Gultate

Indications

Calcium Gluconate is a form of calcium. As an injection it is used in hospital for a sudden drop in blood calcium (which can cause muscle spasms, cramps and tingling), to protect the heart when blood potassium is dangerously high, and to treat an overdose of magnesium or of calcium channel blockers. As tablets or effervescent tablets it is used to prevent or treat calcium deficiency, for example in pregnancy, breastfeeding, growth, older age or osteoporosis.

How It Works

Calcium is needed for strong bones and teeth and for normal working of nerves, muscles and the heart. Calcium Gluconate replaces calcium in the blood. In high potassium it steadies the heart muscle while other treatments lower the potassium.

Dosage and Administration

• Injection: as prescribed. It is given slowly into a vein by a doctor or nurse, with heart monitoring when needed. It must never be injected into a muscle or under the skin.
• Tablets or effervescent tablets, adults: the dose depends on the strength and on calcium from the diet. Follow the doctor's advice or the label; effervescent tablets should be fully dissolved in a glass of water before drinking.
• Children: as prescribed.

Interactions

• Digoxin: calcium given into a vein can cause dangerous heart rhythms in people taking Digoxin; it is used only with great care.
• Ceftriaxone: must not be mixed or given through the same line, because a solid deposit can form; in newborns the two should not be given together.
• Oral calcium reduces the absorption of Tetracycline, Doxycycline, Ciprofloxacin and other quinolones, Levothyroxine, iron and bisphosphonates such as Alendronate; take these at least 2 hours apart (4 hours for Levothyroxine).
• Thiazide diuretics such as Hydrochlorothiazide and high doses of vitamin D can raise blood calcium.

Contraindications

• High blood calcium or high calcium in the urine.
• Calcium-containing kidney stones (for supplements, unless the doctor advises).
• Injection: in newborns receiving Ceftriaxone, and in people with certain heart rhythm problems or digitalis toxicity.
• Allergy to any ingredient.

Side Effects

Injection: a feeling of warmth, tingling, a chalky taste, flushing, low blood pressure or a slow heartbeat if given too fast, and irritation at the injection site. Tablets: constipation, wind, bloating and stomach upset.

Get urgent medical help for: an irregular or very slow heartbeat, chest pain or fainting; pain, swelling, redness or blistering where the injection was given (leakage can damage tissue); or signs of high calcium such as severe thirst, frequent urination, vomiting, confusion or extreme tiredness.

Pregnancy and Lactation

Calcium is safe and often recommended in pregnancy and breastfeeding at normal doses. The injection is used in pregnancy when needed under medical care.

Precautions and Warnings

• Tell the doctor about kidney disease, kidney stones, heart disease, sarcoidosis, or use of Digoxin.
• Long-term high doses need blood and urine calcium checks.
• Do not take more than the recommended amount of supplements; total calcium from diet and tablets matters.

Overdose

Too much calcium can cause nausea, vomiting, constipation, thirst, confusion, weakness and heart rhythm problems. Stop the supplement and seek medical help; after an injection overdose the medical team will monitor the heart and blood calcium.

Therapeutic Class

Calcium salt (mineral supplement and electrolyte replacement).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Do not refrigerate or freeze the injection. Keep effervescent tablets tightly closed in their tube.