Calcium gluconate: what is it and what is it for?
This drug is a dietary supplement that compensates for the lack of calcium in the body. This macronutrient performs a number of important functions:
- promotes the transmission of nerve impulses;
- ensures normal muscle function, and, in particular, the heart muscle;
- part of bones and teeth;
- participates in the process of blood clotting.
Calcium deficiency in the body can lead to a condition such as tetany.
In addition, due to the effect of calcium, such as reducing the permeability of the vascular wall, this drug has an anti-inflammatory and antiallergic effect.
Interaction
A drug:
- slows down the absorption of etidronate , estramustine , bisphosphonates , tetracycline antibiotics , quinolones , fluoride and iron preparations for oral administration (an interval of at least 3 hours should be maintained between their doses).
- reduces the bioavailability of phenytoin ;
- enhances the cardiotoxicity of cardiac glycosides ;
- in patients with hypercalcemia , it reduces the effectiveness of calcitonin ;
- reduces the effects of calcium channel blockers;
- increases the toxicity of quinidine .
In combination with quinidine, it provokes a slowdown in intraventricular conduction; in combination with thiazide diuretics hypercalcemia increases . Vitamin D and its derivatives help increase calcium absorption. Cholestyramine reduces Ca absorption in the gastrointestinal tract.
Forms insoluble or slightly soluble Ca salts with salicylates, carbonates, and sulfates.
Certain foods (for example, rhubarb, bran, spinach, cereals) can reduce the absorption of Ca from the digestive tract.
Not compatible with the solution:
- carbonates;
- sulfates;
- salicylates;
- ethanol.
When is the drug prescribed?
Experts recommend using this drug for:
- osteoporosis;
- rickets and osteomalacia - conditions in which vitamin D metabolism is impaired;
- increased levels of phosphates in the blood in patients with renal failure;
- presence of high calcium needs: during pregnancy and lactation;
- poor diet;
- bone fractures;
- postmenopausal calcium deficiency;
- chronic diarrhea.
In addition, the drug as a component of complex therapy is used in dermatovenerology for the treatment of itchy dermatoses, urticaria, and angioedema. It is also used for the treatment of bleeding of various etiologies and nutritional dystrophy.
Compound
One tablet may contain 250 or 500 mg of active substance.
Auxiliary components: potato starch, anhydrous silicon dioxide in colloidal form, calcium stearate.
The concentration of the active substance in 1 ml of solution is 95.5 mg. 1 ml of the drug contains 8.95 mg of total calcium (Ca2+), which in terms of the theoretical content of calcium gluconate is 100 mg/ml. The solution contains calcium sucrose and water as auxiliary components.
What does a calcium gluconate injection do?
Calcium gluconate injections are best known as an adjuvant treatment for allergic diseases. However, they are also used to treat pathology of the parathyroid gland, in which there is an increased excretion of calcium from the body.
In addition, injections are also prescribed for conditions such as:
- eclampsia;
- nephritis;
- hyperkalemia;
- liver intoxication.
Injections of calcium gluconate help reduce the intensity of itching in atopic dermatitis, psoriasis and eczematous rashes.
special instructions
Due to the possibility of developing necrosis, calcium gluconate should be administered exclusively intravenously to children under 14 years of age.
Before filling the syringe, ensure that there is no residual alcohol in it (a sediment may form).
Treatment of patients with of urolithiasis , reduced glomerular filtration rate or mild hypercalciuria should be carried out under the control of Ca2+ levels in the urine. To reduce the risk of developing urolithiasis, it is recommended to drink enough fluids.
“Pharaoh's snake” from calcium gluconate
Calcium gluconate tablets are often used by enthusiastic chemists to produce “pharaoh’s snake,” a porous product that is formed from a small amount of reacting substances.
The tablet is placed on dry fuel, and then the fuel is set on fire. A light gray “snake” with white spots begins to crawl out of the tablet. Moreover, the volume of the “pharaoh snake” significantly exceeds the volume of the original substance: for example, in some experiments, snakes 10-15 cm long were obtained from 1 tablet.
