Liquid Calcium Chloride Sds

Calcium Chloride is a mineral indicated in the immediate treatment of hypocalcemic tetany (abnormally low levels of calcium in the body that cause muscle spasm). Calcium chloride injection is also used in cardiac resuscitation, arrhythmias, hypermagnesemia, calcium channel blocker overdose, and beta-blocker overdose.

Calcium Chloride is available under the following different brand or other names: CaCl and CaCl2.

Dosage Forms and Strengths

Injectable solution

• 100mg/mL

Dosage Considerations – Should be Given as Follows:

Hypocalcemia, Emergency Treatment

• Adults: 500-1000 mg intravenously (IV) over 5-10 minutes; may repeat as necessary
• Infants: less than 75 mg (20 mg elemental Ca) IV; may repeat as necessary
• Children: 75-519 mg (20-140 mg elemental Ca) IV, may repeat as necessary

Arrhythmias, Emergent

• Indicated for arrhythmias associated with hypocalcemia, hyperkalemia, or hypermagnesemia
• 500-1000 mg intravenously (IV) over 5-10 minutes

Hypermagnesemia

• 500-1000 mg intravenously (IV) over 2-5 minutes; observe the patient for signs of recovery; may repeat if CNS depression persists

Calcium Channel Blocker Overdose

• 1-2 g intravenously (IV) infused over 10-20 min; may repeat every 20 minutes prn up to 5 doses

Beta-blocker Overdose, Refractory to Glucagon and High Dose Vasopressor

• 1000 mg intravenous (IV) bolus via central line

Hypocalcemic Tetany, Pediatric

• Neonates: 171 mg/kg/day intravenously (IV) in divided doses
• Infants and Children: 10 mg/kg intravenously (IV) over 5-10 min three to four times daily; alternatively, may administer 35-50 mg/kg IV three to four times daily

Other Indications and Uses

• Medullary thyroid cancer diagnosis

Other Information

• 1 g (10 mL) vials of calcium chloride 10% solution contain 273 mg (13.6 mEq) elemental calcium
• Pediatric: (Not recommended) Cardiac Arrest: 20 mg/kg intravenous (IV) push every 10 minutes as necessary

• WHAT ARE SIDE EFFECTS ASSOCIATED WITH USING CALCIUM CHLORIDE?

  Side effects of Calcium Chloride include:

  • Redness
  • Low blood magnesium (hypomagnesemia)
  • Low blood phosphates (hypophosphatemia)
  • Low blood pressure (hypotension)
  • High blood calcium (hypercalcemia)
  • Nausea
  • Tissue necrosis at injection site
  • Vasodilation
  • Weakness
  • Kidney stones
  • Hot flashes
  • Serum amylase increased
  • Tingling sensations
  • Injection site reactions (tingling, burning sensation, inflammation of the veins [phlebitis])
  • Fainting

  Side effects of calcium chloride rapid administration include:

  • Irregular heartbeat (arrhythmia)
  • Slow heart rate
  • Calcium taste
  • Sense of heat waves
  • Ventricular fibrillation

  This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

  WHAT OTHER DRUGS INTERACT WITH CALCIUM CHLORIDE?

  If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

  Severe interactions of Calcium Chloride include:

  • ceftriaxone

  Serious interactions of Calcium Chloride include:

  • demeclocycline
  • dolutegravir
  • doxycycline
  • eltrombopag
  • lymecycline
  • minocycline
  • oxytetracycline
  • tetracycline

  Calcium Chloride has moderate interactions with at least 48 different drugs.

  Calcium Chloride has mild interactions with at least 52 different drugs.

  This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

  WHAT ARE WARNINGS AND PRECAUTIONS FOR CALCIUM CHLORIDE?

  Warnings

  • • This medication contains calcium chloride. Do not take CaCl or CaCl2 if you are allergic to calcium chloride or any ingredients contained in this drug.
    • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

  Contraindications

  • • • VFib during CPR, hypercalcemia, risk for digitalis toxicity, hypophosphatemia, renal calculi
      • Intramuscular (IM) or subcutaneous (SC) administration
      • Pulseless ventricular tachycardia

  Effects of Drug Abuse

  • • • No information available

  Short-Term Effects

  • • • See “What Are Side Effects Associated with Using Calcium Chloride?”

  Long-Term Effects

  • • • See “What Are Side Effects Associated with Using Calcium Chloride?”

  Cautions

  • • • Hepatic impairment, sarcoidosis, cardiovascular disease, renal disease, acidosis, cor pulmonale, or digitalized patients.
      • Not recommended in treatment of asystole and electromechanical dissociation.
      • PALS no longer recommends Ca for pediatric cardiac arrest.
      • Life-threatening cardiac arrhythmias may occur in severe hypokalemia.

