Calcium Jayson Injection
Calcium Gluconate
1gm/10ml
Jayson Pharmaceuticals Ltd.
| Pack size | 5 ml,10ml |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 10.00, 9.77 AED |
Indications
Calcium Jayson Injection is used for:
Acute symptomatic hypocalcemia, Hypocalcaemic tetany, Acute severe hyperkalemia, Hypoparathyroidism, Magnesium sulfate overdose
Adult Dose
Hypocalcemia
Treatment of conditions arising from calcium deficiency (eg, hypocalcemic tetany, hypoparathyroidism)
Mild (ionized calcium 1-1.2 mmol/L)
Management of non-life-threatening symptoms
IV: 1-2 g over 2 hours
Severe (ionized calcium <1 mmol/L)
Without seizure or tetany: 0.5 mg/kg/hr IV; may be increased to 2 mg/kg/hr; not to exceed 3-4 g IV over 4 hours
Hypocalcemic tetany: 100-300 mg elemental calcium (~3 g calcium gluconate) IV over 5-10 minutes, followed by continuous IV infusion at 0.5 mg/kg/hr (may be increased to 2 mg/kg/hr)
Monitor serum calcium q4-6hr to maintain serum calcium levels
Hyperkalemia
1.5-3 g IV infused over 2-5 minutes
Hypermagnesemia
1.5-3 g IV infused over 2-5 minutes
Child Dose
Hypocalcemia
Treatment of conditions arising from calcium deficiency (eg, hypocalcemic tetany, hypoparathyroidism)
Severe
Neonates: 200-800 mg/kg/day IV by continuous infusion or divided q6hr as intermittent infusions
Infants/children: 200-500 mg/kg/day IV by continuous infusion or divided q6hr as intermittent infusions
Hypocalcemic tetany
100-200 mg/kg IV over 10 minutes; may be repeated after 6 hours, or initiate continuous infusion not to exceed 500 mg/kg/day
Renal Dose
Renal impairment: Initiate with the lower limit of the dosage range and monitor serum calcium levels every 4 hours.
Administration
1 g calcium gluconate salt contains 93 mg elemental calcium
Injectable 10% solution 10% contains 100 mg/mL (ie, elemental calcium 0.465 mEq/ mL or 9.3 mg/mL)
IV Preparation
May be given diluted or undiluted
Solution may be diluted in NS, D5W (mix in up to 1000 mL), or 2/3-1/3
Store at room temperature
Do not mix in same bag or line with carbonates, phosphates, sulfates, and tartrates, because of precipitation
IV Administration
May administer IV push at rate of 50-100 mg/min (0.5-1 mL/min); rapid IV administration may produce arrhythmias, hypotension, myocardial infarction, or vasodilation
For intermittent IV infusion, maximum rate is 200 mg/min (2 mL/min)
Contra Indications
Patients with calcium renal calculi or history of renal calculi.
Conditions associated with hypercalcemia and hypercalciuria.
Neonates (28 days of age or younger) receiving ceftriaxone
Precautions
Arrhythmias with Concomitant Cardiac Glycoside Use: If concomitant therapy is necessary, Calcium Gluconate in Sodium Chloride Injection should be given slowly in small amounts and close ECG monitoring is recommended.
End-Organ Damage due to Intravascular Ceftriaxone-Calcium Precipitates: Concurrent use of intravenous ceftriaxone may cause life-threatening precipitates. Do not administer ceftriaxone simultaneously with Calcium Gluconate in Sodium Chloride via a Y-site in any age group. Cases of fatal outcomes in neonates have occurred.
Tissue Necrosis and Calcinosis: Calcinosis cutis can occur with or without extravasation of Calcium Gluconate in Sodium Chloride Injection. Tissue necrosis, ulceration, and secondary infection are the most serious complications. If extravasation occurs or clinical manifestations of calcinosis cutis are noted, immediately discontinue intravenous administration at that site and treat as needed.
