Calcium chloride

See critical care quick reference for drug doses by weight.

General

• Type: Mineral, Antidote
• Dosage Forms: injectable solution
• Dosage Strengths: 100 mg/mL
• Routes of Administration: IV
• Common Trade Names:

Adult Dosing

• Hypocalcemia (emergent): 500-1000 mg IV over 5-10 minutes, repeat as needed
• Arrhythmias (emergent): 500-1000 mg IV over 5-10 minutes, repeat as needed
• Hypermagnesemia: 500-1000 mg IV over 2-5 minutes, repeat if CNS depression persists
• Calcium channel blocker toxicity: 1-2 g IV infused over 10-20 min; repeat every 20 minutes PRN up to 5 doses
• Beta-blocker toxicity (Refractory to glucagon/vasopressors): 1g IV bolus
• Hyperkalemia: 1g IV
• Cardiac Arrest: 1g IV (not recommended for routine use)

Pediatric Dosing

See critical care quick reference for drug doses by weight.

Special Populations

• Pregnancy Rating: C
• Lactation: Infant risk cannot be ruled out
• Renal Dosing: base dosing on serum Ca if CrCl <25, may need reduced dose if on HD
• Hepatic dosing: No adjustment

Contraindications

• Allergy to class/drug
• Current use of ceftriaxone sodium injection in neonates
• Ventricular fibrillation
• Do NOT administer for IM or subq
• Administer through central venous access except in cases of cardiac arrest
  • High risk of extravasation and tissue necrosis

Adverse Reactions

Serious

• Vasodilation
• Tissue necrosis (if extravasated)

Common

• Burning sensation

Pharmacology

• Half-life:
• Metabolism:
• Excretion: Renal, fecal

Mechanism of Action

• Cofoactor in many enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

	Indication	Dose	Context	Route	Population
Beta-blocker toxicity#Calcium chloride Calcium supplementation Adult	Beta-blocker toxicity	1-3 g IV (10-20 mL 10% solution)	Calcium supplementation	IV	Adult
Calcium channel blocker toxicity#Calcium chloride Calcium supplementation (preferred, 3x calcium vs gluconate) Adult	Calcium channel blocker toxicity	1-3 g IV bolus (10-20 mL 10% solution), then 1 g IV q5min to BP effect; drip 10-50 mg/kg/hr	Calcium supplementation (preferred, 3x calcium vs gluconate)	IV/IV drip	Adult
Hypermagnesemia#Calcium chloride Antagonize cardiac/respiratory effects of hypermagnesemia Adult	Hypermagnesemia	5-10mL of 10% solution	Antagonize cardiac/respiratory effects of hypermagnesemia	IV	Adult
Hypocalcemia#Calcium chloride Symptomatic hypocalcemia (alternative to calcium gluconate) Adult	Hypocalcemia	10mL of 10% solution	Symptomatic hypocalcemia (alternative to calcium gluconate)	IV	Adult

See Also

• Hypocalcemia
• Antidotes