カルシウム塩（グルコン酸カルシウム、塩化カルシウム、乳酸カルシウム、グルセプチン酸カルシウム）
Calcium Salts
Calcium gluconate, Calcium chloride, Calcium lactate, Calcium gluceptate
別名: AmTech Calcium Gluconate · Cal-Nate 1069 · Cal Supreme Gel · Clearcal 50 · Pet-Cal · Osteoform · Calcium borogluconate · Calcium glubionate
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hypocalcemia | 94-140 mg/kg IV slowly to effect | IV | PRN | — | 🌎 NA |
| Acute hypocalcemia | Calcium gluconate 10% injection: Warm to body temperature and give IV at a rate of 50-150 mg/kg (0.5-1.5 mL/kg) over 20-30 minutes. Following acute crisis, infuse 10-15 mL (of a 10% solution) per kg over a 24-hour period. Long-term therapy: Calcium lactate 0.5-2 g/day. | IV/PO | PRN/Daily | — | 🌎 NA |
| Hypocalcemia | Calcium gluconate 10% 0.5-1.5 mL/kg or calcium chloride 10% 1.5-3.5 mL (total) IV slowly over 15 minutes | IV | PRN | — | 🌎 NA |
| Emergency treatment of tetany and seizures secondary to hypoparathyroidism | Calcium gluconate 10%: 0.5-1.5 mL/kg (up to 20 mL) over 15-30 minutes. May repeat at 6-8 hour intervals or give as continuous infusion at 10-15 mg/kg/hour. Long-term oral: Calcium gluconate at 500-750 mg/kg/day divided three times daily, or calcium lactate at 400-600 mg/kg/day divided three times daily, or calcium carbonate 100-150 mg/kg/day divided twice daily. | IV/PO | q6-8h or CRI | — | 🌎 NA |
| Emergency treatment of hypocalcemia | Calcium gluconate 10% 5-15 mg/kg (0.5-1.5 mL/kg) slowly to effect over a ten minute period, or calcium chloride 10% 5-15 mg/kg (0.15-0.5 mL/kg). Short-term treatment immediately after correction of tetany: CRI of calcium gluconate 10% at 60-90 mg/kg/day (6.5-9.75 mL/kg/day) added to fluids or give daily dosage SC in 3-4 divided doses per day after diluting with equal volume of saline. | IV/SC | PRN/CRI/Divided | — | 🌎 NA |
| Hyperkalemic cardiotoxicity (secondary to uremic crisis) | Calcium gluconate (10%) indicated if serum K+ is >8 mEq/L. Give at an approximate dose of 0.5-1 mL/kg over 10-20 minutes | IV | PRN | — | 🌎 NA |
- Hypocalcemia: Intraperitoneal route may also be used. Monitor respirations and cardiac rate and rhythm during administration.
- Acute hypocalcemia: If bradycardia develops, halt infusion.
- Hypocalcemia: Monitor heart rate or ECG during infusion. If ST segment elevation or Q-T interval shortening occur, temporarily discontinue.
- Emergency treatment of tetany and seizures secondary to hypoparathyroidism: Monitor ECG and stop infusion if S-T segment elevates, Q-T interval shortens, or arrhythmias occur.
- Emergency treatment of hypocalcemia: Calcium chloride is extremely caustic if administered extravascularly.
- Hyperkalemic cardiotoxicity (secondary to uremic crisis): Monitor ECG. Rapidly corrects arrhythmias but effects are very short (10-15 minutes).
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hypocalcemia | 94-140 mg/kg IV slowly to effect | IV | PRN | — | 🌎 NA |
| Acute hypocalcemia secondary to hypoparathyroidism | 10% calcium gluconate injection, give 1-1.5 mL/kg IV slowly over 10-20 minutes. Once controlled, add to IV fluids as slow infusion at 60-90 mg/kg/day (of elemental calcium) [converts to 2.5 mL/kg every 6-8 hours of 10% calcium gluconate]. Oral: initially 50-100 mg/kg/day divided 3-4 times daily of elemental calcium. | IV/PO | PRN/CRI/Divided | — | 🌎 NA |
| Hypocalcemia secondary to phosphate enema toxicity or puerperal tetany | 10% calcium gluconate injection, give 1-1.5 mL/kg IV slowly over 10-20 minutes. | IV | PRN | — | 🌎 NA |
| Emergency treatment of hypocalcemia | Calcium gluconate 10% 5-15 mg/kg (0.5-1.5 mL/kg) slowly to effect over a ten minute period, or calcium chloride 10% 5-15 mg/kg (0.15-0.5 mL/kg). Short-term treatment immediately after correction of tetany: CRI of calcium gluconate 10% at 60-90 mg/kg/day (6.5-9.75 mL/kg/day) added to fluids or give daily dosage SC in 3-4 divided doses per day after diluting with equal volume of saline. | IV/SC | PRN/CRI/Divided | — | 🌎 NA |
- Hypocalcemia: Intraperitoneal route may also be used. Monitor respirations and cardiac rate and rhythm.
