Calcium gluconate is a medication used to regulate calcium-phosphorus metabolism.
Pharmacological action of Calcium gluconate
The action of the drug Calcium gluconate is aimed at replenishing Ca2+ deficiency, in which:
- The process of transmission of nerve impulses deteriorates;
- Contractions of smooth and skeletal muscles, bone formation, myocardial activity, and blood clotting are disrupted.
Release form, composition and analogues of Calcium gluconate
Calcium gluconate containing the active substance of the same name is produced in the form:
- Chewable tablets 500 mg;
- Solution for injection in ampoules of 1, 2, 3, 5 and 10 ml;
- Tablets of 250 and 500 mg.
According to indications, the doctor may recommend one of the drug analogues with a similar effect. For example: Additive calcium, Hydroxyapatite, Glycerophosphate granules, Hydroxyapatite paste, CalViv, Calcium-Sandoz forte, Calcium lactate, Calcium lactate.
Indications for use of Calcium gluconate
Calcium gluconate injections and tablet form of the drug are prescribed for the treatment of:
- Hypoparathyroidism (latent tetany, osteoporosis);
- Diseases accompanied by hypocalcemia, increased permeability of cell membranes, disorders in muscle tissue in the conduction of nerve impulses;
- Increased excretion of Ca2+, which occurs during prolonged bed rest, chronic diarrhea, secondary hypocalcemia due to prolonged use of diuretics, antiepileptic drugs, glucocorticosteroids;
- Vitamin D metabolism disorders, including rickets (spasmophilia, osteomalacia), hyperphosphatemia in patients with chronic kidney disease;
- Hyperkalemic form of paroxysmal myoplegia;
- Poisoning with Mg2+ salts, fluoric and oxalic acids, as well as their soluble salts.
Also, Calcium gluconate according to the instructions is prescribed against the background of an increased need for Ca2+, which occurs in children and adolescents during periods of intensive growth, with an unbalanced diet, which causes a deficiency of Ca2+, as well as in the postmenopausal period with disturbances in calcium-phosphorus metabolism.
For women, calcium gluconate is usually prescribed during pregnancy and lactation due to the increasing need for calcium during this period.
Contraindications
The medicine is not used against the background:
- Hypercalcemia;
- Hypersensitivity;
- Nephrourolithiasis (calcium);
- Severe hypercalciuria;
- Concomitant use with cardiac glycosides (due to the risk of arrhythmias);
- Sarcoidosis.
In pediatrics, the medication in any dosage form is approved for use from the age of three.
When using Calcium gluconate, caution must be exercised when:
- Electrolyte disturbances (due to an increased risk of developing hypercalcemia);
- Dehydration;
- Malabsorption syndrome;
- Diarrhea;
- Slight hypercalciuria;
- Calcium nephrourolithiasis (history);
- Chronic heart failure;
- Moderate chronic renal failure;
- Hypercoagulation;
- Widespread atherosclerosis.
How to use Calcium gluconate
Calcium gluconate tablets are taken before meals or 1-1.5 hours after meals. It is recommended to take the medicine with milk. Adult daily dosage varies from 2 to 9 g depending on indications, children - from 1 g depending on age. The frequency of use of tablets is 2-3 times a day.
Calcium gluconate injections with a 10% solution at room temperature are given intramuscularly, slowly intravenously (2-3 minutes) or by drip. Depending on the indications, the medication is administered daily or every other day.
To reduce the risk of developing nephrourolithiasis during therapy, drinking plenty of fluids is recommended.
The dosage of calcium gluconate during pregnancy and lactation should be checked with your doctor.
Side effects
When taking Calcium gluconate tablets, constipation and irritation of the mucous membrane of the gastrointestinal tract may occur.
When administered intramuscularly or intravenously, calcium gluconate, according to reviews, can lead to the development of:
- Nausea;
- Vomiting;
- Diarrhea;
- Bradycardia;
- Burning sensation in the mouth;
- Feelings of heat;
- Reducing blood pressure;
- Arrhythmias;
- Fainting;
- Cardiac arrest;
- Necrosis at the injection site.
When using increased dosages of calcium gluconate, according to reviews, it can cause hypercalcemia, for the treatment of which calcitonin is used parenterally.
Drug interactions Calcium gluconate
During therapy, it should be taken into account that calcium gluconate, according to the instructions, is pharmaceutically incompatible with salicylates, carbonates and sulfates.