During the decomposition of calcium gluconate, Ca oxide, carbon dioxide, carbon and water are formed. The characteristic shade of the resulting snake is given by Ca oxide. The only drawback of such a “pharaoh snake” is its fragility; it crumbles very easily.
Using the drug for allergies
If allergic reactions occur, calcium gluconate is a safe and effective remedy, the use of which practically cannot lead to an overdose. When the drug enters the body, the permeability of the vascular wall decreases and the allergen practically does not penetrate into the bloodstream. Thus, the development of an allergic reaction is inhibited. Calcium gluconate can be taken for preventive purposes.
The duration of the course depends on the characteristics of the disease. Calcium gluconate is prescribed by specialists together with antihistamines.
Analogs
Level 4 ATC code matches:
Calcium Sandoz Forte
Calcium glycerophosphate
Calcium gluconate-Vial , LekT , B. Brown ; Additive calcium , Hydroxyapatite , Glycerophosphate granules , Calcium lactate , CalViv , Calcium pangamate , Calcium-Sandoz .
How to give calcium gluconate to children
The drug can be given to children from the first year of life if indicated. At the age of up to 12 months, the optimal daily dose is 3 tablets. Children 1-4 years old are recommended to take 6 tablets per day. Children under 9 years of age can take from 6 to 12 tablets per day, depending on the doctor’s recommendations. Adolescents under 14 years of age can take 12-18 tablets per day.
The daily dose of the drug is divided into 2-4 doses.
Calcium gluconate in the form of a solution is used to treat children of any age as an emergency treatment for severe allergic reactions and the development of bleeding.
Calcium gluconate
Calcium gluconate
(English
calcium gluconate,
lat.
calcii gluconas
) is a calcium salt of gluconic acid, used in medicine for calcium deficiency in the body.
Calcium gluconate is a chemical substance
The gross formula of calcium gluconate is C12H22CaO14. The systematic name is calcium (2 R
,3
S
,4
R
,5
R
)-2,3,4,5,6-pentahydroxyhexanoate. White granular or crystalline powder, odorless and tasteless. Calcium gluconate dissolves quite slowly in cold water, and quickly in boiling water. Practically insoluble in ethanol and ether. Molecular weight 430.373 g/mol. The calcium content in calcium gluconate is 8.9% (which is less than in most other calcium salts used in medicine). In pharmaceuticals, it is often used in the form of calcium gluconate monohydrate, when a water molecule is attached to a calcium gluconate molecule: C12H22CaO14·H2O or the “text” version: (HOCH2(CHOH)4COO)2Ca·H2O.
Calcium gluconate is the international nonproprietary name of the drug
Calcium gluconate is the international nonproprietary name (INN) of the drug. According to the pharmacological index, calcium gluconate is included in the group “Macro- and microelements”. In ATC, calcium gluconate is included in the following sections:
- "A. Drugs affecting the digestive tract and metabolism”, subsection “A12 Mineral Supplements”, group “A12AA Calcium Preparations” and has code A12AA03
- "D. Preparations for the treatment of skin diseases", subsection "D11 Other drugs for the treatment of skin diseases", group "D11AX Other drugs for the treatment of skin diseases" and has the code D11AX03
See also the article “ Calcium as medicine
”.
Indications for use of calcium gluconate
Calcium gluconate is indicated for:
- diseases accompanied by calcium deficiency, increased permeability of cell membranes, disruption of nerve impulses in muscle tissue
- hypoparathyroidism (latent tetany, osteoporosis)
- disorders of vitamin D metabolism: rickets (spasmophilia, osteomalacia), hyperphosphatemia in patients with chronic renal failure.
