An IV form of calcium given by a healthcare provider to treat a sudden, symptomatic drop in blood calcium. It is diluted and given slowly through a secure IV line, because a fast injection can slow the heart and a leak from the vein can damage the skin.
The label does not describe a narrow therapeutic index or direct dosing by measured blood levels of the drug. Serum calcium is monitored to adjust the infusion.
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No specific antidote. For overdose with hypercalcemia (symptoms usually appear at total calcium of 12 mg/dL or more), stop the infusion, restore intravascular volume, and promote urinary calcium excretion if needed. For extravasation or calcinosis cutis, stop IV administration at that site right away and treat as needed.
Doses come from the FDA label. Study tool, not for clinical decisions.
Start at the lowest dose of the recommended range and monitor serum calcium every 4 hours. Prolonged use in renal impairment can let aluminum build up to toxic levels; the product contains up to 512 mcg/L.
Hepatic function does not affect how much ionized calcium becomes available after IV dosing, so dose adjustment may not be needed.
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Supplies calcium. IV calcium gluconate dissociates in plasma into ionized calcium and gluconate, raising serum ionized calcium, the biologically active fraction (about 50% of total serum calcium; about 40% is protein bound, mainly to albumin). It is 100% bioavailable IV, is not metabolized, and increases urinary calcium excretion. Each mL (100 mg of calcium gluconate) provides 9.3 mg (0.465 mEq) of elemental calcium.