You should also know that Calcium gluconate simultaneously with:
- Tetracycline antibiotics form insoluble complexes, which reduces the antibacterial effect;
- BMCC leads to a decrease in its effect;
- Quinidine can slow down intraventricular conduction and cause increased toxicity;
- With tetracyclines, digoxin, and oral medications, Fe slows down their absorption. The interval between medications should be at least two hours;
- Thiazide diuretics enhances hypercalcemia;
- Calcitonin reduces its effect when used against the background of hypercalcemia;
- Phenytoin reduces its bioavailability.
Storage conditions
Calcium gluconate is one of the regulators of calcium-phosphorus metabolism, dispensed from pharmacies only as prescribed by a doctor. The shelf life of tablets is 5 years, chewable tablets - 24 months, solution for injection - 2.5 years, provided the medicine is stored in accordance with the manufacturer's recommendations.
active substance: Salcium gluconate;
1 tablet contains calcium gluconate 500 mg;
Excipients: potato starch, talc, calcium stearate.
Dosage form. Pills.
Basic physical and chemical properties: solid, regular, round cylinders, the upper and lower surfaces of which are flat, the edges of the surfaces are beveled, with a mark for dividing, white. Marbling is allowed on the surface of the tablets.
Pharmacotherapeutic group.
Mineral supplements. Calcium preparations. ATX code A12A A03.
Pharmacological properties
Pharmacodynamics.
Calcium gluconate is a calcium salt of gluconic acid containing 9% calcium. Calcium ions are involved in the transmission of nerve impulses, the contraction of smooth and skeletal muscles, the functioning of the myocardium, and blood clotting processes; they are necessary for the formation of bone tissue and the normal functioning of other systems and organs. The concentration of calcium ions in the blood decreases in many pathological processes; Severe hypocalcemia contributes to the occurrence of tetany. Calcium gluconate, in addition to eliminating hypocalcemia, reduces vascular permeability, has antiallergic, anti-inflammatory, hemostatic effects, and also reduces exudation. Calcium ions are a plastic material for the skeleton and teeth, participate in various enzymatic processes, regulate the speed of nerve impulses and the permeability of cell membranes. Calcium ions are necessary for the process of neuromuscular transmission and to maintain the contractile function of the myocardium. Unlike calcium chloride, calcium gluconate has a weaker local irritant effect.
Pharmacokinetics.
When taken orally, calcium gluconate is partially absorbed mainly in the small intestine. The maximum concentration in blood plasma is achieved after 1.2-1.3 hours. The half-life of ionized calcium from blood plasma is 6.8-7.2 hours. Penetrates the placental barrier and is excreted into breast milk. It is excreted from the body in urine and feces.
Clinical characteristics.
Indications.
Diseases accompanied by hypocalcemia, increased permeability of cell membranes, and disruption of the conduction of nerve impulses in muscle tissue. Hypoparathyroidism (latent tetany, osteoporosis), vitamin D metabolism disorders (rickets, spasmophilia, osteomalacia), hyperphosphatemia in patients with chronic renal failure.
Increased need for calcium (period of intensive growth of children and adolescents, pregnancy or breastfeeding), insufficient Ca 2+ content in food, disturbance of its metabolism in the postmenopausal period, bone fractures. Increased excretion of Ca 2+ (prolonged bed rest, chronic diarrhea, hypocalcemia with long-term use of diuretics, antiepileptic drugs, glucocorticosteroids). In complex therapy: bleeding of various etiologies, allergic diseases (serum sickness, urticaria, febrile syndrome, itchy dermatoses, angioedema); bronchial asthma, dystrophic alimentary edema, pulmonary tuberculosis, eclampsia, parenchymal hepatitis, toxic liver damage, nephritis. As an antidote for poisoning with magnesium salts, oxalic acid, soluble salts of fluoric acid (when interacting with calcium gluconate, insoluble and non-toxic calcium oxalate and calcium fluoride are formed).
Contraindications
Hypersensitivity to the components of the drug. Hypercalcemia, severe hypercalciuria, hypercoagulation, tendency to thrombus formation, severe atherosclerosis, increased blood clotting, nephrourolithiasis (calcium), severe renal failure, sarcoidosis, taking digitalis drugs.
Interaction with other drugs and other types of interactions.
