)
• Nausea
• Tissue necrosis at injection site
• Vasodilation
• Weakness
• Kidney stones
• Hot flashes
• Serum amylase increased
• Tingling sensations
• Injection site reactions (tingling, burning sensation, inflammation of the veins [phlebitis])
• Fainting

Side effects of calcium chloride rapid administration include:

• Irregular heartbeat (arrhythmia)
• Slow heart rate
• Calcium taste
• Sense of heat waves
• Ventricular fibrillation

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

Severe interactions of Calcium Chloride include:

• ceftriaxone

Serious interactions of Calcium Chloride include:

• demeclocycline
• dolutegravir
• doxycycline
• eltrombopag
• lymecycline
• minocycline
• oxytetracycline
• tetracycline

Calcium Chloride has moderate interactions with at least 48 different drugs.

Calcium Chloride has mild interactions with at least 52 different drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

• This medication contains calcium chloride. Do not take CaCl or CaCl2 if you are allergic to calcium chloride or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• VFib during CPR, hypercalcemia, risk for digitalis toxicity, hypophosphatemia, renal calculi
• Intramuscular (IM) or subcutaneous (SC) administration
• Pulseless ventricular tachycardia

Effects of Drug Abuse

• No information available

Short-Term Effects

• See "What Are Side Effects Associated with Using Calcium Chloride?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Calcium Chloride?"

Cautions

• Hepatic impairment, sarcoidosis, cardiovascular disease, renal disease, acidosis, cor pulmonale, or 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

• Use calcium chloride with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.
• As a component of human milk calcium enters milk. Use caution if breastfeeding.