Study of the solubility of calcium gluconate and the stability of its solutions

What is Calcium Gluconate?

Medicinal mineral concentrate replenishes the lack of calcium ions, promotes the regulation of metabolism, and participates in many physiological processes. The drug is produced in several forms:

• non-coated white tablets: in dosages of 250 and 500 mg;
• chewable lozenges;
• aqueous solution for parenteral administration in ampoules: with 100 mg of active substance in 1 ml.

Among the auxiliary compounds of the drug: silicon dioxide, starch and other form-building additives. The solution additionally contains calcium sucrose.

How much calcium should be added

Remember that you usually only need 1000-1200 mg of calcium each day. There is no point in getting more calcium. It might even be dangerous. There are recommendations that the maximum daily calcium intake should not be more than 2000-2500 mg per day. To avoid the danger of getting too much calcium and causing constipation, hypercalcemia, calcium accumulation in soft tissues, problems with the absorption of iron and zinc, it is not recommended to receive more than 1400 mg of calcium per day for a long time.

If you cannot supplement your diet with foods high in calcium (dairy products, leafy greens, nuts, beans and tofu), you can take up to 500-1000 mg of elemental calcium from supplements.

What is Calcium Gluconate good for?

Mineral ions ensure the functioning of muscle tissue, bone restoration, and hematopoiesis. Calcium Gluconate has a systemic effect, regulating metabolic processes and the functioning of internal organs. The drug has a hemostatic, anti-allergenic effect, reduces the intensity of inflammation, stabilizes the permeability of cell membranes, helps prevent swelling, supports heart function, and strengthens tooth enamel.

Calcium gluconate is non-toxic, absorbed into the blood in the small intestine, and penetrates fluids and tissues. Excess ionized substance is filtered by the kidneys and excreted in the urine.

What tests to take

It is difficult to detect calcium deficiency using a blood test, because the body does everything possible to maintain a constant level of ionized calcium in the blood. But it’s easy to be deficient or deficient in vitamin D by taking a blood test for 25-OH vitamin D.

To identify contraindications and evaluate the effectiveness of treatment with calcium preparations, you should take tests:

• Calcium and phosphorus in the blood
• Calcium in daily urine
• Blood creatinine
• 25-OH vitamin D

In the Lab4U laboratory this can be done with a discount of up to 50%.

What are calcium gluconate tablets used for?

They are prescribed for suspected development of hypocalcemia, for its prevention, for various metabolic disorders, intoxication and injuries:

• osteoporosis;
• hyperphosphatemia;
• calcium deficiency and its increased costs: during pregnancy, menopause;
• to accelerate bone regeneration after fractures;
• poisoning with salts of heavy metals, chemicals;
• with long-term treatment with diuretics, laxatives;
• with malnutrition: lack of foods containing calcium.

As an additional therapy, the drug is recommended for skin allergies, tuberculosis, liver damage, bronchial asthma, and nephritis.

When to think about calcium deficiency

If you have a lack or deficiency of vitamin D, if you don’t get enough sun exposure, drink little or no milk and dairy products, for example due to an allergy or lactose intolerance, follow special types of diet (high protein diet, veganism, etc.) .), if you are addicted to caffeine (coffee, strong tea, chocolate), then you should think about the lack of calcium intake from food. By the way, foods such as spinach, greens, rhubarb, and beans, although rich in calcium, also contain oxalic and phytic acids. As a result, insoluble calcium-oxalate and calcium-phytate complexes are formed, which does not allow calcium to be absorbed.

Diseases of the kidneys, parathyroid glands and inflammatory bowel diseases also disrupt the calcium balance in the body.

When are calcium gluconate injections given?

Among the indications for the course of injections of the drug:

• pathologies of the parathyroid glands;
• allergic complications;
• liver intoxication;
• hyperkalemia;
• psoriasis;
• eczema;
• diabetes;
• rheumatism.

The solution is administered intravenously and intramuscularly once a day. If necessary, the product is diluted in saline and heated to +35°C.

Single dose: 5–10 ml of the drug. For children from the first days of life and adolescents under 14 years of age, the medicine is administered intravenously. The dose is calculated from 0.1 to 5 ml.

The treatment regimen involves daily injections or 2-3 injections per week.

Calcium gluconate

Calcium gluconate

(English
calcium gluconate,
lat.
calcii gluconas
) is a calcium salt of gluconic acid, used in medicine for calcium deficiency in the body.