- Acute hypocalcemia secondary to hypoparathyroidism: Monitor ECG. If bradycardia or Q-T interval shortening occurs, slow rate or temporarily discontinue.
- Hypocalcemia secondary to phosphate enema toxicity or puerperal tetany: Follow guidelines for use of intravenous calcium.
- Emergency treatment of hypocalcemia: Monitor heart rate or ECG.
鳥
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hypocalcemic tetany | Calcium gluconate: 50-100 mg/kg IV slowly to effect; may be diluted and given IM if a vein cannot be located | IV/IM | PRN | — | 🌎 NA |
| Egg-bound birds | Initially, calcium gluconate 1% solution 0.01-0.02 mL/g IM. | IM | Once initially | — | 🌎 NA |
- Egg-bound birds: Provide moist heat (80-85°F) and allow 24 hours for bird to pass egg.
爬虫類
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Egg binding (in combination with oxytocin) | Calcium glubionate: 10-50 mg/kg IM as needed until calcium levels back to normal or egg binding is resolved. | IM | PRN | — | 🌎 NA |
- Egg binding (in combination with oxytocin): Use care when giving multiple injections. Calcium/oxytocin is not as effective in lizards as in other species.
馬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hypocalcemia | 150-250 mg/kg IV slowly to effect | IV | PRN | — | 🌎 NA |
| Hypocalcemia | Calcium gluconate 23% injection: 250-500 mL IV slowly, or IM or SC (divided and given in several locations, with massage at sites of injection) | IV/IM/SC | PRN | — | 🌎 NA |
| Lactation tetany | 250 mL per 450 kg body weight of a standard commercially available solution that also contains magnesium and phosphorous IV slowly | IV | PRN | — | 🌎 NA |
- Hypocalcemia: Intraperitoneal route may also be used. Monitor respirations and cardiac rate and rhythm.
- Lactation tetany: Auscultate heart. If no improvement after 10 minutes, repeat. Stop infusion immediately if a pronounced change in rate or rhythm is detected.
牛
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hypocalcemia | 150-250 mg/kg IV slowly to effect | IV | PRN | — | 🌎 NA |
| Hypocalcemia | Calcium gluconate 23% injection: 250-500 mL IV slowly, or IM or SC (divided and given in several locations, with massage at sites of injection) | IV/IM/SC | PRN | — | 🌎 NA |
| Hypocalcemia | 8-12 grams of calcium IV infused over a 5-10 minute period | IV | PRN | — | 🌎 NA |
- Hypocalcemia: Intraperitoneal route may also be used. Monitor respirations and cardiac rate and rhythm.
- Hypocalcemia: Use a product containing magnesium during the last month of pregnancy if subclinical hypomagnesemia is detected.
豚
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hypocalcemia | 150-250 mg/kg IV slowly to effect | IV | PRN | — | 🌎 NA |
| Hypocalcemia | Calcium gluconate 23% injection: 25-50 mL IV slowly, or IM or SC (divided and given in several locations, with massage at sites of injection) | IV/IM/SC | PRN | — | 🌎 NA |
- Hypocalcemia: Intraperitoneal route may also be used. Monitor respirations and cardiac rate and rhythm.
羊
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hypocalcemia | 150-250 mg/kg IV slowly to effect | IV | PRN | — | 🌎 NA |
| Hypocalcemia | Calcium gluconate 23% injection: 25-50 mL IV slowly, or IM or SC (divided and given in several locations, with massage at sites of injection) | IV/IM/SC | PRN | — | 🌎 NA |
- Hypocalcemia: Intraperitoneal route may also be used. Monitor respirations and cardiac rate and rhythm.
