Calcium Dosing for Pediatrics

CALCIUM INFORMATION SHEET FOR PEDIATRICS Calcium (all doses listed as elemental calcium, except Ca Chloride): ***Ca ***Ca Chloride Dose Order as Salt  (usual dose = 10 mg/kg/dose) Elemental Doses:

IV

PO

Neonate

20 to 80 mg/kg/day ÷ QID (usual dose = 10 mg/kg/dose)

20 to 80 mg/kg/day ÷ QID

Child

20 to 50 mg/kg/day ÷ QID (usual dose = 15 mg/kg/dose)

45 to 65 mg/kg/day ÷ QID

Adolescent

400 to 1,500 mg/day ÷ QID (usual dose = 100 mg / dose)

1000 to 2000 mg/day ÷ QID

Salt

PO/IV

Ca PO Carbonate only

Ca IV Chloride Ca PO Glubionate only IV Ca Gluconate

PO

Amount of   Elemental Ca Tablet = 500 mg (Os-cal) Tablet = 260 mg Suspension = 100 mg/ml

Amount of  Salt 1250 mg Ca carbonate 650 mg Ca carbonate 250 mg/ml Ca carbonate 100 mg/ml Ca chloride Syrup = 23 360 mg/ml mg/ml Ca glubionate Injection = 9.3 100 mg/ml mg/ml Ca gluconate Tablet = 45 mg 500 mg Ca gluconate

Ratio Elemental Ca to Salt 500 mg of elemental/ 1250 mg Ca carbonate 260 mg elemental/ 650 mg Ca carbonate 100 mg of elemental/ 250 mg Ca carbonate

23 mg elemental/ 360 mg Ca glubionate 9.3mg of elemental/ 100 mg Ca gluconate 45 mg of elemental/ 500 mg of Ca gluconate

Advantages Salt of choice for  CRF (helps ↓ Phos and may help with metabolic acidosis)

Irritating to veins, acidifying properties Better absorption than Carbonate Less irritating than Chloride

Orders should be written as follows (except for calcium chloride): IV:

Ca++ _____mg as calcium (salt) = X ml in D5W D5W or NSS Xml q _______. Infuse over X hour. Example: 5 kg patient: Ca++ 75 mg as Ca gluconate = 8 ml in 100ml D5W IV over 2 hr X 1 dose. 75 mg elemental Ca = 8 ml 9.3mg elemental Ca/ml

PO:

Ca++_____ mg as calcium (salt) = X ml q _______. Example: 30 kg patient: Ca++ 375 mg as Ca carbonate = 3.75 ml PO QID. 50 mg/kg/day x 30kg = 1500 mg elemental Ca/day/4 (to give it QID) = 375 mg/dose QID 375 mg elemental Ca++/ 100 mg elemental Ca/ml carbonate suspension = 3.75 ml/dose