calcium chloride dihydrate + potassium chloride + sodium chloride: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
calcium chloride dihydrate + potassium chloride + sodium chloride: clinical details
Prescribing considerations
- Assess fluid status, electrolyte balance, acid–base status, renal function and relevant concomitant medicines.
- This solution does not contain enough potassium or calcium to maintain these ions or correct a significant deficiency.
- Use particular caution with renal, cardiac or pulmonary impairment, sodium-retaining conditions, adrenal insufficiency, severe burns, pre-eclampsia or risk factors for hyponatraemia.
- Prevent extravasation and do not administer through the same infusion set as blood.
- Assess every additive for physical and chemical compatibility; calcium can precipitate with numerous medicines.
Contraindications and cautions
- Extracellular hyperhydration or hypervolaemia; hypertonic dehydration.
- Hyperkalaemia, hypernatraemia, hypercalcaemia or hyperchloraemia.
- Severe renal insufficiency with oliguria or anuria.
- Uncompensated heart failure, severe hypertension, generalised oedema or ascitic cirrhosis.
- Concomitant digitalis therapy.
- In preterm or term newborn infants aged 28 days or younger, concomitant intravenous ceftriaxone even through separate lines.
Monitoring
- Fluid balance and clinical signs of fluid overload.
- Plasma sodium, potassium, calcium and chloride; consider acid–base balance.
- Renal function and urine output where clinically relevant.
- Serum sodium particularly in acute illness, SIADH, neurological disease or use of vasopressin-enhancing medicines.
- Close plasma-electrolyte monitoring in children.
Clinical pharmacology
An isotonic crystalloid electrolyte solution that expands the extracellular compartment. Its disposition reflects the distribution and renal handling of water, sodium, potassium, calcium and chloride.
Formulation and product differences
- A clear, particle-free solution for intravenous infusion in a single-use Viaflo bag.
- Contains sodium chloride, potassium chloride and calcium chloride dihydrate, with water for injections and sodium hydroxide for pH adjustment.
- Contains calcium but no lactate or glucose; it should not be confused with Hartmann's or Ringer-lactate solution.
calcium chloride dihydrate + potassium chloride + sodium chloride interactions
Clinicians should review medicines affecting calcium, potassium, sodium or water balance and check compatibility before adding or co-infusing medicines.
Ceftriaxone
Calcium–ceftriaxone precipitates can form. Simultaneous intravenous administration is prohibited, with stricter contraindications for newborn infants.
Digoxin and other digitalis glycosides
Calcium may enhance their cardiac effects and cause serious or fatal arrhythmias; concomitant treatment is contraindicated.
Potassium-sparing diuretics, ACE inhibitors, angiotensin receptor blockers, tacrolimus and ciclosporin
These can increase blood potassium, particularly when renal function is impaired.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.