CALCIUM GLUCONATE 10% INJECTION 10ML 10`S

Calcium Gluconate 10% Injection is a sterile intravenous (IV) solution used to rapidly restore calcium levels in the body when they fall dangerously low. Calcium is an essential mineral required for muscle contraction, heart rhythm, nerve transmission, blood clotting, and bone integrity. This injection is administered exclusively in clinical settings under the direct supervision of a healthcare professional — it is never a self-administered medicine.

Approved Uses

•     Emergency treatment of acute symptomatic hypocalcaemia (dangerously low blood calcium — tetany, seizures, laryngospasm)

•     Emergency management of severe hyperkalaemia (high potassium levels threatening heart rhythm — calcium stabilises the cardiac membrane)

•     Treatment of hypermagnesaemia (elevated magnesium causing cardiac or respiratory depression)

•     Antidote for hydrofluoric acid (HF) burns — applied topically, injected, or given IV

•     Neonatal hypocalcaemia (newborn low calcium)

•     Hypocalcaemia associated with massive blood transfusion, hypoparathyroidism, and renal failure

This medicine is prepared and administered exclusively by trained healthcare professionals in a hospital or clinical setting. The dose and rate of infusion depend on the reason for use, the severity of the condition, and the patient's clinical status.

Standard Dosing

•     Adults: 10 mL (1 g) of 10% solution administered by slow IV infusion over at least 10 minutes. Do not exceed 200 mg/min infusion rate.

•     Children: 100–200 mg/kg IV over 10 minutes. Continuous infusion may follow at 200–500 mg/kg/day.

•     Neonates: 200–500 mg/kg/day by continuous infusion or divided doses every 6 hours.

Always dilute before administration. ECG monitoring is recommended during infusion. Administer through a secure IV line — extravasation (leakage) causes serious tissue damage.

Common (may affect more than 1 in 10 patients)

•     Tingling or warmth sensation during injection

•     Flushing and feeling of heat

•     Metallic or chalky taste in the mouth

•     Nausea

Serious — Tell Your Doctor or Nurse Immediately

•     Rapid infusion: severe bradycardia (slow heart rate), hypotension, arrhythmias, or cardiac arrest — always administer slowly

•     Extravasation (IV leakage into surrounding tissue): tissue necrosis and calcification — painful and serious

•     Signs of hypercalcaemia (too much calcium): confusion, excessive thirst, frequent urination, constipation, bone pain, irregular heartbeat

•     Aluminium toxicity (with prolonged use in neonates or renally impaired patients — specific formulations)

•     Do not use if you have hypercalcaemia (already high blood calcium levels)

•     Do not use if you have known hypersensitivity to calcium gluconate or any ingredient

•     Do not use in patients with sarcoidosis or conditions that already cause elevated blood calcium

•     Do not administer at the same time as IV ceftriaxone — risk of fatal calcium-ceftriaxone precipitate in the lungs and kidneys

•     Use with extreme caution in patients taking digoxin or other cardiac glycosides — can trigger life-threatening arrhythmias

Pregnancy

Use only when clearly necessary. Untreated maternal hypocalcaemia poses more risk to the fetus than careful IV calcium use. Limited safety data exists for IV use during pregnancy.

Breastfeeding

Calcium is naturally present in breast milk. IV use is unlikely to harm the nursing infant but exercise caution.

Renal Impairment

Risk of hypercalcaemia is increased. Use the lowest effective dose and monitor serum calcium closely.

Neonates

Particularly vulnerable to aluminium toxicity from prolonged parenteral calcium administration. Monitor closely.

•     Ceftriaxone: ABSOLUTELY CONTRAINDICATED — fatal precipitate can form in the bloodstream

•     Digoxin and cardiac glycosides: Increased risk of life-threatening arrhythmias — avoid or monitor very closely with ECG

•     Sodium bicarbonate: INCOMPATIBLE — do not mix in the same IV line

•     Thiazide diuretics: May further elevate calcium levels — monitor serum calcium

•     Beta-blockers: Calcium may reduce antihypertensive effectiveness

•     Tetracyclines and bisphosphonates: Calcium reduces their oral absorption — separate dosing times

•     Store below 25°C, away from light

•     If crystallisation occurs, warm ampoule in a 60°C water bath for 15–30 minutes with occasional shaking; cool to body temperature before use

•     Discard any unused portion — single-use ampoules only

•     Do not use if solution is not clear and colourless

POM — Prescription Only Medicine. Hospital/clinical use only. Requires IV access and continuous monitoring.

If you are receiving this treatment in hospital, you will be continuously monitored. Alert your nurse immediately if you feel your heart racing, chest tightness, or unusual pain at your IV site.

•     Always confirm absence of ceftriaxone co-administration before dispensing or administering — risk of fatal precipitate

•     Verify and document IV site patency before infusion; extravasation risk is significant

•     Slow infusion rate is mandatory — do not exceed 200 mg/min; ideally infuse over 10–20 minutes

•     Cardiac glycoside patients require continuous ECG monitoring during infusion

•     Check serum ionised calcium before and after dosing; repeat as clinically indicated

•     For hyperkalaemia management: the effect on cardiac membrane is immediate but transient — concurrent potassium-lowering therapy must be initiated in parallel

•     Do not confuse with calcium chloride injection — calcium gluconate contains less elemental calcium per mL; calcium chloride is 3× more potent per volume

Q: Why am I receiving an injection instead of calcium tablets?

A: Calcium tablets work slowly through digestion and are suitable for maintaining calcium levels in non-emergency situations. The injection is used when calcium levels need to be raised immediately — such as during cardiac emergencies or severe tetany — because it delivers calcium directly into the bloodstream within seconds.

Q: Is this the same as the calcium supplements I can buy at a pharmacy?

A: No. This is a high-strength injectable formulation used only for emergencies or specific hospital indications. Oral calcium supplements (calcium carbonate or calcium citrate tablets) are entirely different products used for dietary supplementation and are safe to take at home.

Q: Why is my IV calcium drip going so slowly?

A: Giving calcium too quickly can cause a dangerous drop in heart rate and blood pressure and potentially trigger a cardiac arrest. The slow drip rate is a critical safety measure, not inefficiency.