Normally, the concentration of total calcium in the blood serum is 2.25-2.75 mmol / l or 4,45-5.5 mEq / L. Therapy with calcium gluconate is aimed at restoring the normal concentration of calcium in the blood plasma. Solutions containing calcium should be administered slowly in order to minimize peripheral vasodilation and inhibition of cardiac activity.
The drug is injected deeply intramuscularly, or intravenously slowly (within 2-3 minutes), or drip, to exclude the possibility of local irritation or necrosis in case of getting the drug into the perivascular tissue. Because of the risk of local irritation, intramuscular injections should be performed only if intravenous injection is not possible. Intramuscular injections must be done deep enough in the muscle, preferably in the gluteal region. For patients suffering from obesity, a longer needle should be chosen for safe insertion into the muscle, rather than in fatty tissue. If repeated injections are required, the injection site should be changed each time.
During treatment, the concentration of calcium in the serum should be carefully monitored.
Adults: deep intramuscularly, intravenously slowly (for 2-3 min) or drip 5-10 ml of 100 mg / ml (10% solution) daily, every other day or 2 days (depending on the nature of the disease and the clinical condition of the patient). The subsequent doses are determined in accordance with the concentration of calcium in the blood serum.
Children under 18 years: the dose and mode of administration depend on the degree of development of hypocalcemia, the nature and severity of the symptoms.
Children, depending on the age, the drug at a concentration of 100 mg / ml (10% solution) is administered in the following doses: up to 6 months 0.1-1 ml; 7-12 months - 1-1.5 ml; 1-3 years - 1,5-2 ml; 4-6 years old - 2-2.5 ml; 7-14 years old - 3.5 ml; over 14 years old -doses for both adults.
Children should not inject the drug intramuscularly because of the possible development of necrosis. It is recommended only slow intravenous injection or intravenous infusion, after dilution, in order to achieve sufficiently low rates of administration and to exclude the possibility of local irritation or necrosis in case of accidental ingestion of the drug into the perivascular tissue.
For intravenous infusion, the drug is diluted 1:10 to 10 mg / ml with the following infusion solutions: 0.9% sodium chloride solution or 5% glucose solution.The rate of intravenous administration should not exceed 50 mg of calcium gluconate per minute. Dilution should be carried out under aseptic conditions.
Elderly patients: data indicating an unfavorable tolerance of calcium gluconate to elderly patients are not available, however, age-related changes, such as renal dysfunction and metabolic slowdown, may require a dose reduction.