ヤギ
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hypocalcemia | 150-250 mg/kg IV slowly to effect | IV | PRN | — | 🌎 NA |
| Hypocalcemia | Calcium gluconate 23% injection: 25-50 mL IV slowly, or IM or SC (divided and given in several locations, with massage at sites of injection) | IV/IM/SC | PRN | — | 🌎 NA |
- Hypocalcemia: Dosing extrapolated from sheep guidelines. Intraperitoneal route may also be used.
- Hypocalcemia: Dosing extrapolated from sheep guidelines.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
カルシウム塩は必須ミネラルサプリメントであり、主に低カルシウム血症の治療や予防、および腎不全患者における経口リン吸着剤として使用されます。
注射用カルシウムは、以下の治療に用いられる重要な救急薬です：
- 確認されたイオン化低カルシウム血症（例：子癇/産褥テタニー、原発性副甲状腺機能低下症）。
- 高カリウム血症による心毒性（例：尿道閉塞の猫、アジソン病クリーゼ）。臨床のポイント：カルシウムは血清カリウム値を低下させるわけではありません。心筋の閾電位を上昇させ、正常な静止膜電位と閾値の差を回復させることで、致命的な不整脈から心臓を保護します。
- カルシウム拮抗薬中毒。
臨床のポイント： カルシウム塩の違いを区別することが極めて重要です。10%塩化カルシウムは、10%グルコン酸カルシウム（9.3 mg/mL）の約3倍の元素カルシウム（27.2 mg/mL）を含んでいます。塩化カルシウムは刺激性が強く、酸性化作用があり、血管外に漏出すると重度の組織壊死を引き起こす危険性があるため、理想的には中心静脈ラインから投与すべきです。末梢静脈からの投与にはグルコン酸カルシウムが推奨されます。
作用機序
Calcium is an essential intracellular and extracellular cation vital for numerous physiological processes:
- Nervous and Musculoskeletal Function: Facilitates excitation-contraction coupling in cardiac and smooth muscle, and is required for neurotransmitter release at synaptic clefts.
- Cell Membrane Permeability: Maintains cell membrane integrity and capillary permeability.
- Enzymatic Reactions: Acts as a crucial cofactor for various enzymatic reactions and the coagulation cascade.
- Hyperkalemia Antagonism: In hyperkalemia, elevated resting membrane potentials lead to cardiac conduction blocks. Calcium administration → raises the threshold potential → restores the normal electrical gradient → stabilizes the myocardium.
安全性・警告
禁忌
- Ventricular fibrillation
- Hypercalcemia
有害事象
- Hypercalcemia
- GI irritation and/or constipation (oral administration)
- Mild to severe tissue reactions, pyogranulomatous panniculitis, adipocyte mineralization (IM or SC administration)
- Venous irritation (IV administration)
- Hypotension (if given IV too rapidly)
- Cardiac arrhythmias and cardiac arrest (if given IV too rapidly)
注意事項
WARNING: Intravenous calcium must be administered SLOWLY while continuously monitoring the ECG and/or heart rate. Too rapid administration can cause fatal arrhythmias, bradycardia, hypotension, and cardiac arrest. If bradycardia or Q-T interval shortening occurs, halt the infusion immediately.
- Extravasation Risk: Calcium salts (especially calcium chloride) are highly irritating. Perivascular administration can cause severe tissue necrosis. If extravasation occurs, stop infusion, infiltrate with normal saline, apply heat, and consider local corticosteroids or 1% procaine/hyaluronidase.
- Subcutaneous Use: While historically used SC in dogs/cats, it is now known to cause severe tissue reactions (pyogranulomatous panniculitis, mineralization) and should be used with extreme caution or avoided if possible.
- Acid-Base/Renal: Calcium chloride is acidifying; use with caution in respiratory failure, respiratory acidosis, or renal disease.
医薬品相互作用
Intravenous calcium may antagonize the effects of calcium-channel blocking agents.
Patients on digitalis therapy are more apt to develop arrhythmias if receiving IV calcium; use with extreme caution.
May lead to increased serum magnesium and/or calcium, particularly in patients with renal failure.
Parenteral calcium can neutralize the effects of hypermagnesemia or magnesium toxicity secondary to parenteral magnesium sulfate.
Parenteral calcium may reverse the effects of nondepolarizing neuromuscular blocking agents; has been reported to prolong or enhance the effects of tubocurarine.
