Drug Safety Notice – Product shortage – Calcium Chloride Injections
January 29, 2020
Calcium chloride 10 mmol in 10 ml and 5 mmol in 5 ml ampoules for injection and the 10% pre filled syringes are out of stock until mid-March 2020. The ampoules are licensed for use as an intravenous injection or infusion for the treatment of hypocalcaemia or electrolyte imbalance. They are also used in some settings in the management of severe acute hyperkalaemia. The pre-filled syringes 10% (6.8 mmol in 10 ml) are licensed for use in cardio-pulmonary resuscitation, as well as the treatment of hypocalcaemia and calcium deficiency states.
Actions:
- Any remaining stock of pre-filled syringes of calcium chloride in clinical areas must be reserved for use in Resus. Area leads to check stock of pre-filled syringes and reserve.
- There may be certain patients, e.g. in critical care, or severe liver impairment; for whom the increased volume of gluconate or the time taken to infuse this additional volume may be problematic. Prioritise remaining stock of calcium chloride for this group.
- Review the content of crash boxes and antidote stock in line with product availability locally. Contact the Pharmacy department for stock supplies. Stock lists have been updated to include calcium gluconate where calcium chloride is stocked.
- Clinical leads and area managers to communicate the content of this notice amongst local teams to highlight the difference in calcium content of calcium gluconate and recommendations for dosing.
- Further advice and dose comparative table here: https://www.sps.nhs.uk/articles/shortage-of-calcium-chloride-injection-10-millimoles-in-10-ml-and-5millimoles-in-5ml-ampoules/
Please read the attached Drug Safety notice for further information on alternative agents and management options.