Calcium gluconate reduces ciprofloxacin absorption (chelation with divalent cations), potentially failing infection treatment.
Quinolones form insoluble chelates with Ca2+, Mg2+, Fe2+ and Al3+ (Annex 7 Quinolones: "See also Antacids, Iron"; Cipro label: dose 2 h before or 6 h after calcium salts).
Clinical infection response; plasma levels if critically ill.
Persistent fever, lack of antibiotic response.
Separate quinolone dosing (2 h before or 6 h after calcium); IV, do not mix in the same line without flush.
DailyMed — Ciprofloxacin Tablet label [Bayer, RLD Cipro], Drug Interactions (cations): https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c47250c2-bece-46b5-8b3b-b7c97d9005d8; INFARMED Prontuário Terapêutico (11th ed., 2012), Annex 7 — Quinolones.
IV calcium administration in patients on digoxin can precipitate severe arrhythmias ("stone heart") and should be avoided without clear indication.
Raised intracellular Ca2+ adds to digoxin\u2019s effect (Na+/K+-ATPase inhibition → ↑ sarcoplasmic Ca2+), increasing the risk of excessive contractility/arrhythmia; Prontuário 3.1.1: "avoid ... calcium administration in digitalis intoxication".
Continuous ECG, serum potassium and ionised calcium, digoxin level.
New arrhythmias, extrasystoles, ST-T changes.
Avoid IV calcium in digoxin-induced hypercalcaemia; if symptomatic hypocalcaemia is genuine, give slowly with continuous ECG; review potassium.
INFARMED Prontuário Terapêutico (11th ed., 2012), Digitalis 3.1.1 — "avoid ... calcium administration in digitalis intoxication"; Annex 7 — Antiarrhythmics: myocardial depression with digoxin; EMC-UK — Ergometrine (vasopressor context): https://www.medicines.org.uk/emc/product/6265/smpc
Adding IV/oral supplementation to milk, dairy and fortified foods can cause milk-alkali syndrome (hypercalcaemia + alkalosis).
Do not exceed 2000–2500 mg/day of calcium from all sources (site monograph); inform the team if taking supplements.
Site monograph (calcium — do not exceed 2000–2500 mg/day from all sources).
No documented disease interactions.
No restrictive Annex 1 entry; IV calcium gluconate is the antidote for hypermagnesaemia (a complication of tocolytic magnesium sulfate) and calcium-channel-blocker poisoning, and is part of calcium replacement in pre-eclampsia. Safe in pregnancy when indicated.
Compatible for therapeutic IV use when indicated (symptomatic hypocalcaemia, hyperkalaemia/hypermagnesaemia, CCB poisoning).
Compatible; calcium passes into milk in amounts regulated by the body.
WHO — WHO recommendation on calcium supplementation in pregnant women. Prontuário Terapêutico INFARMED — 11.3.3 (Mineral salts) and 2.2 (Correctors).
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Immediate myocardial stabilisation (hyperkalaemia), tetany correction and contractility support.
Provides ionised Ca2+: ↑ transmembrane electrochemical gradient, stabilises Na+ channels (hyperkalaemia), restores excitation-contraction and reverses calcium channel block.
IV: 100%; oral: 10–30% (prefer carbonate for oral supplementation).
No metabolism; extracellular distribution; renal excretion regulated by PTH/vitamin D.
~ 30–60 min (clinical stabilisation effect 30–120 min).
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
