칼슘염 (글루콘산 칼슘, 염화 칼슘, 젖산 칼슘, 글루셉산 칼슘)
Calcium Salts
Calcium gluconate, Calcium chloride, Calcium lactate, Calcium gluceptate
다른 이름: AmTech Calcium Gluconate · Cal-Nate 1069 · Cal Supreme Gel · Clearcal 50 · Pet-Cal · Osteoform · Calcium borogluconate · Calcium glubionate
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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).
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
새
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
파충류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
돼지
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
양
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
염소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
칼슘염은 주로 저칼슘혈증을 치료하거나 예방하고, 신부전 환자에서 경구용 인 결합제로 사용되는 필수 미네랄 보충제입니다.
주사용 칼슘은 다음과 같은 경우에 사용되는 중요한 응급 약물입니다:
- 확인된 이온화 저칼슘혈증 (예: 자간증/산욕기 테타니, 원발성 부갑상선 기능 저하증).
- 고칼륨혈증성 심장 독성 (예: 요도 폐색 고양이, 애디슨 위기). 임상 요점: 칼슘은 혈청 칼륨 수치를 낮추지 않습니다. 대신 심근의 역치 전위를 높여 정상적인 휴지기-역치 간격을 회복시킴으로써 치명적인 부정맥으로부터 심장을 보호합니다.
- 칼슘 채널 차단제 중독.
임상 요점: 칼슘염을 구별하는 것이 매우 중요합니다. 10% 염화칼슘(Calcium chloride)은 10% 글루콘산칼슘(Calcium gluconate)(9.3 mg/mL)에 비해 약 3배 많은 원소 칼슘(27.2 mg/mL)을 함유하고 있습니다. 염화칼슘은 자극성이 강하고 산성화 작용을 하며, 혈관 외로 유출될 경우 심각한 조직 괴사의 위험이 있으므로 이상적으로는 중심 정맥관을 통해 투여해야 합니다. 말초 정맥 투여 시에는 글루콘산칼슘이 선호됩니다.
작용 기전
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.
안전성·주의사항
금기사항
- Ventricular fibrillation
- Hypercalcemia
부작용
- 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)
주의
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.
약물 상호작용
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.
모니터링
- 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)
약동학
흡수
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.
분포
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.
대사
Ionized calcium enters the extracellular fluid and is rapidly incorporated into skeletal tissue.
배설
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).
과다투여
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.
제품
제형
- Injection: 10% and 23% solutions
- Oral tablets
- Oral capsules
- Oral powder
- Oral gel/paste
동물용의약품
- 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)
인용의약품
- 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)
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store oral tablets and capsules in tight, well-closed containers at room temperature. Store injectable solutions at room temperature and protect from freezing.
보호자 정보
반려동물 보호자 안내
- 목적: 칼슘 보충제는 근육 경련, 쇠약 또는 발작(특히 수유 중인 어미에게서 나타나는 자간증 또는 '유열'이라고 하는 상태)을 유발할 수 있는 저칼슘혈증을 치료하는 데 사용됩니다.
- 투여 방법: 경구용 칼슘을 투여할 경우 수의사의 지시를 정확히 따르십시오. 칼슘이 특정 항생제(테트라사이클린 또는 플루오로퀴놀론 등)의 흡수를 방해할 수 있으므로 함께 먹이지 마십시오. 두 약물의 투여 간격은 최소 2시간 이상 두어야 합니다.
- 부작용: 경구용 칼슘은 때때로 위장 장애나 변비를 유발할 수 있습니다.
- 경고: 수의사와 상의 없이 사람용 칼슘 보충제나 제산제를 반려동물에게 먹이지 마십시오. 용량과 성분이 반려동물에게 안전하지 않을 수 있습니다. 반려동물이 병원에서 주사용 칼슘을 맞고 있는 경우, 너무 빨리 투여하면 심장에 영향을 줄 수 있으므로 수의사가 주의 깊게 모니터링할 것입니다.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.