The drug slows down the absorption of estramustine, etidronate and other bisphosphonates, quinolones, tetracycline antibiotics, oral iron supplements and fluoride preparations (the interval between their doses should be at least 3 hours). Calcium gluconate reduces the bioavailability of phenytoin. When taken simultaneously with vitamin D or its derivatives, calcium absorption increases. Cholesterolamine reduces calcium absorption in the digestive tract. When used together with cardiac glycosides, the cardiotoxic effects of the latter are enhanced. Glucocorticosteroids reduce calcium absorption. When combined with thiazide diuretics, the risk of hypercalcemia may increase. The drug may reduce the effect of calcitonin in hypercalcemia, the bioavailability of phenytoin, and the effect of calcium channel blockers. When used simultaneously with quinidine, intraventricular conduction may slow down and the toxicity of quinidine may increase.
Forms insoluble or slightly soluble calcium salts with carbonates, salicylates, and sulfates.
Calcium absorption from the digestive tract can be reduced by some types of food (spinach, rhubarb, bran, grains).
Features of application
When used in patients receiving cardiac glycosides and/or diuretics, as well as during long-term treatment, the concentration of calcium and creatinine in the blood should be monitored. If their concentration increases, you need to reduce the dose of the drug or temporarily stop using it. Due to the fact that vitamin D 3 increases the absorption of calcium from the digestive tract, in order to avoid an overdose of calcium, it is necessary to take into account the intake of vitamin D 3 and calcium from other sources.
With caution and with regular monitoring of the level of calcium excretion in the urine, it is prescribed to patients with moderate hypercalciuria exceeding 300 mg/day (7.5 mmol/day), mildly expressed renal dysfunction, and a history of urolithiasis. If necessary, you need to reduce the dose of the drug or discontinue it. Patients with a tendency to form stones in the urinary tract are advised to increase the volume of fluid consumed during treatment.
When treating with the drug, you should avoid taking high doses of vitamin D or its derivatives, unless there are special indications for this.
It is necessary to maintain an interval of at least 3 hours between taking calcium gluconate and oral medications estramustine, etidronate and other bisphosphonates, phenytoin, quinolones, tetracycline antibiotics, oral iron supplements and fluoride preparations.
Use during pregnancy or breastfeeding.
The use of the drug is permissible taking into account the ratio of benefit for the woman/risk for the fetus/child, which is determined by the doctor.
When taking calcium supplements during breastfeeding, it may pass into breast milk.
The ability to influence the reaction rate when driving vehicles or other mechanisms.
Does not affect.
Directions for use and doses
Administer orally before meals. The tablet must be chewed or crushed.
For adults and children over 14 years of age, the drug should be prescribed in a single dose of 1-3 g (2-6 tablets), for children from 3 to 4 years old - 1 g (2 tablets), from 5 to 6 years old - 1-1.5 g. (2-3 tablets), from 7 to 9 years – 1.5-2 g (3-4 tablets), from 10 to 14 years – 2-3 g (4-6 tablets) 2-3 times a day .
The daily dose for elderly patients should not exceed 2 g (4 tablets).
The duration of treatment is determined by the doctor individually depending on the patient’s condition.
Children.
The drug should be used in children over 3 years of age.
Overdose
With long-term use in high doses, hypercalcemia is possible with the deposition of calcium salts in the body, and dyspeptic symptoms are possible. The likelihood of developing hypercalcemia increases with simultaneous treatment with high doses of vitamin D or its derivatives.
Symptoms of hypercalcemia: drowsiness, weakness, anorexia, abdominal pain, vomiting, nausea, constipation, polydipsia, polyuria, weakness, increased fatigue, irritability, poor health, depression, dehydration, possible heart rhythm disturbances, myalgia, arthralgia, arterial hypertension.
Treatment: drug withdrawal; in severe cases - parenteral calcitonin at a dose of 5-10 IU/kg body weight per day (diluted in 500 ml of 0.9% sodium chloride solution), intravenously drip for 6 hours. Possible intravenous jet slow administration 2-4 times a day.
Adverse reactions
Usually the drug is well tolerated, but sometimes allergic reactions and other disorders are possible:
from the digestive tract: nausea, vomiting, diarrhea, abdominal pain, constipation; with long-term use in high doses – the formation of calcium stones in the intestines;
from the cardiovascular system: bradycardia;
on the metabolic side: hypercalcemia, hypercalciuria;
from the urinary system: impaired renal function (increased urination, swelling of the lower extremities).
These phenomena quickly disappear after reducing the dose or discontinuing the drug.
Best before date
Storage conditions
Store in original packaging at a temperature not exceeding 25 °C.
