Calcium (intravenous, prescription)
Pronunciation: KAL-see-um.
- Generic name
- calcium gluconate / calcium chloride
- Brand names
- Calcium Gluconate Injection (generic, multiple manufacturers), Calcium Gluconate 10% w/v Injection BP (B. Braun), Calcium Gluconate 10% solution for injection/infusion BP (hameln)
- Drug class
- Electrolyte / mineral replacement -- intravenous calcium salt
- Form
- Injection, solution (10% w/v; 100 mg/mL, providing 9.3 mg elemental calcium/mL for calcium gluconate)
- Route
- Intravenous injection or infusion (after dilution where required)
- Legal status
- Prescription-only, hospital/clinician administration for the injectable form covered by this page
Availability and supply rules vary by country
Trade names by country: United States · United Kingdom · Canada
Australia: · Full directory
What calcium gluconate / calcium chloride is and how it works
Intravenous calcium (given as calcium gluconate or calcium chloride) is a prescription medicine used in hospital to quickly correct dangerously low blood calcium or to protect the heart during a dangerously high blood potassium level. It is given directly into a vein by a healthcare professional. (1) (2)
This page is about the prescription, hospital-given intravenous form of calcium used in medical emergencies -- not the everyday calcium tablets or chewables sold over the counter as a dietary supplement for bone health, which are a different, non-prescription product.
Mechanism of action: how calcium gluconate / calcium chloride works
Calcium is an essential electrolyte and second messenger involved in neuromuscular transmission, cardiac conduction, and coagulation. Intravenous calcium gluconate and calcium chloride rapidly restore serum ionised calcium and, in hyperkalaemia, directly stabilise cardiac cell membranes to counter the arrhythmogenic effects of high potassium, independent of lowering the potassium level itself. Calcium gluconate and calcium chloride differ substantially in elemental calcium content per mL/gram and must not be dosed interchangeably. (1) (2)
What calcium gluconate / calcium chloride is used for
Acute symptomatic low blood calcium (hypocalcaemia)
Intravenous calcium is used to treat acute, symptomatic hypocalcaemia in adults and children, when blood calcium has dropped low enough to cause symptoms needing urgent correction. (1) (2)
Severe high blood potassium (hyperkalaemia) and its cardiac effects
In the UK label, intravenous calcium gluconate is also used for acute severe hyperkalaemia (with or without ECG changes) and as part of treating cardiac arrest caused by severe hyperkalaemia, by protecting the heart's electrical activity. This specific indication is drawn from the UK label; the US label for this product focuses on hypocalcaemia. This is a genuine difference between country labels, not a single universal claim. (2)
Before taking calcium gluconate / calcium chloride
Do not take / not appropriate for
- Do not give intravenous calcium to someone with high blood calcium (hypercalcaemia) or high urinary calcium (hypercalciuria). (all indications) (1) (2)
- Do not give intravenous calcium and ceftriaxone (an antibiotic) together, or within a short time of each other, to a newborn baby 28 days old or younger, because of a real risk of fatal precipitates forming in the lungs and kidneys. (neonates) (1) (2)
- The UK label states that concurrent cardiac glycoside therapy (e.g. digoxin) is an absolute contraindication with intravenous calcium; the US label instead calls for caution and close ECG monitoring rather than treating it as an outright contraindication. This is a genuine difference between country labels -- follow the applicable local label and clinician guidance. (cardiac glycoside therapy) (2) (1)
Tell your clinician about
- Tell the clinical team about any heart disease or use of digoxin or other cardiac glycosides, since calcium can dangerously increase their effect on the heart.
- Tell the team about kidney problems, since dosing may need to be lower with more frequent blood calcium monitoring.
- Tell the team if a newborn baby (28 days or younger) has recently received or is due to receive ceftriaxone.
- Tell the team about pregnancy or breastfeeding.
How to take calcium gluconate / calcium chloride
- Intravenous calcium is given by a healthcare professional directly into a vein, either as a slow injection or as an infusion after dilution, depending on the emergency being treated.
- It must be given slowly to avoid a fast rise in blood calcium, which can cause dangerous drops in blood pressure, a slow heart rate, or heart rhythm problems -- maximum infusion rates are set by the treating team (for example, no faster than 200 mg/minute in adults for calcium gluconate in the US label, or no faster than 2 mL/minute for the UK 10% injection).
- Blood calcium levels are checked regularly (for example, every 1-4 hours) during and after treatment to guide further dosing.
- Intramuscular injection is not used in children.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3)
Missed dose
Not applicable. This is a clinician-administered emergency/hospital treatment given at a specific point in care, not an ongoing home dosing schedule.
Overdose
An overdose can cause high blood calcium (hypercalcaemia), with symptoms that can include nausea, vomiting, low blood pressure, and heart rhythm problems, generally once blood calcium rises above about 12 mg/dL. The clinical team will stop the infusion immediately and give supportive care, including fluids to help the kidneys remove the excess calcium. (1) (2)
Side effects
Most side effects relate to how quickly the calcium is given (too fast can affect the heart and blood pressure) or to the injection site itself.
