calcium

(C) Vancouver General Hospital.
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For further information, please contact a Pharmacist.

NAME OF DRUG
calcium chloride

CLASSIFICATION

Electrolyte

ALTERNATE NAME

INDICATIONS

for emergency use during cardiac resuscitation and life-threatening hyperkalemia

RECONSTITUTION AND STABILITY

stable at room temperature
only available as 100 mg/mL (10%) 10 mL prefilled syringe

COMPATIBILITY

compatible with most commonly used IV solutions
compatible via Y-site with ascorbic acid, dopamine, epinephrine, hydrocortisone, isoproterenol, lidocaine, multiple vitamin infusion, potassium chloride, vitamin B complex with C
incompatible with ceftriaxone, dobutamine, sodium bicarbonate

ROUTES OF ADMINISTRATION

IV direct
- rate should not exceed 100 mg calcium chloride per minute
  (1 mL/minute of 10% solution)
- cardiac arrest - 1 g (10mL) over 10-20 seconds
IV intermittent
- dilute in 50 mL minibag
- rate should not exceed 100 mg calcium chloride per minute
  (= 1 g calcium chloride 10% over 10 minutes)

VH & HSC ADMINISTRATION POLICY

B - Direct IV route restricted to nurses in Special and Critical Care areas. On general nursing units the direct IV route must be administered by a physician.

DOSAGE

Adult:

Treatment of Hyperkalemia:
- 1 g IV over 10 minutes; if life-threatening complications of hyperkalemia persist, a second dose may be considered, however, further dosing requires careful monitoring of ionized calcium
Cardiac Resuscitation:
- 1g IV over 10-20 seconds

Children:

0.2 mL /kg/dose (maximum 1 g) IV given at maximum rate of
100 mg/minute (1mL/minute)
for cardiac arrest - may administer dose over 10-20 seconds
avoid scalp veins

NOTE: 10 mL of calcium chloride 10% contains 1g calcium chloride (= 273 mg calcium or 14 mEq calcium)

POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION

too rapid IV: cardiotoxicity, hypotension, local thrombophlebitis, tingling sensation, calcium taste, flushing, nausea, vomiting, sweating
irritation on extravasation
antidote for overdose - magnesium sulfate IV

IMPORTANT IMPLICATIONS

SC, IM routes are NOT USED because of severe sloughing and necrosis
caution in digitalized patients - do not exceed 0.5 mL/minute
serum calcium levels should be monitored

Rev. July 2007