Keep out of the reach of children.
Package
10 tablets in blisters.
Manufacturer.
JSC "Lubnyfarm"
The location of the manufacturer and the address of the place of its activities.
Ukraine, 37500, Poltava region, Lubny, st. Barvinkova, 16.
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A drug that replenishes calcium deficiency in the body
Active substance
Calcium gluconate monohydrate
Release form, composition and packaging
◊ Pills white, flat-cylindrical, with chamfer and notch.
Excipients: potato starch 23 mg, talc 5 mg, calcium stearate monohydrate 2 mg.
10 pieces. - cellless contour packages (1) - cardboard packs.
10 pieces. - cellless contour packages (2) - cardboard packs.
10 pieces. - contour cellular packaging (1) - cardboard packs.
10 pieces. - contour cell packaging (2) - cardboard packs.
pharmachologic effect
The calcium supplement replenishes the deficiency of calcium ions necessary for the transmission of nerve impulses, contraction of skeletal and smooth muscles, myocardial activity, bone tissue formation, and blood clotting.
Pharmacokinetics
Approximately 1/5-1/3 of the orally administered drug is absorbed in the small intestine; this process depends on the presence of D, pH, diet and the presence of factors capable of binding calcium ions. The absorption of calcium ions increases with calcium deficiency and the use of a diet with a reduced content of calcium ions. About 20% is excreted by the kidneys, the remaining amount (80%) is removed with the contents of the intestine.
Indications
Diseases accompanied by hypocalcemia, increased permeability of cell membranes (including blood vessels), disruption of the conduction of nerve impulses in muscle tissue.
Hypoparathyroidism (latent tetany, osteoporosis), vitamin D metabolism disorders: rickets (spasmophilia, osteomalacia), hyperphosphatemia in patients with chronic.
Increased need for calcium ions (pregnancy, lactation, period of increased growth of the body), insufficient content of calcium ions in food, disturbance of its metabolism (in the postmenopausal period).
Enhanced excretion of calcium ions (prolonged bed rest, chronic, secondary hypocalcemia due to long-term use of diuretics and antiepileptic drugs, glucocorticosteroids).
Poisoning with salts of magnesium ions, oxalic and fluoric acids and their soluble salts (when interacting with calcium gluconate, insoluble and non-toxic calcium oxalate and calcium fluoride are formed).
Hypercalcemic form of paroxysmal myoplegia.
Contraindications
Hypersensitivity, hypercalcemia (calcium ion concentration should not exceed 12 mg% ~ 6 mEq/l), severe hypercalciuria, nephrourolithiasis (calcium), sarcoidosis, concomitant use of cardiac glycosides (risk of arrhythmias), children under 3 years of age.
Carefully. Dehydration, electrolyte disturbances (risk of developing hypercalcemia), diarrhea, malabsorption syndrome, slight hypercalciuria, moderate chronic renal failure, chronic failure, widespread atherosclerosis, hypercoagulation, calcium nephrourolithiasis (history).
Dosage
Grind before use.
Orally, before meals or 1-1.5 hours after consumption (with milk). Adults - 1-3 g 2-3 times a day (maximum daily dose - 9 g).
Pregnant and nursing mothers- 1-3 g 2-3 times a day (maximum daily dose - 9 g).
For children: 3-4 years - 1 g (maximum daily dose - 3.0 g); 5-6 years - 1-1.5 g (maximum daily dose - 4.5 g); 7-9 years – 1.5-2 g (maximum daily dose - 6 g); 10-14 years - 2-3 g (maximum daily dose - 9 g); frequency of administration - 2-3 times a day.
Side effects
Constipation, irritation of the gastrointestinal mucosa, hypercalcemia.
Overdose
Symptoms: development of hypercalcemia.
Treatment: calcitonin is administered 5-10 IU/kg/day. (diluted in 500 ml of 0.9% solution). Duration of administration 6 hours.
Drug interactions
Forms insoluble complexes with tetracycline antibiotics (reduces the antibacterial effect).
When used simultaneously with quinidine, intraventricular conduction may slow down and the toxicity of quinidine may increase.
Slows down the absorption of digoxin and oral iron supplements (the interval between doses should be at least 2 hours).
When combined with thiazide diuretics, it may increase hypercalcemia. Reduces the effect of calcitonin in hypercalcemia. Reduces the bioavailability of phenytoin.
Composition and release form
Tablets - 1 tablet: calcium gluconate 500 mg.