Nausea, vomiting
What to notice: These can occur, especially if the calcium level rises quickly.
What to do: Tell the clinical team, who can adjust the infusion rate. (2)
Low blood pressure, flushing, or a warm feeling
What to notice: These can occur, particularly with faster administration.
What to do: The clinical team monitors blood pressure and adjusts the infusion rate as needed. (1)
Discomfort, redness, or swelling at the injection/infusion site
What to notice: Local irritation can occur at the injection site.
What to do: Tell the nurse or doctor if the site becomes painful, swollen, or hard. (1)
Signs of extravasation (leakage into surrounding tissue)
What to notice: Pain, swelling, hardness, or skin changes near the injection site, which can progress to tissue damage (calcinosis cutis) and, rarely, skin breakdown.
What to do: This is a medical emergency at the injection site. The clinical team will stop the infusion immediately and manage the area. (1) (2)
Heart rhythm changes
What to notice: A slow or irregular heartbeat, palpitations, dizziness, or fainting during or after the infusion.
What to do: The clinical team monitors the heart rhythm (ECG) during treatment and will respond immediately to any changes. (1) (2)
Serious warnings
Extravasation and tissue damage (calcinosis cutis) — emergency
Symptoms: Pain, swelling, or skin changes at the infusion site, which can progress to tissue necrosis, ulceration, or infection.
Action: If extravasation is suspected, the clinical team will stop the infusion immediately and manage the affected area. (1) (2)
Cardiac arrhythmia and cardiac arrest from rapid administration — emergency
Symptoms: Vasodilation, falling blood pressure, a slow heart rate, irregular heart rhythms, fainting, and in severe cases cardiac arrest.
Action: Intravenous calcium must be given slowly, with continuous monitoring; the clinical team follows strict maximum infusion rates to reduce this risk. (1) (2)
Dangerous interaction with digoxin/cardiac glycosides — emergency
Symptoms: Serious heart rhythm toxicity can occur if calcium is given to someone on digoxin or a similar cardiac glycoside.
Action: The clinical team reviews current medicines before giving calcium and monitors the heart rhythm closely (ECG) if both must be used; the UK label treats concurrent cardiac glycoside therapy as an outright contraindication, while the US label calls for caution and monitoring -- follow the applicable local label. (2) (1)
Fatal precipitate risk with ceftriaxone in newborns — emergency
Symptoms: Not a symptom the patient would notice -- this is a known, serious drug-drug incompatibility that can cause fatal deposits (precipitates) in the lungs and kidneys of a newborn.
Action: The clinical team does not give intravenous calcium and ceftriaxone together, or close together in time, to babies 28 days old or younger. (1) (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Digoxin and other cardiac glycosides | Calcium can increase the effect of cardiac glycosides on the heart, risking serious toxicity and dangerous heart rhythms. | The UK label treats concurrent cardiac glycoside therapy as an outright contraindication; the US label calls for caution and close ECG monitoring if co-administration is necessary. Follow the applicable local label and clinician guidance. (2) (1) |
| Ceftriaxone (in neonates 28 days old or younger) | Risk of fatal calcium-ceftriaxone precipitates forming in the lungs and kidneys. | The clinical team avoids giving these together, or close together in time, in this age group. (1) (2) |
| Bicarbonate, phosphate, and minocycline (in the same IV line) | Physical incompatibility can occur if mixed in the same line. | The clinical team gives these through a separate line or flushes the line between medicines. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
There is limited human data specifically on intravenous calcium gluconate/chloride in pregnancy, but untreated severe maternal hypocalcaemia carries its own risks. The clinical team weighs the emergency need against the available data. (1)
Breastfeeding
Calcium is a normal component of breast milk; whether treatment changes breastfeeding compatibility is an individual assessment made with the clinical team. (2)
Newborns and infants
Dosing is weight-based and closely monitored. Intramuscular injection is not used in children. Newborns 28 days old or younger must not receive calcium and ceftriaxone together or close together in time, and are at higher risk of aluminium exposure from some calcium products, which the clinical team accounts for. (1) (2)
Kidney impairment
The lowest recommended dose is used, with blood calcium checked more frequently (for example, every 4 hours) to guide safe dosing. (1)
Monitoring
Before starting
- Confirm the indication (symptomatic hypocalcaemia, or severe hyperkalaemia with cardiac effects per the UK label) and rule out hypercalcaemia.
- Review current medicines, especially digoxin/cardiac glycosides, and check whether ceftriaxone has been or will be given to a newborn.
- Establish baseline blood calcium, kidney function, and heart rhythm (ECG) where relevant.
During treatment
- Give the infusion slowly, within the maximum recommended rate, with continuous heart rhythm and blood pressure monitoring.
- Check blood calcium levels regularly (for example every 1-4 hours) to guide further dosing.
- Watch the infusion site closely for any sign of extravasation.
