What are the recommended treatment options for acute symptomatic hypocalcaemia in primary care?

Treatment options for acute symptomatic hypocalcaemia in primary care primarily involve urgent correction of the low calcium levels to relieve symptoms and prevent complications. Initial management includes administration of oral calcium supplements if the symptoms are mild and the patient can tolerate oral intake. For more severe symptoms or if oral treatment is not feasible, urgent referral to secondary care for intravenous calcium administration is recommended. Additionally, identifying and treating the underlying cause, such as vitamin D deficiency, is essential. Vitamin D supplementation should be initiated if deficiency is confirmed or suspected. Monitoring and follow-up are important to ensure calcium levels normalize and symptoms resolve. Referral to a specialist is advised if hypocalcaemia is severe, persistent, or if the cause is unclear.

Summary of key treatment steps:

• Administer oral calcium supplements for mild symptomatic hypocalcaemia.
• Urgent hospital referral for intravenous calcium in severe or acute symptomatic cases.
• Assess and treat underlying causes, especially vitamin D deficiency, with appropriate vitamin D supplementation.
• Monitor calcium and vitamin D levels as appropriate.
• Refer to specialist care if hypocalcaemia is severe, persistent, or of uncertain cause.

These recommendations are extrapolated from the Vitamin D deficiency guideline and expert opinion on hypocalcaemia management in primary care, as no specific primary care hypocalcaemia guideline was provided in the context ².