- Calcium replacement during CRRT with citrate-based anticoagulation
- NOT to be used for calcium replacements in other clinical situations (please see calcium gluconate for further management outside of CRRT)
- Supplied as 50 mL vials of 100 mg/mL (10%, 0.68 mmol/mL, 1.36 mEq/mL of calcium ions)
- Store vials in original carton at room temperature (15 - 30°C), do not freeze
- Diluted solution stable for 24 hours at room temperature
Available Form:
- Premixed BAG of calcium chloride 8 mg/mL (0.8%)
Available from Pharmacy
Administer via LARGE VOLUME PUMP for calcium replacement during CRRT using citrate anticoagulation
- Solutions compatible: 0.9% Sodium Chloride, D5W, lactated ringers
- Additives/Above Cassette Compatible: Unknown
- Y-Site compatibility: dopamine, dexmedetomidine, epinephrine, fentanyl, furosemide, hydromorphone, midazolam, morphine, nitroprusside, norepinephrine, heparin
- Incompatible: phosphate salts, TPN (calcium chloride has a higher likelihood of precipitation than calcium gluconate), ceftriaxone, pantoprazole
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
SC | NO |
IM | NO |
IV Direct | NO |
IV Intermittent Infusion | NO |
IV Continuous Infusion |
YES - LARGE VOLUME PUMP Usual dilution: 8 mg/mL Infusion rate: do not exceed 100 mg/minute or 45 to 90 mg/kg/hour (0.6 to 1.2 mEq/kg/hour) |
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
- CRRT blood flow rate (BFR, mL/HOUR) x 0.6 = ______ mL/h (Max 1.5 x BFR in mL/min)
- Administer via central line, if possible, due to risk of severe necrosis secondary to extravasation.
- Do not infuse calcium chloride in the same IV line as phosphate-containing solutions.
- Rapid IV administration can result in cardiotoxicity (bradycardia, dysrhythmias), hypotension, local thrombophlebitis, tingling sensation, calcium taste, flushing, nausea, vomiting, sweating, dizziness, confusion.
- Calcium chloride is a vesicant and will cause irritation on extravasation resulting in tissue necrosis and sloughing. If extravasation occurs, see Treatment of Infiltrated Vesicant or Irritant Drugs Guidelines on CHEOnet.
- SC, IM routes are NOT recommended due to possibility of severe sloughing, necrosis, abscess formation.
- Avoid administration via scalp veins or small hand or foot veins.
- Calcium chloride and calcium gluconate are not the same concentration of calcium and should not be used interchangeably. Specifically, 1 g of calcium chloride contains 14 mEq (270 mg) of elemental calcium, while 1 g of calcium gluconate contains 4.65 mEq (93 mg) of elemental calcium.
- Use with caution in patients with severe hyperphosphatemia – may result in calcium-phosphate precipitation in soft tissues and pulmonary arteries.
- Use with caution in patients with hypokalemia – acute rise in serum calcium can result in cardiac arrhythmias.
- Calciject Monograph, Omega Laboratories Limited
- Calciject (Calcium Chloride), LexiComp