Calcium Sandoz Injectable

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Kemas kini Tarikh 12/05/2020 . 5 minit bacaan
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Uses

What is Calcium Sandoz® injection (calcium, calcium gluconate) used for?

Calcium Sandoz® injection is commonly used for hypocalcaemia (causing tetany and related neuromuscular disorders); chronic calcium deficiency; rickets, osteomalacia, osteoporosis, in patients with poor intestinal absorption; adjuvant therapy for exudative, inflammatory and allergic processes; adjunct in the treatment of severe hyperkalemia; lead poisoning (acute colic), fluoride poisoning.

How should I take Calcium Sandoz® injection (calcium, calcium gluconate)?

Intravenous injections should be given slowly (3 minutes per 10 ml) and cardiac rhythm monitored throughout.

Injections by the intramuscular route, which should not be used in children, should be given deep into the gluteal muscle.

Calcium-Sandoz should not be injected subcutaneously.

How do I store Calcium Sandoz® injection (calcium, calcium gluconate)?

Calcium Sandoz® injection is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Calcium Sandoz® injection in the bathroom or the freezer. There may be different brands of Calcium Sandoz® injection that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Calcium Sandoz® injection down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Calcium Sandoz® injection (calcium, calcium gluconate)?

Before using this drug, tell your doctor if you have hypersensitivity to this drug.

Parenteral calcium is strictly contraindicated in patients receiving digitalis or adrenaline.
Parenteral administration of high doses of calcium should always be accompanied by close monitoring of blood and urine levels, particularly in children, and treatment discontinued at once if blood calcium exceeds 2.625 mmol (105-110 mg/l) or 24 hour urinary excretion is higher than 0.125 mmol (5 mg/kg).

It is particularly important to prevent a high concentration of
calcium from reaching the heart because of the danger of cardiac syncope. ECG monitoring is indicated in patients receiving calcium by IV infusion for the treatment of severe hyperkalemia.

Injectable calcium solutions (including Calcium-Sandoz) have been found to contain small amounts of aluminium (up to 5 mg/l). Prolonged use in neonates, infants and patients with severely impaired renal function should therefore be avoided as it may lead to aluminium accumulation with the possibility of skeletal, neurological or haematological disturbances.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using Calcium Sandoz® injection during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this Calcium Sandoz® injection. Calcium Sandoz® injection is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from Calcium Sandoz® injection (calcium, calcium gluconate)?

When using this drug, some side effects may occur:

  • Nausea
  • Vomiting
  • Hot flushes
  • Sweating
  • Hypotension
  • Bradycardia
  • Sense of oppression
  • Tingling
  • Metallic
  • Calcium or chalky taste
  • Cardiac arrhythmia and even sudden circulatory failure

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Calcium Sandoz® injection (calcium, calcium gluconate)?

Calcium Sandoz® injection may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

These products may include:

  • Digitalis glycosides: calcium enhances the effects of digitalis glycosides on the heart; the response to verapamil and possible other calcium antagonists may be reduced.
  • Thiazide diuretics: hypercalcemia resulting from renal tubular reabsorption, or bone release of calcium by thiazides may be amplified by exogenous calcium.
  • Atenolol: mean peak plasma levels and bioavailability of atenolol may be decreased, possibly resulting in decreased beta blockade.
  • Sodium polystyrene sulfonate: Co-administration in patients with renal impairment may result in an unanticipated metabolic alkalosis and a reduction of the resin’s binding of potassium.
  • Drug/Lab test interactions: Transient elevations of plasma 11-hydroxycoticosteroid levels (Glenn-Nelson technique) may occur when IV calcium is administered, but levels return to control values after 1 hour in addition.

Does food or alcohol interact with Calcium Sandoz® injection (calcium, calcium gluconate)?

Calcium Sandoz® injection may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Calcium Sandoz® injection (calcium, calcium gluconate)?

Calcium Sandoz® injection may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Especially if you have:

  • Hypercalcaemia and severe hypercalciuria (e.g. in hyperparathyroidism, vitamin D overdosage, decalcifying tumours such as plasmocytomas or bone metastases, or immobilization osteoporosis)
  • Severe renal failure
  • Galactosaemia
  • Ventricular fibrillation

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Calcium Sandoz® injection (calcium, calcium gluconate).

What is the dose of Calcium Sandoz® injection (calcium, calcium gluconate) for an adult?

The recommended dose is 10 ml IV or IM 1-3 times daily.

Warm solutions to body temperature and give slowly (0.5-2 ml/min); stop if patient

complains of discomfort. Resume when symptoms disappear. Following injection, patient should remain recumbent for a short time. Repeated injections may be needed because of the rapid calcium excretion.

Administration by intravenous drip infusion is recommended in cases of severe hypocalcaemia (for adults as well as children), with dose determination on the basis of calcium blood and urinary excretion levels.

What is the dose of Calcium Sandoz® injection (calcium, calcium gluconate)  for a child?

The recommended dose is 5-10 ml IV once daily.

Infants and young children with severe hypocalcaemia should normally be given 40-80 mg ionizable calcium (4-9 ml injectable solution) per kg bodyweight by IV infusion every 24 hours for a maximum of 3 days, with concomitant vitamin D if indicated.

The pulse rate should be monitored during administration and should a bradycardia

develop, the intravenous infusion should be stopped immediately.

Follow-up treatment should be by the oral route.

How is Calcium Sandoz® injection (calcium, calcium gluconate) available?

Calcium Sandoz® injection is available in the following dosage forms and strengths:

  • Calcium Sandoz® injection 10ml

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Calcium Sandoz® injection, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

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