Calcium gluconate is a chemical substance

The gross formula of calcium gluconate is C12H22CaO14. The systematic name is calcium (2 R
,3
S
,4
R
,5
R
)-2,3,4,5,6-pentahydroxyhexanoate. White granular or crystalline powder, odorless and tasteless. Calcium gluconate dissolves quite slowly in cold water, and quickly in boiling water. Practically insoluble in ethanol and ether. Molecular weight 430.373 g/mol. The calcium content in calcium gluconate is 8.9% (which is less than in most other calcium salts used in medicine). In pharmaceuticals, it is often used in the form of calcium gluconate monohydrate, when a water molecule is attached to a calcium gluconate molecule: C12H22CaO14·H2O or the “text” version: (HOCH2(CHOH)4COO)2Ca·H2O.

Calcium gluconate is the international nonproprietary name of the drug

Calcium gluconate is the international nonproprietary name (INN) of the drug. According to the pharmacological index, calcium gluconate is included in the group “Macro- and microelements”. In ATC, calcium gluconate is included in the following sections:

• "A. Drugs affecting the digestive tract and metabolism”, subsection “A12 Mineral Supplements”, group “A12AA Calcium Preparations” and has code A12AA03
• "D. Preparations for the treatment of skin diseases", subsection "D11 Other drugs for the treatment of skin diseases", group "D11AX Other drugs for the treatment of skin diseases" and has the code D11AX03

See also the article “ Calcium as medicine
”.

Indications for use of calcium gluconate

Calcium gluconate is indicated for:

• diseases accompanied by calcium deficiency, increased permeability of cell membranes, disruption of nerve impulses in muscle tissue
• hypoparathyroidism (latent tetany, osteoporosis)
• disorders of vitamin D metabolism: rickets (spasmophilia, osteomalacia), hyperphosphatemia in patients with chronic renal failure.
• conditions that increase the need for calcium: pregnancy, breastfeeding, increased body growth
• insufficient calcium content in food, calcium metabolism disorders (in the postmenopausal period)
• acute inflammatory processes in the oral cavity, accompanied by swelling, the postoperative period (to reduce swelling), remineralizing therapy for the prevention and treatment of caries and non-carious tooth lesions
• increased excretion of calcium during prolonged bed rest, chronic diarrhea, secondary hypocalcemia during prolonged use of diuretics and antiepileptic drugs, glucocorticosteroids
• poisoning with magnesium salts, oxalic and fluoric acids and their soluble salts (when interacting with calcium gluconate, insoluble and non-toxic calcium oxalate and calcium fluoride are formed)
• hypercalcemic form of paroxysmal myoplegia

How to take calcium gluconate

Calcium gluconate is taken:

• The tablets are crushed before taking; taken orally before meals 2-3 times a day in the following dosage:
• adults - 1–3 g or more
• children 10–14 years old – 2–3 years
• children 7–9 years old – 1.5–2 g
• children 5–6 years old – 1–1.5 g
• children 3–4 years old - 1 g

• adults and children over 9 years old - 9 g
• children 7–9 years old – 6 g
• children 5–6 years old - 4.5 g
• 3–4 years – 3 g

• adults intramuscularly or intravenously, administer 5–10 ml of 10% calcium gluconate solution daily, every other day or two days, depending on the indications
• children intravenously, slowly from 1 to 5 ml of 10% calcium gluconate solution every 2-3 days, depending on age.

Side effects when treated with calcium gluconate

Calcium gluconate therapy may be accompanied by the following side effects:

• constipation (when taken orally)
• irritation of the mucous membrane of the gastrointestinal tract (when taken orally)
• nausea, vomiting, diarrhea, bradycardia (with intramuscular or intravenous administration)
• heat or burning in the mouth and throughout the body (with intravenous administration)
• hypercalcemia

Features of calcium gluconate therapy for pregnant and lactating women

Calcium is transported across the human placenta.
Fetal calcium accumulation occurs primarily during the third trimester. By the end of a normal pregnancy, the fetus gains approximately 28 g of calcium and 16 g of phosphorus for skeletal development. The recommended daily calcium supplement for pregnant women averages 1,200 mg (compared to 400 mg per day for an adult not pregnant or lactating). During the last trimester, an additional 250 to 300 mg of calcium per day is recommended. At the same time, the FDA established a risk category for the effect of calcium gluconate on the fetus when used in pregnant women - “C” (animal studies revealed a negative effect of the drug on the fetus, and there were no adequate studies in pregnant women, but there is a potential benefit associated with the use of this drug in pregnant women , may justify its use despite the risks). There is no scientific data on the penetration of calcium into milk from the body of a nursing mother. Calcium is considered a normal nutritional component of human milk. The calcium content in breast milk averages 300 mg per liter. The recommended daily intake of calcium for a woman during lactation is 1200 mg. One liter of cow's milk contains about 1200 mg of calcium.