10 pieces. - cellless contour packages (3) - cardboard packs.
Description of the dosage form
Tablets are white, flat-cylindrical, with a chamfer and a score.
pharmachologic effect
Calcium is a macroelement involved in the formation of bone tissue, the process of blood clotting, and is necessary to maintain stable cardiac activity and the processes of transmission of nerve impulses. Improves muscle contraction in muscular dystrophy, myasthenia gravis, and reduces vascular permeability. When administered intravenously, calcium causes stimulation of the sympathetic nervous system and increased secretion of adrenaline by the adrenal glands; has a moderate diuretic effect.
Pharmacokinetics
Approximately 1/5-1/3 of the orally administered drug is absorbed in the small intestine; this process depends on the presence of vitamin D, pH, diet and the presence of factors that can bind calcium ions. The absorption of calcium ions increases with calcium deficiency and the use of a diet with a reduced content of calcium ions. About 20% is excreted by the kidneys, the remaining amount (80%) is removed with the contents of the intestine.
Clinical pharmacology
A drug that replenishes calcium deficiency in the body.
Indications for use
Diseases accompanied by hypocalcemia, increased permeability of cell membranes (including blood vessels), disruption of the conduction of nerve impulses in muscle tissue.
Hypoparathyroidism (latent tetany, osteoporosis), vitamin D metabolism disorders: rickets (spasmophilia, osteomalacia), hyperphosphatemia in patients with chronic renal failure.
Increased need for calcium ions (pregnancy, lactation, period of increased growth of the body), insufficient content of calcium ions in food, disturbance of its metabolism (in the postmenopausal period).
Enhanced excretion of calcium ions (prolonged bed rest, chronic diarrhea, secondary hypocalcemia due to long-term use of diuretics and antiepileptic drugs, glucocorticosteroids).
Poisoning with salts of magnesium ions, oxalic and fluoric acids and their soluble salts (when interacting with calcium gluconate, insoluble and non-toxic calcium oxalate and calcium fluoride are formed).
Hypercalcemic form of paroxysmal myoplegia.
Contraindications for use
Hypersensitivity, hypercalcemia (calcium ion concentration should not exceed 12 mg% ~ 6 mEq/l), severe hypercalciuria, nephrourolithiasis (calcium), sarcoidosis, concomitant use of cardiac glycosides (risk of arrhythmias), children under 3 years of age.
Carefully. Dehydration, electrolyte disturbances (risk of developing hypercalcemia), diarrhea, malabsorption syndrome, slight hypercalciuria, moderate chronic renal failure, chronic heart failure, widespread atherosclerosis, hypercoagulation, calcium nephrourolithiasis (history).
Use during pregnancy and children
Application is possible according to the dosage regimen.
Use in children
Contraindicated in children under 3 years of age.
Side effects
Constipation, irritation of the gastrointestinal mucosa, hypercalcemia.
Drug interactions
Calcium gluconate, when used simultaneously, reduces the effect of calcium channel blockers. IV administration of calcium gluconate before or after verapamil reduces its hypotensive effect, but does not affect its antiarrhythmic effect. Under the influence of cholestyramine, calcium absorption from the gastrointestinal tract is reduced. When used simultaneously with quinidine, intraventricular conduction may slow down and the toxicity of quinidine may increase. During treatment with cardiac glycosides, parenteral use of calcium gluconate is not recommended due to increased cardiotoxic effects. With simultaneous oral administration of calcium gluconate and tetracyclines, the effect of the latter may decrease due to a decrease in their absorption.
Dosage
For oral administration, a single dose is 1-3 g, the frequency of administration is 2-3 times a day. When administering a solution of calcium gluconate intravenously or intramuscularly, a single dose of the drug should correspond to 2.25-4.5 mmol of calcium. A solution of calcium chloride is administered intravenously in a stream (slowly) in a single dose of 500 mg, intravenously in a drip - in a single dose of 0.5-1 g.
Overdose
Symptoms: development of hypercalcemia.
Treatment: calcitonin is administered 5-10 IU/kg/day. (diluted in 500 ml of 0.9% sodium chloride solution). Duration of administration 6 hours.
Precautionary measures
In patients with mild hypercalciuria, decreased glomerular filtration rate, or a history of nephrourolithiasis, treatment should be carried out under the control of the concentration of calcium ions in the urine.
To reduce the risk of developing nephrourolithiasis, drinking plenty of fluids is recommended.