  Pregnancy and Lactation

  • • Use calcium chloride with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.
    • As a component of human milk calcium enters milk. Use caution if breastfeeding.
    • WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
      • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
      • Dizziness or passing out.
      • Mood changes.
      • Change in how much urine is passed.
      • A heartbeat that does not feel normal.
      • Back pain, belly pain, or blood in the urine. May be signs of a kidney stone.
      • This drug may cause tissue damage if the drug leaks from the vein. Tell your nurse if you have any redness, burning, pain, swelling, blisters, skin sores, or leaking of fluid where the drug is going into your body.
        

      What are some other side effects of this drug?

      All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

      • Bad taste in your mouth.
      • Hot flashes.
      • Not hungry.
      • Upset stomach or throwing up.
      • Constipation.
      • Feeling tired or weak.
      • More thirst.
      • Bone pain.

      These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

      You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

      Managing side effects (general information)

      For Healthcare Professionals

      Applies to calcium chloride: compounding powder, injectable solution, intravenous solution

      Other

      Rapid injection may cause tingling sensations, calcium taste, sense of oppression and “heat wave”.

      Precipitations of ceftriaxone-calcium salt, including fatalities, have been seen in newborns under 28 days old, both pre-term and full term, treated with intravenous ceftriaxone and calcium. The precipitates were found in lungs and kidneys. Newborns have a low blood volume and ceftriaxone has a longer half-life in them, leading to a high precipitation risk.^[Ref]

      Frequency not reported: Tingling sensations, calcium taste, sense of oppression, “heat wave, soft tissue calcification, precipitations of ceftriaxone-calcium salt^[Ref]

      Cardiovascular

      Frequency not reported: Peripheral vasodilatation, moderate fall in blood pressure, hypertension, venous thrombosis, flushing, bradycardia, arrhythmias^[Ref]

      Nervous system

      Frequency not reported: Drowsiness, tingling sensation, calcium taste^[Ref]

      Local

      Frequency not reported: Local burning sensation, venous irritation, necrosis^[Ref]

      Dermatologic

      Frequency not reported: Sloughing, sweating^[Ref]

      Renal

      Frequency not reported: Nephrocalcinosis^[Ref]

      Musculoskeletal

      Frequency not reported: Muscle weakness, bone pain^[Ref]

      Metabolic

      Frequency not reported: Anorexia, polydipsia^[Ref]

      Psychiatric

      Frequency not reported: Mental disturbances^[Ref]

      Genitourinary

      Frequency not reported: Polyuria^[Ref]

      Gastrointestinal

      Frequency not reported: Vomiting, constipation, abdominal pain, nausea, mild gastrointestinal disturbances and irritation^[Ref]

      USES: This medication is used to prevent or treat low blood calcium levels in people who do not get enough calcium from their diets. It may be used to treat conditions caused by low calcium levels such as bone loss (osteoporosis), weak bones (osteomalacia/rickets), decreased activity of the parathyroid gland (hypoparathyroidism), and a certain muscle disease (latent tetany). It may also be used in certain patients to make sure they are getting enough calcium (e.g., women who are pregnant, nursing, or postmenopausal, people taking certain medications such as phenytoin, phenobarbital, or prednisone).Calcium plays a very important role in the body. It is necessary for normal functioning of nerves, cells, muscle, and bone. If there is not enough calcium in the blood, then the body will take calcium from bones, thereby weakening bones. Having the right amount of calcium is important for building and keeping strong bones.

      HOW TO USE: Take this medication by mouth with food. If your product contains calcium citrate, then it may be taken with or without food. Follow all directions on the product package, or take as directed by your doctor. For best absorption, if your daily dose is more than 600 milligrams, then divide your dose and space it throughout the day. If you are uncertain about any of the information, consult your doctor or pharmacist.If you are using the chewable product, chew it well before swallowing.If you are using the effervescent tablet, allow the tablet to fully dissolve in a glass of water before drinking it. Do not chew or swallow the tablet whole.If you are using the liquid product or powder, measure the medication with a dose-measuring spoon or device to make sure you get the correct dose. Do not use a household spoon. If the liquid product is a suspension, shake the bottle well before each dose.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.If your doctor has recommended that you follow a special diet, it is very important to follow the diet to get the most benefit from this medication and to prevent serious side effects. Do not take other supplements/vitamins unless ordered by your doctor.If you think you may have a serious medical problem, seek immediate medical attention.

      SIDE EFFECTS: Constipation and upset stomach may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but serious side effects occur: nausea/vomiting, loss of appetite, unusual weight loss, mental/mood changes, bone/muscle pain, headache, increased thirst/urination, weakness, unusual tiredness.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.