Pregnant or breastfeeding women who do not consume milk or dairy products may need supplemental calcium.

Medicinal mono- and multicomponent preparations containing calcium gluconate

Calcium gluconate
are approved for use, sometimes with additions such as “
stabilized
”, “
VIAL
”, “
LekT
” and others.

Calcium gluconate is also included in multicomponent preparations:

• anti-cold and anti-flu drugs Anvimax
  (calcium gluconate monohydrate + paracetamol + ascorbic acid + rimantadine hydrochloride + rutoside + loratadine),
  Antigrippin-Anvi
  (
  first capsule:
  acetylsalicylic acid + ascorbic acid + rutoside and
  second capsule:
  calcium gluconate monohydrate + metamizole sodium monohydrate + diphenhydramine hydrochloride),
  Antigrippin-Maximum
  (calcium gluconate monohydrate + paracetamol + rimantadine hydrochloride + ascorbic acid + loratadine + rutoside),
  Antigrippin-ARVI
• anticonvulsants " Pagluferal
  "
  -1, 2, 3
  (calcium gluconate + bromizal + caffeine + papaverine + phenobarbital)
• solution for intracoronary infusion Consol
  (calcium gluconate + potassium chloride + lidocaine hydrochloride + magnesium sulfate + sodium bicarbonate + sodium chloride)

and others. On the website in the Literature section there is a subsection “Nutraceuticals”, containing articles that touch upon, among other things, the use of mineral supplements.
Calcium gluconate (solution for intravenous and intramuscular administration; solution for injection; tablets) is included in the “List of vital and essential medicines.”

Calcium gluconate has contraindications, side effects and application features; before use, consultation with a specialist is necessary.

Calcium provocative test to confirm the presence of gastrinoma

In cases where high gastric secretion is observed but serum gastrin levels are between 100 and 1000 pg/ml, the diagnosis of gastrinoma should be confirmed using provocative tests. Tests are performed with secretin, calcium or a standard breakfast. The calcium test is carried out as follows: a 10% solution of calcium gluconate is administered intravenously for 3 hours at a dose of 5 mg Ca/kg/h; gastrin is determined before the administration of calcium and every 30 minutes for 4 hours. A test with calcium is more dangerous for the patient compared to a test with the introduction of secretin, so it is not recommended as a primary test. Zollinger-Ellison syndrome is characterized by a sharp increase in gastrin content after administration of a calcium solution. The secretin test has the greatest diagnostic value. It is positive in 87% of patients with Zollinger-Ellison syndrome. The indication for a calcium test is a negative result of the secretin test (13% of patients with Zollinger-Ellison syndrome). Unfortunately, a calcium test can additionally identify only 4% of patients with gastrinomas. Thus, in 9% of patients with Zollinger–Ellison syndrome, both provocative tests are negative (Okhlobystin A.V.).

Calcium gluconate - food supplement

Calcium gluconate, as a food additive, has code E578 and is characterized by SanPiN 2.3.2.1293-03 as an acidity regulator and hardener. As a supplement E578 calcium gluconate can be added to:

• infant formula
• coffee drinks
• bread and bakery products
• flour confectionery products

Calcium gluconate is used in the production of canned vegetables and fruits as a thickening agent for plant tissues.
In agriculture, calcium gluconate is used in the preparation of animal feed. Back to section

Side effects of calcium gluconate

When used correctly, the product is well tolerated. Occasionally, during treatment the following are possible:

• heart rhythm disturbance;
• dyspepsia, stool disorder;
• pain in the epigastric region;
• with long-term use: formation of stones in the renal pelvis.

After the injection, you may feel intense heat in the area where the solution was administered and hyperhidrosis. Increased blood pressure, skin irritation, formation of calcifications in soft tissues, and physical weakness are likely. In case of overdose, the risk of side effects increases many times over.

Who are calcium supplements indicated for?

• In the treatment of pathological fractures due to osteoporosis
• Women over 50 years of age with vitamin D deficiency or deficiency
• If you have osteoporosis
• For women who have reached menopause to prevent osteoporosis
• If you have insufficient calcium intake from food:

The daily requirement for calcium in children under 3 years of age is 700 mg, for children 4-10 years of age and adults 1000 mg. An increased requirement of up to 1200 mg is observed in women in menopause or over 50 years of age and in men over 70 years of age. Adolescents during the growing period (10-16 years), pregnant and breastfeeding women should receive up to 1300 mg of calcium.