Active substance (INN): Calcium chloride

ATC code: В05АХ07

Pharmacotherapeutic group:

Mineral drugs, trace substances.

Pharmacological properties

A source of calcium ions playing an important role in contraction of skeletal and unstriated muscles, activity of the heart muscle, a process of transfer of nervous impulses, formation of a bone tissue, adjustment of permeability of the vascular wall and blood coagulability. It has an anti-allergic action. The mechanism of anti-allergic action is unknown; however, in intravenous injection of calcium salts it causes excitation of the sympathetic nervous system and enhances release of adrenaline by the adrenal gland.

Indications to use

In allergic diseases (serum disease, urticaria, Quincke's disease, hay fever, etc.) and allergic complications due to medication, in enhanced calcium excretion from the body that can take place during prolonged immobilization of a patient, pregnancy; as an agent reducing vascular permeability, in hemorrhagic vasculitis, X-ray sickness events, in inflammatory and exudative processes (pneumonia, pleuritis, plexitis, endometritis, etc.), skin diseases (itching, eczema, psoriasis, etc.), in parathyroid insufficiency (tetany), rachitis (spasmophilia), in parenchymatous hepatitis, toxic liver lesions, nephritis, eclampsia, a hyperkalemic form of paroxysmal myoplegia. It is also used as a hemostatic agent in pulmonary, gastrointestinal, nasal, uterine bleedings, prior to operative interventions to enhanced blood coagulability. It is used as an antidote in poisoning with magnesium salts, oxalic acid and its soluble salts as well as dissolved fluorine acid salts (in interaction with calcium chloride not dissociating and nontoxical sodium oxalate and calcium fluoride are formed). It is used in combination with other methods and agents to stimulate labouractivity.

Administration and dosage

The drug is prescribed intravenously, dropwise (slowly); intravenously, streamwise (very slowly); intracardially (strictly into the ventricular cavity!). The drug is administered dropwise into a vein with prior dilution of 5-10 ml of 10% of the drug solution in 100-200 ml of isotonic sodium chloride solution or 5% glucose solution. 5 ml of 10% of the drug solution is administered slowly (within 3-5 minutes) intravenously streamwise.

Side effects

In intravenous injection bradycardia, fall of the arterial blood pressure, incidence of heat sensation, first in the oral cavity and then all over the body may occur.

Contraindications

The drug should not be used in patients prone to thrombosis, advanced atherosclerosis and hypercalcemia, ventricular fibrillation,hypersensitivity to the drug. It should be used with caution in sarcoidosis, renal or heart failure, in patients taking cardiac glycosides and in respiratory insufficiency (taking into account ability of calcium chloride to cause acidosis).

Drug interaction

It should not be administered in one syringe with other medicinal preparations! Calcium chloride should not be injected immediately following injections or taking cardiac glycosides to prevent development of arrhythmias as inotropic and toxic effects of the drugs are synergic. In co-administration, calcium chloride forms complexes with tetracycline antibiotics neutralizing their antibacterial effect.

Special warnings

The drug cannot be injected subcutaneously or intramuscularly as it causes strong irritation and tissue necrosis. In case of accidental injection under the skin or into muscles, calcium chloride should be pumped out with of a syringe whenever possible and 10 ml of 25% sodium sulfate solution or 5-10 ml of 25% magnesium sulfate solution into the site of injection. To eliminate a resorptive effect diphenhydramine (dimedrol) is prescribed and ethylenediaminetetraacetic acid in hypocalcaemia. If a solution enters a cardiac muscle, it may damage coronary arteries, develop cardiac tamponade or pheumothorax. It is recommended to administration the drug into a large vein with a fine needle to avoid a fast rise in calcium concentration in blood serum and its penetration into surrounding tissues with their subsequent necrosis. In fast administration in a vein fibrillation of ventricles and heart arrest may occur.

Supply

10% solution for injections, in ampoules of 5 and 10 ml

Storage conditions

To be kept in a dry and protected from light place at room temperature

Shelf life

5 years

Dispensed with a prescription

Not to be used after the expiry date indicated on the package To be stored out of the reach to children