- conditions that increase the need for calcium: pregnancy, breastfeeding, increased body growth
- insufficient calcium content in food, calcium metabolism disorders (in the postmenopausal period)
- acute inflammatory processes in the oral cavity, accompanied by swelling, the postoperative period (to reduce swelling), remineralizing therapy for the prevention and treatment of caries and non-carious tooth lesions
- increased excretion of calcium during prolonged bed rest, chronic diarrhea, secondary hypocalcemia during prolonged use of diuretics and antiepileptic drugs, glucocorticosteroids
- poisoning with magnesium salts, oxalic and fluoric acids and their soluble salts (when interacting with calcium gluconate, insoluble and non-toxic calcium oxalate and calcium fluoride are formed)
- hypercalcemic form of paroxysmal myoplegia
How to take calcium gluconate
Calcium gluconate is taken:
- The tablets are crushed before taking; taken orally before meals 2-3 times a day in the following dosage:
- adults - 1–3 g or more
- children 10–14 years old – 2–3 years
- children 7–9 years old – 1.5–2 g
- children 5–6 years old – 1–1.5 g
- children 3–4 years old - 1 g
- adults and children over 9 years old - 9 g
- children 7–9 years old – 6 g
- children 5–6 years old - 4.5 g
- 3–4 years – 3 g
- adults intramuscularly or intravenously, administer 5–10 ml of 10% calcium gluconate solution daily, every other day or two days, depending on the indications
- children intravenously, slowly from 1 to 5 ml of 10% calcium gluconate solution every 2-3 days, depending on age.
Side effects when treated with calcium gluconate
Calcium gluconate therapy may be accompanied by the following side effects:
- constipation (when taken orally)
- irritation of the mucous membrane of the gastrointestinal tract (when taken orally)
- nausea, vomiting, diarrhea, bradycardia (with intramuscular or intravenous administration)
- heat or burning in the mouth and throughout the body (with intravenous administration)
- hypercalcemia
Features of calcium gluconate therapy for pregnant and lactating women
Calcium is transported across the human placenta.
Fetal calcium accumulation occurs primarily during the third trimester. By the end of a normal pregnancy, the fetus gains approximately 28 g of calcium and 16 g of phosphorus for skeletal development. The recommended daily calcium supplement for pregnant women averages 1,200 mg (compared to 400 mg per day for an adult not pregnant or lactating). During the last trimester, an additional 250 to 300 mg of calcium per day is recommended. At the same time, the FDA established a risk category for the effect of calcium gluconate on the fetus when used in pregnant women - “C” (animal studies revealed a negative effect of the drug on the fetus, and there were no adequate studies in pregnant women, but there is a potential benefit associated with the use of this drug in pregnant women , may justify its use despite the risks). There is no scientific data on the penetration of calcium into milk from the body of a nursing mother. Calcium is considered a normal nutritional component of human milk. The calcium content in breast milk averages 300 mg per liter. The recommended daily intake of calcium for a woman during lactation is 1200 mg. One liter of cow's milk contains about 1200 mg of calcium.
Pregnant or breastfeeding women who do not consume milk or dairy products may need supplemental calcium.
Medicinal mono- and multicomponent preparations containing calcium gluconate
Calcium gluconate
are approved for use, sometimes with additions such as “
stabilized
”, “
VIAL
”, “
LekT
” and others.
Calcium gluconate is also included in multicomponent preparations:
- anti-cold and anti-flu drugs Anvimax
(calcium gluconate monohydrate + paracetamol + ascorbic acid + rimantadine hydrochloride + rutoside + loratadine),
Antigrippin-Anvi
(
first capsule:
acetylsalicylic acid + ascorbic acid + rutoside and
second capsule:
calcium gluconate monohydrate + metamizole sodium monohydrate + diphenhydramine hydrochloride),
Antigrippin-Maximum
(calcium gluconate monohydrate + paracetamol + rimantadine hydrochloride + ascorbic acid + loratadine + rutoside),
Antigrippin-ARVI - anticonvulsants " Pagluferal
"
-1, 2, 3
(calcium gluconate + bromizal + caffeine + papaverine + phenobarbital) - solution for intracoronary infusion Consol
(calcium gluconate + potassium chloride + lidocaine hydrochloride + magnesium sulfate + sodium bicarbonate + sodium chloride)
and others. On the website in the Literature section there is a subsection “Nutraceuticals”, containing articles that touch upon, among other things, the use of mineral supplements.
