鈣鹽（葡萄糖酸鈣、氯化鈣、乳酸鈣、葡庚糖酸鈣）
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
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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).
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
爬蟲類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
豬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
山羊
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
鈣鹽是必需的礦物質補充劑，主要用於治療或預防低血鈣症，並在腎衰竭患者中作為口服磷結合劑。
注射用鈣劑是一種關鍵的急救藥物，用於：
- 確診的游離鈣低下（例如：產後子癇症/產褥期抽搐、原發性副甲狀腺機能低下）。
- 高血鉀性心臟毒性（例如：貓下泌尿道阻塞、愛迪生氏症危機）。臨床要點：鈣劑並不會降低血清鉀離子濃度；相反地，它能提高心肌的閾值電位，恢復正常的靜止至閾值電位差，從而保護心臟免受致命性心律不整的影響。
- 鈣離子通道阻斷劑中毒。
臨床要點： 區分不同的鈣鹽至關重要。10%氯化鈣 (Calcium chloride) 所含的元素鈣（27.2 mg/mL）約為 10%葡萄糖酸鈣 (Calcium gluconate)（9.3 mg/mL）的三倍。氯化鈣具有高度刺激性和酸化作用，若發生血管外滲漏會導致嚴重的組織壞死；理想情況下應透過中央靜脈導管給藥。葡萄糖酸鈣則是周邊靜脈注射的首選鈣鹽。
作用機轉
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.
安全性與警告
禁忌症
- Ventricular fibrillation
- Hypercalcemia
不良反應
- 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.
藥物交互作用
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.
監測
- 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)
藥物動力學
吸收
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.
分佈
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.
排除
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).
過量
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.
可用產品
劑型
- Injection: 10% and 23% solutions
- Oral tablets
- Oral capsules
- Oral powder
- Oral gel/paste
獸醫用
- 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)
人用標示
- 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)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store oral tablets and capsules in tight, well-closed containers at room temperature. Store injectable solutions at room temperature and protect from freezing.
飼主須知
寵物主人指引
- 用途： 鈣補充劑用於治療低血鈣症，低血鈣會導致肌肉抽搐、虛弱或癲癇發作（特別是在哺乳期的母犬/貓，這種情況稱為產後子癇症或「乳熱症」）。
- 給藥方式： 如果給予口服鈣劑，請嚴格遵循獸醫的指示。請勿與某些抗生素（如四環黴素或氟喹諾酮類）同時餵食，因為鈣會阻礙這些藥物的吸收。兩者給藥時間應至少間隔 2 小時。
- 副作用： 口服鈣劑有時可能會引起腸胃不適或便秘。
- 警告： 未經獸醫同意，切勿給寵物服用人類的鈣片或制酸劑，因為其劑量和配方對寵物可能不安全。如果您的寵物在診所接受注射鈣劑，獸醫會密切監測，因為注射過快可能會影響心臟功能。
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