Oral calcium can reduce the amount of these antibiotics absorbed from the GI tract via chelation; separate dosages by at least two hours.
Patients receiving both parenteral calcium and potassium supplementation may have an increased chance of developing cardiac arrhythmias.
Used in conjunction with large doses of calcium may cause hypercalcemia.
Excessive intake may stimulate calcium loss from bone and cause hypercalcemia.
Concurrent use of large doses of vitamin D or its analogs may cause enhanced calcium absorption and induce hypercalcemia.
監視
- Serum calcium (total and ionized)
- Serum magnesium, phosphate, and potassium
- Serum PTH (parathormone) if indicated
- Renal function tests
- ECG and heart rate (continuously during IV therapy)
- Urine calcium (if hypercalciuria develops)
薬物動態
吸収
Absorbed in the small intestine in the ionized form only. Requires active Vitamin D and an acidic pH for oral absorption. Parathormone (PTH) increases absorption in deficiency states. Dietary factors (high fiber, phytates), age, and certain drugs/diseases can reduce absorption.
分布
Approximately 99% of total body calcium is found in bone. Of circulating calcium, ~50% is bound to serum proteins (primarily albumin) or complexed with anions, and ~50% is in the active ionized form. Crosses the placenta and is distributed into milk.
代謝
Ionized calcium enters the extracellular fluid and is rapidly incorporated into skeletal tissue.
消失
Eliminated primarily in the feces (unabsorbed calcium + calcium excreted into bile and pancreatic juice). Small amounts are excreted in the urine (most filtered calcium is reabsorbed by the tubules and ascending loop of Henle).
過剰投与
Oral overdoses of calcium-containing products are unlikely to cause hypercalcemia unless other drugs (e.g., Vitamin D) are given concurrently that enhance absorption.
Hypercalcemia can occur with parenteral therapy or oral therapy combined with Vitamin D or increased PTH levels.
- Mild hypercalcemia: Generally resolves without intervention when renal function is adequate. Withhold calcium therapy and Vitamin D analogs.
- Serious hypercalcemia (>12 mg/dL): Treat by hydrating with IV normal saline and administering a loop diuretic (e.g., furosemide) to increase sodium and calcium excretion. Monitor and replace potassium and magnesium as necessary. Monitor ECG. Corticosteroids, calcitonin, and hemodialysis may also be employed.
製品
製剤
- Injection: 10% and 23% solutions
- Oral tablets
- Oral capsules
- Oral powder
- Oral gel/paste
動物用医薬品
- Calcium Gluconate 23% Injection (230 mg/mL)
- Cal Supreme Gel (40-42 g calcium/300 mL tube)
- Clearcal 50 (Calcium Chloride 35% w/w or 47% w/v)
ヒト用医薬品
- Calcium Gluconate Injection 10% (100 mg/mL)
- Calcium Chloride Injection 10% (100 mg/mL)
- Calcium Gluconate Tablets (500 mg, 648 mg, 650 mg, 972 mg, 975 mg)
- Calcium Gluconate Oral Powder
- Calcium Gluconate Capsules (500 mg, 700 mg)
- Calcium Lactate Tablets (648 mg to 650 mg)
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store oral tablets and capsules in tight, well-closed containers at room temperature. Store injectable solutions at room temperature and protect from freezing.
飼主向け情報
飼い主向け情報
- 目的： カルシウムサプリメントは、筋肉のけいれん、脱力感、または発作（特に授乳中の母親に見られる子癇や「乳熱」と呼ばれる状態）を引き起こす可能性のある低カルシウム血症の治療に使用されます。
- 投与方法： 経口カルシウムを投与する場合は、獣医師の指示に厳密に従ってください。カルシウムは特定の抗生物質（テトラサイクリン系やフルオロキノロン系など）の吸収を妨げる可能性があるため、同時に与えないでください。投与間隔は少なくとも2時間空けてください。
- 副作用： 経口カルシウムは、時に胃腸の不調や便秘を引き起こすことがあります。
- 警告： 獣医師に相談することなく、人間用のカルシウムサプリメントや制酸薬をペットに与えないでください。用量や成分がペットにとって安全でない場合があります。ペットが動物病院で注射用カルシウムの投与を受けている場合、投与が早すぎると心臓に影響を与える可能性があるため、注意深く監視されます。
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