Presentation
10%, 1gram in 10mL (2.2 mmol in 10mL) vial
Role
Calcium supplementation is recommended in the management of verapamil and diltiazem overdose along with appropriate inotropic and vasopressor therapy as indicated.
10% calcium chloride contains three times the elemental calcium in the same volume of 10% calcium gluconate.
Consultation with a clinical toxicologist through the local toxicology service or Poisons Information Centre on 13 11 26 is advised with all symptomatic calcium channel blocker poisonings.
Dose
10%, 30 mL (6.6mmol calcium) [child: 0.6 mL/kg] IV, repeat q5min aiming for an ionised Ca between 1.5-2.0mmol/L.
Stocking recommendations
Calcium gluconate is readily available given it is a standard resuscitation drug.
Precautions
Rapid bolus of calcium gluconate can cause transient hypotension – should be given as a slow push over a few minutes.
Disclaimer
Fact sheet developed by Queensland Poisons Information Centre.
This fact sheet is about the use of these antidotes in Australia, and may not apply to other countries. Children’s Health Queensland Hospital and Health Service cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this fact sheet.
Last updated: July 2023