1 May 2026Injectable drugsSource update: November 2022
Calcium gluconate injectable
Calcium gluconate guidance for severe hypocalcaemia and magnesium sulfate intoxication, with IV-only use and hypercalcaemia precautions.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
Calcium therapy.
Antidote to magnesium sulfate.
Indications
- Severe hypocalcaemia.
- Magnesium sulfate intoxication.
Forms and strengths, route of administration
- 1 g ampoule, 100 mg/ml, 10 ml, 10% solution, for slow IV injection or infusion in 5% glucose or 0.9% sodium chloride or Ringer lactate.
- Never use by IM or SC injection.
Dose
Severe hypocalcaemia
- Neonate and child under 20 kg: 0.5 ml/kg, maximum 10 ml, by slow IV injection over at least 5 minutes, then 2 to 4 ml/kg, maximum 40 ml, by continuous infusion over 24 hours.
- Child 20 kg and over and adult: 10 ml by slow IV injection over at least 5 minutes, then 40 ml by continuous infusion over 24 hours.
Magnesium sulfate intoxication
- Child under 20 kg: 0.5 ml/kg, maximum 10 ml, by slow IV injection over at least 5 minutes.
- Child 20 kg and over and adult: 10 ml by slow IV injection over at least 5 minutes.
Duration
According to clinical response and plasma-calcium levels. For hypocalcaemia, change to oral route as soon as possible.
Contra-indications, adverse effects, precautions
- Do not administer to patients with severe renal disease or patients receiving cardiac glycosides.
- Do not administer ceftriaxone to neonates receiving calcium gluconate.
- May cause tingling sensations, warm flushes, dizziness, tissue necrosis in the event of extravasation, and hypercalcaemia in the event of too rapid IV injection or overtreatment.
- Do not use in prolonged treatment if plasma-calcium levels cannot be monitored.
- The patient should be placed in the horizontal position prior to injection and remain lying down for 30 to 60 minutes.
- Pregnancy and breast-feeding: no contra-indication.
- Calcium gluconate is incompatible with many drugs. Do not mix with other drugs in the same syringe or infusion fluid and flush the IV line thoroughly between infusions.
- Do not use if the solution appears cloudy or particles are visible.
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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