Storage
Storage conditions vary by manufacturer and product; refer to the specific product labelling for exact storage and expiry information. This information has not been independently verified this session and is not asserted as a specific claim.
Professional information
This is clinician-facing context only. Always refer to the current local product information and institutional protocols for dosing, administration, and safety guidance.
All regions
Indication: Acute symptomatic hypocalcaemia; severe hyperkalaemia with cardiac effects (UK label)
Dose summary: Calcium gluconate 10% (100 mg/mL, 9.3 mg elemental calcium/mL): US label -- adult bolus 1000-2000 mg, pediatric weight-based (29-60 mg/kg), continuous infusion 5.4-21.5 mg/kg/hour with serum calcium checks every 1-4 hours, max infusion rate 200 mg/min (adults) / 100 mg/min (pediatric). UK label -- hypocalcaemia: 10 mL (2.25 mmol calcium) initial dose, repeatable; hyperkalaemia: 30 mL slow IV over 10 minutes; administration rate not to exceed 2 mL/min in adults. Dosing must be individualised and clinician-directed; no fixed universal dose applies.
Renal context: Use the lowest recommended dose in renal impairment, with serum calcium monitored every 4 hours per the US label. (1) (2)
Hepatic guidance
No specific hepatic dose-adjustment guidance was identified in the sources reviewed this session.
Overdose note
Hypercalcaemia (serum calcium >=12 mg/dL) can cause neurologic and renal effects. Discontinue the infusion and provide supportive care, including fluids to promote urinary calcium excretion. (1) (2)
Frequently asked questions
Is this the same as the calcium supplement tablets sold at the pharmacy?
No. This page covers the prescription, hospital-given intravenous form of calcium used for medical emergencies. Everyday calcium tablets or chewables sold without a prescription for bone health (such as calcium carbonate or calcium citrate) are a different, non-prescription product.
Can I be given intravenous calcium at home?
No. This form of calcium is given only in a hospital or clinical setting by a healthcare professional, with heart-rhythm and blood-level monitoring. (1)
Why can't newborns get calcium and a certain antibiotic together?
In babies 28 days old or younger, giving intravenous calcium together with the antibiotic ceftriaxone, or close together in time, has caused fatal deposits (precipitates) to form in the lungs and kidneys. Clinical teams avoid this combination in this age group. (1) (2)
Is calcium gluconate the same as calcium chloride?
No. Both are real intravenous calcium salts, but they contain different amounts of elemental calcium per mL and are not interchangeable dose-for-dose. Careful, clinician-calculated dosing is required for either. (2)
What is the mechanism of action of calcium gluconate / calcium chloride?
Calcium is an essential electrolyte and second messenger involved in neuromuscular transmission, cardiac conduction, and coagulation. Intravenous calcium gluconate and calcium chloride rapidly restore serum ionised calcium and, in hyperkalaemia, directly stabilise cardiac cell membranes to counter the arrhythmogenic effects of high potassium, independent of lowering the potassium level itself. Calcium gluconate and calcium chloride differ substantially in elemental calcium content per mL/gram and must not be dosed interchangeably. (1) (2)
What is the generic name of Calcium (intravenous, prescription)?
The generic name is calcium gluconate / calcium chloride. It is sold under brand names including Calcium Gluconate Injection (generic, multiple manufacturers), Calcium Gluconate 10% w/v Injection BP (B. Braun), Calcium Gluconate 10% solution for injection/infusion BP (hameln). (1) (2) (3)
References
- CALCIUM GLUCONATE injection, solution (Fresenius Kabi USA, LLC, and multiple other manufacturers)U.S. Food and Drug Administration (via DailyMed) · United States · accessed 2026-07-31 · source 1
- Calcium Gluconate 10% w/v Injection BP - Summary of Product Characteristics (SmPC)electronic Medicines Compendium (UK), B. Braun Medical · United Kingdom · accessed 2026-07-31 · source 2
- Health Canada Drug Product Database API query results for brand name 'calcium gluconate'Health Canada (Drug Product Database, official public API) · Canada · accessed 2026-07-31 · source 3
- EMA medicines search - no calcium gluconate/chloride centralised entryEuropean Medicines Agency · European Union · accessed 2026-07-31 · source 4
Brand names by country
Single-ingredient calcium gluconate / calcium chloride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Calcium Gluconate Injection (generic; multiple manufacturers) (1)current regulator label · 100 mg/mL (10% solution) · Fresenius Kabi USA, Amneal Pharmaceuticals, Hikma Pharmaceuticals, B. Braun Medical, Glenmark Pharmaceuticals, and others; see current FDA labelling
United Kingdom
Canada
- Calcium Gluconate Injection 10% (generic; multiple manufacturers) (3)current regulator registration · 10% injection · Hospira Healthcare ULC, AstraZeneca Canada Inc, Fresenius Kabi Canada Ltd, Baxter Corporation, Sterimax Inc, Sandoz Canada, International Medication Systems Ltd.