Calcium chloride Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

  • Calcium chloride is second-line when the gluconate salt is unavailable (ref 1)
  • Calcium chloride minijets MAY BE USED in the resus situation
  • Very irritant solution- give slowly, and stop if extravasation occurs
  • Calcium chloride should NEVER be given by IM or subcutaneous routes, as severe necrosis and sloughing may occur
  • Do NOT administer through same line as solutions containing phosphate, bicarbonate or sulphates
  • Do NOT CONFUSE WITH CALCIUM GLUCONATE
  • There is a risk of arrhythmias if the drug is given too quickly. Also, nausea, vomiting, hot flushes, sweating, hypotension, tingling, chalky taste and vasomotor collapse may occur if the drug is given too quickly (ref 2)

Available preparations

Drug Presentation Concentration (mmol) Concentration (%= g/100ml) Content in grams
Calcium chloride minijet 6.8 mmol in 10ml 10% 1g in 10ml
ampoule 5mmol in 5ml 14.7% 0.735g in 5ml
ampoule 10mmol in 10ml 14.7% 1.47g in 10ml

Reconstitution

Already in solution

Draw up using a 5 micron filter needle (ampoules)

Infusion fluids

Sodium chloride 0.9% (ref 2)

Methods of intravenous administration

Slow intravenous injection (in resus situations)

  • Minijet: as per resuscitation guidelines
  • Ampoules: administer slowly over at least 3 minutes (ref 2)
  • See under 'Important information' re rate of administration

Intermittent intravenous infusion(administer using an electronically controlled infusion pump)

  • Dilute with at least four times its own volume with infusion fluid (ref 2)
  • Administer over one hour via a large vein (ref 1)
  • Rate may be increased if necessary to a maximum rate of 1mmol per minute (ref 2)

Dose in adults

Emergency situations

  • As per resus guidelines

Hypocalcaemia

  • Calcium gluconate salt preferred - see separate monograph
  • The dose is determined by the requirements of the patient
  • Suggest initial dose of Calcium chloride 10mmol (10ml of ampoule solution)
  • Repeat every day if needed

Hypocalcaemic tetany/severe hypocalcaemia

  • See calcium gluconate monograph

Monitoring

  • Monitor serum calcium, blood pressure
  • The infusion site must be monitored to ensure extravasation injury has not occurred
  • There is a risk of arrythmias if the drug is given too quickly (ref 2)

Further information

  • Conversion: 1mmol is the same as 2mEq
  • Calcium chloride 1g = 270mg elemental calcium = 13.6mEq = 6.8mmol (ref 3)

Storage

Store at room temperature

References

SPC Minijet May 2019

1. Uptodate- accessed online 09/05/2023

2. Injectable medicines administration Medusa downloaded 29/03/2023

3: Druginformation.com Conversion calculator

Therapeutic classification

Electrolyte