Icalziss (Calcium Chloride Dihydrate)

Calcium chloride dihydrate is used in extracorporeal procedures to manage calcium balance.

• Hypocalcemia during dialysis: restores serum calcium levels to maintain electrolyte homeostasis.
• Cardiopulmonary bypass surgery: supports myocardial contractility and assists coagulation during the procedure.
• Blood product preparation: provides calcium necessary for clotting factor activation in plasma and platelet concentrates.

• Calcium chloride dihydrate dissociates in solution to release calcium ions (Ca²⁺), which act as essential cofactors in numerous physiological processes. In the extracellular compartment, Ca²⁺ stabilizes cell membranes, participates in the coagulation cascade by activating clotting factors II, VII, IX and X, and enhances myocardial contractility by modulating voltage‑gated calcium channels. When administered extracorporeally, the added calcium rapidly equilibrates with the circulating blood, correcting hypocalcemia and supporting hemostasis.

Calcium chloride dihydrate may be associated with several adverse reactions, ranging from mild to severe.

Common Side Effects

• Local irritation at infusion site: redness, pain or swelling at the catheter entry point.
• Transient hypercalcemia: temporary elevation of serum calcium that usually resolves after infusion.
• Nausea: feeling of sickness that may occur during or shortly after administration.
• Vomiting: expulsion of stomach contents associated with rapid calcium infusion.

Serious or Rare Side Effects

• Severe hypercalcemia: marked increase in calcium leading to cardiac arrhythmias or neurological impairment.
• Tissue calcification: deposition of calcium in soft tissues, potentially affecting organ function.
• Hypotension: sudden drop in blood pressure during infusion.
• Allergic reaction: rash, itching, bronchospasm or anaphylaxis in sensitised individuals.

When using calcium chloride dihydrate, careful clinical assessment and monitoring are essential to minimise risks.

• Patient assessment: check baseline serum calcium and renal function before administration.
• Dose adjustment: modify the infusion rate in patients with renal impairment or existing calcium disorders.
• Monitoring: observe serum calcium levels and electrocardiogram continuously during and after infusion.
• Contraindications: avoid use in patients with documented hypercalcemia or severe cardiac dysfunction.
• Drug interactions: review concomitant calcium‑sensitive medications such as vitamin D analogues or thiazide diuretics.
• Store at ambient temperature: keep in original container, protect from moisture and light.

Calcium chloride dihydrate can interact with other medicines, influencing calcium balance or cardiac function.

Major Interactions (Avoid)

• Vitamin D analogues: combined effect may cause severe hypercalcemia.
• Thiazide diuretics: additive calcium retention increasing risk of hypercalcemia.

Moderate Interactions (Monitor Closely)

• Digitalis glycosides: elevated calcium may enhance digitalis toxicity.
• Beta‑blockers: calcium may alter cardiac response, requiring dose review.
• Anticoagulants (e.g., warfarin): calcium can affect clotting test results, necessitating monitoring.