Normally, the calcium concentration in the plasma is in the range of 2.25-2.75 mmol / l or 4.5-5.5 meq / l. Treatment should be aimed at restoring this level. During treatment, the concentration of calcium in the serum should be carefully monitored.
Recommended doses
Adults
The initial dose for adults is usually 10 ml of calcium gluconate B. Brown, which corresponds to 2.26 mmol or 4.52 meq of calcium. Depending on the clinical condition of the patient, you can re-enter the drug. The subsequent doses are determined in accordance with the concentration of calcium in the blood serum.
Children under 18 years of age
The dose and mode of administration depend on the degree of development of hypocalcemia, the nature and severity of the symptoms. With mild neuromuscular symptoms, calcium should be given orally.
The table shows the recommended initial dose values:
| Age | Body weight (kg) | ml | Equivalent to mmol (meq) of calcium |
| 3 months | 5,5 | 2-5 | 0,45-1,13 (0,9-2,26) |
| 6 months | 7,5 | 2-5 | 0,45-1,13 (0,9-2,26) |
| 1 year | 10 | 2-5 | 0,45-1,13 (0,9-2,26) |
| 3 years | 14 | 5-10 | 1,13-2,26 (2,26-4,52) |
| 7,5 years | 24 | 5-10 | 1,13-2,26 (2,26-4,52) |
| 12 years | 38 | 5-10 | 1,13-2,26 (2,26-4,52) |
| > 12 years | >38 | | as for adults |
This corresponds approximately to:
- 0.4-1 ml / kg body weight (corresponding to 0.09-0.23 mmol [0.18-0.45 meq] of calcium per kg of body weight) for children under 3 years;
- 0.2-0.5 ml / kg body weight (corresponding to 0.05-0.1 mmol [0.1-0.2 meq] of calcium per kg of body weight) for children from 4 to 12 years old.
For patients over the age of 12 years applicable doses for adults.
In cases of severe hypocalcemia, for example, symptoms of the cardiovascular system, higher initial doses (up to 2 ml / kg body weight, corresponding to 0.45 mmol [0, 9 meq] calcium / kg body weight).
Also, depending on the clinical condition of the patient, the drug can be re-introduced. The subsequent doses are determined in accordance with the concentration of calcium in the blood serum.
If necessary, for example, with a lack of calciferol, oral administration of calcium should be performed after intravenous administration.
Elderly patients
Although there is no evidence that the tolerability of calcium gluconate is directly affected by the elderly, nevertheless the age-specific features that are associated with aging,such as renal dysfunction and metabolic slowdown, can indirectly affect tolerability and may require a dose reduction.
Slow intravenous or deep intramuscular injection.
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 the event of accidental ingestion of the drug into the perivascular tissue. For intravenous infusion Calcium gluconate B. Brown can be diluted 1:10 to 10 mg / ml with the following infusion solutions: 0.9% sodium chloride solution or 5% glucose solution.
Children should not inject the drug intramuscularly.
The rate of intravenous administration should not exceed 50 mg calcium gluconate / min. The patient should be in a prone position and under close monitoring during the injection. Monitoring should include heart rate or ECG.
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.