Hypotension, Bradycardia, and Cardiac Arrhythmias with Rapid Administration: To avoid adverse reactions that may follow rapid intravenous administration, Calcium Gluconate in Sodium Chloride Injection should be infused slowly, with careful ECG monitoring for cardiac arrhythmias.
Aluminum Toxicity: This product contains aluminum, up to 100 mcg per liter, that may be toxic.
MONITORING REQUIREMENTS
With intravenous use, Plasma-calcium and ECG monitoring are required for administration by slow intravenous injection (risk of arrhythmias if given too rapidly).
Pregnancy-Lactation
Pregnancy
Risk summary
Limited available data with Calcium Gluconate Injection use in pregnant women are insufficient to inform a drug associated risk of adverse developmental outcomes. There are risks to the mother and the fetus associated with hypocalcemia in pregnancy.
Clinical Considerations
Disease-associated maternal risk
Maternal hypocalcemia can result in an increased rate of spontaneous abortion, premature and dysfunctional labor, and possibly preeclampsia.
Fetal/Neonatal adverse reactions
Infants born to mothers with hypocalcemia can have associated fetal and neonatal hyperparathyroidism, which in turn can cause fetal and neonatal skeletal demineralization, subperiosteal bone resorption, osteitis fibrosa cystica and neonatal seizures. Infants born to mothers with hypocalcemia should be
carefully monitored for signs of hypocalcemia or hypercalcemia, including neuromuscular irritability, apnea, cyanosis and cardiac rhythm disorders.
Lactation
Risk summary
Calcium is present in human milk as a natural component of human milk. It is not known whether intravenous administration of Calcium Gluconate in Sodium Chloride Injection can alter calcium concentration in human milk. There are no data on the effects of Calcium Gluconate Injection on the breastfed infant, or on milk production.
The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Calcium Gluconate in Sodium Chloride Injection and any potential adverse effects on the breastfed child from Calcium Gluconate in Sodium Chloride Injection or from the underlying maternal condition.
Interactions
Cardiac Glycoside: Synergistic arrhythmias may occur if calcium and cardiac glycosides are administered together.
Calcium Channel Blockers: Administration of calcium may reduce the response.
Drugs that may cause hypercalcemia: Vitamin D, vitamin A, thiazide diuretics, estrogen, calcipotriene and teriparatide administration may cause hypercalcemia.
Monitor plasma calcium concentrations in patients taking these drugs concurrently.
Calcium Gluconate: Co-admin of high calcium doses with thiazide diuretics may result in milk-alkali syndrome and hypercalcemia.
May potentiate digoxin toxicity.
Enhanced absorption with calcitriol (a vitamin D metabolite).
Contraindicated (1)
ceftriaxone
Serious (7)
baloxavir marboxil
demeclocycline
doxycycline
eltrombopag
minocycline
oxytetracycline
tetracycline
Adverse Effects
Side effects of Calcium Gluconate :
Bradycardia,Hypotension,Headache,Constipation,Diarrhea,Flatulence,Nausea,Vomiting,Hypomagnesemia,Hypophosphatemia,Extravasation necrosis
Hypercalcaemia characterised by anorexia, nausea, vomiting, constipation, abdominal pain, muscle weakness, mental disturbances, polydipsia, polyuria, nephrocalcinosis, renal calculi; chalky taste, hot flushes and peripheral vasodilation.
Potentially Fatal: Cardiac arrhythmias and coma.
Mechanism of Action
Calcium gluconate/lactate is used to prevent or treat negative calcium balance. It also helps facilitate nerve and muscle performance as well as normal cardiac function. Bone mineral component; cofoactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways.
Note
Calcium Jayson 1gm/10ml Injection manufactured by Jayson Pharmaceuticals Ltd.. Its generic name is Calcium Gluconate. Calcium Jayson is availble in Bangladesh.
Farmaco BD drug index information on Calcium Jayson Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.