Calcium gluconate (solution for intravenous and intramuscular administration; solution for injection; tablets) is included in the “List of vital and essential medicines.”
Calcium gluconate has contraindications, side effects and application features; before use, consultation with a specialist is necessary.
Calcium provocative test to confirm the presence of gastrinoma
In cases where high gastric secretion is observed but serum gastrin levels are between 100 and 1000 pg/ml, the diagnosis of gastrinoma should be confirmed using provocative tests. Tests are performed with secretin, calcium or a standard breakfast. The calcium test is carried out as follows: a 10% solution of calcium gluconate is administered intravenously for 3 hours at a dose of 5 mg Ca/kg/h; gastrin is determined before the administration of calcium and every 30 minutes for 4 hours. A test with calcium is more dangerous for the patient compared to a test with the introduction of secretin, so it is not recommended as a primary test. Zollinger-Ellison syndrome is characterized by a sharp increase in gastrin content after administration of a calcium solution. The secretin test has the greatest diagnostic value. It is positive in 87% of patients with Zollinger-Ellison syndrome. The indication for a calcium test is a negative result of the secretin test (13% of patients with Zollinger-Ellison syndrome). Unfortunately, a calcium test can additionally identify only 4% of patients with gastrinomas. Thus, in 9% of patients with Zollinger–Ellison syndrome, both provocative tests are negative (Okhlobystin A.V.).
Calcium gluconate - food supplement
Calcium gluconate, as a food additive, has code E578 and is characterized by SanPiN 2.3.2.1293-03 as an acidity regulator and hardener. As a supplement E578 calcium gluconate can be added to:
- infant formula
- coffee drinks
- bread and bakery products
- flour confectionery products
Calcium gluconate is used in the production of canned vegetables and fruits as a thickening agent for plant tissues.
In agriculture, calcium gluconate is used in the preparation of animal feed. Back to section
For whom the drug is contraindicated
The drug is not used in patients with:
- intolerance to any of the components;
- increased calcium levels in the blood;
- tendency to form blood clots;
- sarcoidosis;
- severe atherosclerosis;
- urolithiasis with the formation of calcium stones.
Calcium gluconate is also not prescribed to patients taking cardiac glycosides.
Contraindications
Contraindications to the use of solution and tablets:
- intolerance to the components of the drug;
- severe hypercalciuria ;
- tendency to thrombosis;
- hypercoagulability;
- severe atherosclerosis ;
- calcium nephrourolithiasis;
- increased blood clotting;
- sarcoidosis;
- severe renal failure;
- period of treatment with cardiac glycosides (for example, digitalis preparations).
Overdose symptoms
With prolonged use of the drug, accumulation of calcium salts in the body is possible. In case of overdose, the following manifestations are observed:
- dyspeptic disorders: constipation, nausea and vomiting;
- increased fatigue and irritability;
- abdominal pain;
- constant thirst;
- muscle weakness and decreased blood pressure.
If these symptoms appear, you must stop taking the drug. Particularly severe cases may require intravenous calcitonin.
Side effects
The drug is usually well tolerated, but in some cases the following disorders are possible:
- bradycardia;
- hypercalciuria , hypercalcemia ;
- nausea, vomiting, stool disorders ( constipation /diarrhea), epigastric pain;
- formation of calcium stones in the intestines (with long-term use of high doses of the drug);
- impaired renal function ( swelling of the lower extremities, frequent urination);
- hypersensitivity reactions.
bradycardia , diarrhea, a feeling of heat in the mouth and then throughout the body, and changes in the skin may sometimes be observed These reactions pass quite quickly and do not require special treatment.
sweating , vomiting, arterial hypotension , and collapse (in some situations, lethal) may occur The result of extravasal penetration of the solution can be calcification of soft tissues.
In very rare cases, allergic and anaphylactic reactions .
When calcium gluconate is administered intramuscularly, local irritation and tissue necrosis .
