Calcium gluconate

Reviewed by Brenda Hughes, Rob Ticehurst, and Dr Carl Kuschel
June 2003
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page


Management of Calcium Administration


IV preparation

Oral preparation



Slow IV Infusion

  1. Administered by a nurse with Neonatal IV Drug Certification.  Calcium is added to IV fluids as per GL/NWH IV policy.
  2. Compatible with sodium chloride 0.9%, glucose 5%, glucose 10%.  Consult pharmacy for further IV compatabilities.
  3. Dilute 1 in 5 prior to administration (i.e. - to 0.045mmol/ml of elemental calcium)
  4. Filter prior to administration through a Pall 0.2 micron filter.
  5. Administer IV by slow infusion over 5-10 minutes via a syringe pump at a rate of 0.22mmol/kg/hour (maximum of 0.0225 mmol/min)
  6. Flush with sodium chloride 0.9% before and after administration.
  7. Do NOT give by intra-arterial, intramuscular or subcutaneous injection.
  8. Do NOT administer with IVN, blood, or blood products.


  1. Administer by diluting into the feed.  Calcium absorption is increased with food.  Both absorption and urinary excretion of calcium are increased with high protein diets. 8
  2. Do NOT administer phosphate at the same feed time.

Nursing Considerations

  1. Observe site closely for extravasation. Infiltration of tissues may cause local tissue necrosis.
  2. Monitor for adverse reactions.
  3. Continuous cardiac monitoring during administration of slow IV infusion via a syringe pump.
  4. Observe for bradycardia and arrhythmia.
  5. Assess gastro-intestinal status carefully during oral administration.


IV Preparation

Oral Preparation


1 Mimouni F, Tsang RC. Disorders of calcium and magnesium metabolism, in Fanaroff AA, Martin RJ (Eds): Neonatal-perinatal Medicine, ed 4. St Louis, CV Mosby Co, 1987, pp1077-1093.
2 Roberts RJ. Drug therapy in infants: Pharmacologic principles and clinical experience. Philadelphia, WB Saunders Co, 1984, p294.
3 Scott SM, Ladenson JH, Aguanna JJ, et al. Effect of calcium therapy in the sick premature infant with early neonatal hypocalcaemia. J Pediatr 1984; 104:747.
4 Broner CW, Stidham GL, Westenkirchner DF, Watson DC. A prospective, randomised, double-blind comparison of calcium chloride and calcium gluconate therapies for hypocalcaemia in critically ill children. J Pediatr 1990: 117:986-9.
5 Nursing 97 Drug Handbook Springhouse 1997, p838-841.
6 Medicines for Children.  Royal College of Paediatrics and Child Health. London: RCPCH Publicatiosn Ltd, 1999.
7 Northern Neonatal Network Neonatal Formulary, 3rd Edition 2000, BMJ Books.
8 Micromedex Healthcare Series.  Exp.31 Oct 2001.
9 Calcium gluconate infection BP datasheet.  Mulgrave North: FH Faulding & Co Ltd, 2001.
10 McClintock AD et al (Eds).  Notes on injectable drugs (4th Ed).  Wellington: New Zealand Healthcare Pharmacists' Assoc (Inc), 1999.
11 Paediatric Formulary (5th Ed).  Guy's, St Thomas' and Lewisham Hospitals.
12 Loe E, et al. Paediatric Pharmacopoeia, Royal Children's Hospital Melbourne and Leicester Royal Infirmary Children's Hospital.  WB Suanders Co, Ltd, London, 1998.
13 Young TE, Mangum B (eds).  Neofax 2000. Acorn Publishing, Raleigh, 2000.