Calcium chloride - instructions for use, dose, side effects, contraindications

Concentration in plasma is 4.25-5.2 meq / l, 50% of which are ionized, 40% in connections with plasma proteins, and 10% in the form of complex compounds. Forms the mineral basis of bone (hydroxyapatite), participates in intracellular information transfer, blood clotting, muscle contraction.

Pharmacokinetics:

Absorption (20-66%) of the orally administered drug depends on the presence of vitamin D, pH, dietary characteristics and the presence of factors that can bind Ca²⁺; increases with a deficiency of Ca²⁺, a diet with a reduced content of Ca²⁺. Connection with plasma proteins - 45%. Elimination by the kidneys (20%) and through the intestine (80%).

Indications:

As an additional remedy for the treatment of allergic diseases (including serum sickness, hives, angioedema, hay fever) and allergic reactions to medications. As an additional haemostatic agent for pulmonary, gastrointestinal, nasal, uterine bleeding. As an antidote for poisoning with magnesium salts, oxalic acid and its soluble salts, as well as soluble salts of fluoric acid.

ICD-10

X.J30-J39.J30.1 Allergic rhinitis caused by pollen of plants

X.J30-J39.J30.3 Other allergic rhinitis

XII.L50-L54.L50 Hives

XV.O60-O75.O62.2 Other types of weakness in labor

XVIII.R50-R69.R58 Bleeding, not elsewhere classified

XIX.T51-T65.T56 Toxicity of metals

XIX.T66-T78.T66 Unspecified radiation effects

XIX.T66-T78.T78.3 Angioedema

XIX.T66-T78.T78.4 Allergy, unspecified

XIX.T80-T88.T80.6 Other serum reactions

Contraindications:

Hypersensitivity, hypercalcemia, atherosclerosis, propensity to thrombosis, chronic renal failure, arrhythmias, urolithiasis, sarcoidosis, pregnancy, lactation.

Carefully:

Hypercalciuria, hypoparathyroidism, renal dysfunction, glycoside intoxication, dehydration, electrolyte imbalance, diarrhea, malabsorption syndrome, achlorhydria, hypochlorhydria, cardiac dysfunction.

Pregnancy and lactation:

Contraindicated. Controlled studies in humans and animals have not been conducted. If necessary, use the drug during lactation breastfeeding is recommended to stop. There is no information on the penetration into breast milk.

FDA recommendation category C.

Dosing and Administration:

When administered intravenously, a single dose is 0.5-1 mg. When administered orally, a single dose of 0.25-1.5 g. Frequency and duration of use depend on the indications and the clinical situation.

Intravenously slowly (for 6-8 drops per minute) for 5-15 ml of 10% solution, diluting before adding 100-200 ml of 0.9% solution of sodium chloride or 5% solution of dextrose.

Inside after eating as a 5-10% solution 2-3 times a day. Adults 10-15 ml per reception.

Side effects:

Bradycardia; with rapid introduction - ventricular fibrillation; with intravenous administration - a feeling of heat in the mouth, and then in the whole body.Reduced blood pressure, nausea or vomiting, redness of the skin, rashes, pain or burning at the injection site, sweating, tingling.

Hypercalcemic syndrome (prolonged nausea and vomiting, weakness), nephrolithiasis.

When ingestion of heartburn, pain in the abdomen.

Overdose:

Early signs of hypercalcemia: constipation, dry mouth, prolonged headache, thirst, irritability, loss of appetite, depression, metallic taste in the mouth, fatigue or weakness.

Late signs of hypercalcemia: confusion, drowsiness, high blood pressure, photophobia and photosensitivity, arrhythmias, nausea and vomiting, polyuria.

Treatment: intravenous administration of bisphosphonates (60-90 mg of pamidronic acid for 4-24 hours), glucocorticoids 40-80 mg per day, calcitonin at 4 mg / kg every 12 hours (maximum 8 mg / kg every 12 hours, with ineffectiveness for 2 weeks to 8 mg / kg every 6 hours), sodium phosphate, hemodialysis, forced diuresis.

Interaction:

Alcohol, caffeine (more than 8 cups of coffee per day) - reduced absorption of calcium.

Antacids containing albumin - an increase in the absorption of albumin.

Calcium channel blockers - co-administration can reduce the pharmacological effects of calcium channel blockers of all types.

Gallium nitrate is a decrease in the effects of gallium nitrate.

Glycosides of digitalis (digoxin and others) - increased risk of arrhythmias, ECG monitoring is required.

Calcitonin - calcium intake reduces the anti-hypercalcemic effect of calcitonin, but in the treatment of osteoporosis and Paget's disease, additional calcium administration is necessary to prevent hypocalcemia.

Cellulose, sodium fluoride - reduction of calcium absorption due to the formation of insoluble complex compounds.

Kolekaltsiferol - an increase in calcium absorption, the risk of overdose.

Milk or dairy products, sodium hydrogen carbonate - prolonged use of calcium supplements can lead to alkalosis.

Nondepolarizing muscle relaxants - a weakening of the myorelaxing effect.

Preparations containing magnesium, other preparations containing calcium - the risk of hypermagnesia or hypercalcemia (especially in the background of chronic kidney failure).

Magnesium preparations - reduction or elimination of effects of magnesium preparations.

Retinol - chronic overdose of vitamin A can lead to a decrease in ossification and reduce the effects of calcium supplements.

Thiazide diuretics - decreased calcium excretion, risk of hypercalcemia.

Phenytoin, tetracyclines - decreased absorption of phenytoin and calcium.

Estrogens, estrogen-containing contraceptives - increased absorption of calcium.

Ethidronic acid - a decrease in the absorption of etidronic acid.

Special instructions:

Solution for parenteral administration should be administered intravenously! Do not administer subcutaneously and intramuscularly. When calcium chloride enters the skin or muscle tissue develops a strong irritation with the formation of foci of necrosis.

Instructions

Calcium chloride (Calcii chloridum)