HYPOCALCEMIA - MEDICINES FOR THE TREATMENT OF HYPOCALCEMIA

Causes

Hypocalcaemia can be induced by various factors: accumulation of phosphorus, alcoholism, deficiency / resistance to the action of vitamin D, magnesium deficiency, maternal diabetes (→ neonatal hypocalcemia), anticonvulsant drugs, infections, acute inflammation of the pancreas, insufficiency chronic kidney disease, hypochlorhydria, hypoparathyroidism, pathological stress, severe burns.

Symptoms

Children affected by hypocalcemia tend not to have obvious symptoms; sometimes, tremors, muscle twitching and convulsions are observed in affected children. In the adult, the symptoms of hypocalcemia are characterized by: tetanic syndrome (exaggerated increase in muscle contractility), tingling, numbness. Symptoms worsen in pregnancy and in episodes of high emotional stress.

Complications: arrhythmias, convulsions, tetanic cramps, laryngospasm, tachycardia.

The information on Hypocalcemia - Drugs for the Treatment of Hypocalcemia is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Hypocalcemia - Drugs for the Treatment of Hypocalcemia.

Medicines

Hypocalcemia is rather simple to cure by supplementing with calcium (supplementation of calcium lactate, calcium chloride and calcium gluconate); clearly, the promptness of intervention minimizes the risk of complications, which could also be very dangerous, especially in the case of infantile hypocalcemia.
For acute forms, an injection of calcium gluconate or calcium chloride is recommended.
In the hypoparathyroidism caused by parathyroidectomy, the administration of calcium is recommended as a preventive therapy against hypocalcemia; in severe forms associated with chronic renal failure in patients undergoing partial parathyroidectomy, the administration of calcium is recommended (indicative dosage: 1 gram of elemental calcium per day, for 5-10 days).
For all variants of hypocalcemia, vitamin D supplementation alone does not seem sufficient. Only if the patient supplements the diet with calcium and phosphate, the therapy with vitamin D for the treatment of hypocalcemia can be effective.
It is recommended that plasma calcium concentration be monitored constantly at intervals of one week (initially) or every 1 to 3 months, depending on the severity of the hypocalcaemia.

The following are the classes of drugs most used in the therapy against hypocalcemia, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:

Calcium Gluconate (eg Calcium Gluconate B Braun): indicatively, for acute forms of hypocalcemia, it is recommended to take the drug intravenously at a dose ranging from 500 to 2000 mg per day (5-20 ml); it is recommended not to exceed the infusion rate of 0.5-2 ml / min. The dosage can be increased as needed, based on the plasma concentration of calcium. The dose most commonly used in therapy to treat hypocalcaemia is it ranges between 1 g and 1.5 g, dividing the load into several daily doses. Repeat drug administration every 1-3 days as needed. The drug is also available in tablets to be taken orally, at a dose of 500-2000 mg per day (in 2-4 doses). The drug is also available in association with calcium carbonate (eg Calcium Sandoz): available in effervescent tablets formulated with 1132 mg of calcium lactate gluconate and 875 mg of calcium carbonate, equal to 500 mg of elemental calcium. It is recommended to take 1 gram of active ingredient per day, dissolving the tablet in a glass of water.

Calcium Carbonate (eg. Recal, Metocal, Cacit): for moderate forms of hypocalcemia, it is recommended to take a dose of the drug ranging from 900 to 2500 mg per day, equally divided into two daily doses. The dose just described can be modulated by the doctor according to the patient's response.

Calcitriol (eg rocaltrol, Difix): particularly indicated for the treatment of hypocalcemia associated with renal insufficiency: the drug, in fact, does not require a metabolic effort by the kidney. Orally, initially take the drug at a dose of 0 , 25 mcg, once daily. Maintenance therapy involves increasing 0.25 mcg / dose at 4-8 week intervals, in full compliance with the physician's instructions. The drug is also available as an infusion for administration parenteral: take 0.5 mcg of drug intravenously, three times a week. The maintenance dose, in this case, involves increasing the dosage by 0.25-0.5 mcg / dose, at intervals of 2-4 The dose just described is indicated to treat adult hypocalcemia; for infantile hypocalcemia the dosage must be modulated and customized by the doctor according to the severity of the condition, the weight of the child and the age.

Dihydrotachisterol (eg Atiten): in the form of a solution, it is recommended to take 1 ml of product - corresponding to about 30 drops - equivalent to 1 mg of Dihydrotachisterol. Indicated for the treatment of hypocalcemia associated with hypoparathyroidism. The average dosage of the drug corresponds to 15-45 drops of solution (0.5-1.5 mg of active); however, it should be emphasized that the precise dosage must be customized according to the level of calcium in the plasma.

Ergocalciferoloo vitamin D2 (eg Ostelin): for adults suffering from hypocalcemia, the dosage is to take a dose of the drug ranging from 50,000 to 200,000 units orally or intramuscularly, once a day. For children with familial hypocalcemia, take the drug orally or intramuscularly at a dose of 1000-2000 mcg per day (corresponding to 40,000-80,000 IU) with a "supplementation of phosphates. The daily dosage of vitamin D2 can be increased by 250-500 mcg (10,000-20,000 IU) every 3-4 months For further information: consult your doctor.

Calcium globionate: orally, it is recommended to take a dose of active equal to 15 ml, three times a day, on an empty stomach. 5 ml of product provide the body with 115 mg of elemental calcium. The dosage just described is indicated for the treatment of hypocalcemia in adults; in children, the dosage depends on age, weight and severity of symptoms. Consult your doctor.

Alfacalcidol (eg. Dediol, Geniad, Sefal, Deril, Diserinal): also called 1 alpha-hydroxycholecalciferol, alfacalciferol is a drug synthesizing vitamin D, capable of exerting the same effects as the active form of vitamin D, without however require the intervention of the renal system. Indicatively, it is usually recommended to take the drug at a dose of 0.25-1 mcg per day (in the form of tablets to be taken by mouth), for the treatment of hypocalcemia in adults .