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Pronunciation |
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(KAL
see um gloo BYE oh
nate) |
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U.S. Brand
Names |
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Neo-Calglucon®[OTC] |
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Generic
Available |
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No |
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Pharmacological Index |
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Calcium Salt |
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Use |
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Adjunct in treatment and prevention of postmenopausal osteoporosis; treatment
and prevention of calcium depletion or hyperphosphatemia (eg, osteoporosis,
osteomalacia, mild/moderate renal insufficiency, hypoparathyroidism,
rickets) |
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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Hypercalcemia, renal calculi, ventricular fibrillation |
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Warnings/Precautions |
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Calcium absorption is impaired in achlorhydria (common in elderly - try
alternate salt, administer with food); administration is followed by increased
gastric acid secretion within 2 hours of administration; while hypercalcemia and
hypercalciuria may result when therapeutic replacement amounts are given for
prolonged periods, they are most likely to occur in hypoparathyroid patients
receiving high doses of vitamin D |
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Adverse
Reactions |
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Mild hypercalcemia (calcium: >10.5 mg/dL) may be asymptomatic or manifest
itself as constipation, anorexia, nausea, and vomiting
More severe hypercalcemia (calcium: >12 mg/dL) is associated with
confusion, delirium, stupor, and coma
<1%: Headache, hypophosphatemia, hypercalcemia, nausea, anorexia,
vomiting, abdominal pain, constipation, thirst |
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Overdosage/Toxicology |
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Acute single ingestions of calcium salts may produce mild gastrointestinal
distress, but hypercalcemia or other toxic manifestations are extremely unlikely
Treatment is supportive |
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Drug
Interactions |
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Decreased effect:
Calcium glubionate may significantly decrease the bioavailability of
tetracyclines
Large intakes of dietary fiber may decrease calcium absorption due to a
decreased GI transit time and the formation of fiber-calcium complexes
Increased effect: Calcium glubionate may increase the effects of quinidine
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Mechanism of
Action |
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As dietary supplements, to prevent or treat negative calcium balance (eg,
osteoporosis), the calcium in calcium salts moderates nerve and muscle
performance and allows normal cardiac function |
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Pharmacodynamics/Kinetics |
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Absorption: From the GI tract requires vitamin D; minimal absorption unless
chronic, high doses are given; calcium is absorbed in soluble, ionized form;
solubility of calcium is increased in an acid environment
Distribution: Crosses the placenta; appears in breast milk
Elimination: Mainly in feces as unabsorbed calcium with 20% eliminated by the
kidneys |
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Usual Dosage |
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Dosage is in terms of elemental calcium
0-6 months: 210 mg/day
7-12 months: 270 mg/day
1-3 years: 500 mg/day
4-8 years: 800 mg/day
Adults, male/female:
9-18 years: 1300 mg/day
19-50 years: 1000 mg/day
>51 years: 1200 mg/day
Female: Pregnancy:
less than or equal to 18 years: 1300 mg/day
>19 years: 1000 mg/day
Female: Lactating:
less than or equal to 18 years: 1300 mg/day
>19 years: 1000 mg/day
Syrup is a hyperosmolar solution; dosage is in terms of calcium glubionate,
elemental calcium is in parentheses
Neonatal hypocalcemia: 1200 mg (77 mg Ca++)/kg/day in 4-6 divided
doses
Maintenance: Infants and Children: 600-2000 mg (38-128 mg
Ca++)/kg/day in 4 divided doses up to a maximum of 9 g (575 mg
Ca++)/day
Adults: 6-18 g (~0.5-1 g Ca++)/day in divided doses
Dosing adjustment in renal impairment: Clcr <25
mL/minute: Dosage adjustments may be necessary depending on the serum calcium
levels |
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Dietary
Considerations |
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Should be administered 1-3 hours after meals; may decrease iron absorption so
should be administered 1-2 hours before or after iron supplementation; should
not be administered with bran, foods high in oxalates or whole grain cereals
which may decrease calcium absorption |
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Reference Range |
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Serum calcium: 8.4-10.2 mg/dL: Monitor plasma calcium levels if using calcium
salts as electrolyte supplements for deficiency
Due to a poor correlation between the serum ionized calcium (free) and total
serum calcium, particularly in states of low albumin or acid/base imbalances,
direct measurement of ionized calcium is recommended
In low albumin states, the corrected total serum calcium may be
estimated by: Corrected total calcium = total serum calcium + 0.8 (4.0 -
measured serum albumin) |
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Test
Interactions |
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calcium (S);
magnesium |
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Mental Health: Effects
on Mental Status |
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May cause confusion and delirium (as a consequence of
hypercalcemia) |
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Mental Health:
Effects on Psychiatric
Treatment |
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None reported |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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Do not take calcium supplements within 1-2 hours of taking other medicine by
mouth or eating large amounts of fiber-rich foods; do not take other
calcium-containing products or antacids, drink large amounts of alcohol or
caffeine-containing beverages |
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Nursing
Implications |
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Monitor serum calcium, magnesium, phosphate |
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Dosage Forms |
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Elemental calcium listed in brackets
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