dose: 9 g/24 hr. Calcium can be given as either calcium gluconate or calcium chloride. Calcium plays a vital role in dogs that have just delivered a litter of healthy puppies. IV: (Dose expressed in mg of calcium gluconate): Clinical signs like frequent urination, information provided by you as to your pets history (previous illnesses, current medications, or knowledge of intake of supplements), and a physical examination will all add to the quick diagnosis by the veterinarian. During administration of calcium, heart rate should be carefully monitored by auscultation or ECG for bradycardia or arrhythmias. The effect of calcium gluconate in the treatment of hyperkalemia 11 to 24 years: 1200 mg/day Note: One gram of calcium gluconate salt is equal to 93 mg of elemental calcium. In dogs with hypocalcemia, the usual dose is 25 to 75 mg per pound (50 to 150 mg/kg) of 10% calcium gluconate solution slowly by intravenous injection with careful monitoring of the heart rate. C12H22CaO14. (0.44 mEq) of calcium ions. Calcium is an essential building block for bones, and the balance of dietary calcium and phosphorous is especially important for young, growing animals. Slow intravenous administration of 10% calcium gluconate0.5-1.5 mL/kg over 10-30 minutes (5-20 mL is a typical dose)is an effective treatment for eclampsia, usually resulting in clinical improvement within 15 minutes. The concentration of serum calcium should be monitored weekly. The cardiac effects lead progressively to bradycardia, atrial standstill, and cardiac arrest as the hyperkalemia worsens. Mineral. This results in activation of vitamin D, increased renal resorption of calcium, and mobilization of calcium from bone, thereby normalizing ionized calcium in the extracellular fluid. Hypocalcemic animals should, therefore, receive parenteral calcium support during the initial posttetany period. Clinical signs of hypercalcemia can be difficult to detect. The pathogenesis of hypercalcemia in hypoadrenocorticism is not completely understood either, but total calcium is probably elevated due to hemoconcentration. 1 to 3 years: 500 mg/day Each mL of Calcium Gluconate in Sodium Chloride Injection contains 20 mg of calcium gluconate which contains 1.86 mg (0.093 mEq) of elemental calcium. Hypocalcemia (dose depends on clinical condition and serum calcium level): Calcium gluconate, 10%, contains 9.3 mg of elemental calcium/mL. An enlarged parathyroid gland is usually not palpable in dogs, but can be palpated about half of the time in cats with the disease. Dosing seems totally crazy when you first start: RAFTER 8 PRODUCTS, 87 Skyline Cr NE, Calgary AB T2K 5X2, Copyright 2023 Animalytix LLC. IV Fluids - 1x: Maintenance (30cc x kg) + 70cc IV: . The low concentration of calcium in the extracellular fluid has an excitatory effect on nerve and muscle cells because it lowers the threshold potential (voltage level at which sodium channels become activated) so that it is closer to the resting membrane potential. Oral calcium supplementation is easier. Clinical signs of hypercalcemia can be difficult to detect. Individualize the dose of Calcium Gluconate Injection within the recommended range depending on the severity of symptoms of hypocalcemia, the serum calcium level, and the acuity of onset of PDF Livestock - Agricultural Marketing Service 50 to 150 mg/kg/day in 4 to 6 divided doses Discard unused portion. i) Calcium gluconate or calcium chloride - 10% solution (1) Calcium Gluconate - 0.5 to 1.0 ml/kg slowly IV (2) Calcium Chloride - 0.5 ml/kg slowly IV (3) Duration of effect ~ 20 to 30 minutes (4) Does not lower serum potassium but helps normalize cell membrane potentials. This includes prescription and over-the-counter medicines, vitamins, and herbal products. A commercially available human intact-PTH assay has been validated in both cats and dogs; PTH-calcium curves are also similar in cats and dogs. While it does occur, primary hyperparathyroidism is rare in cats. Dog grass . Dosage IV Dose; Sodium Bicarbonate: prolonged arrest > 10 minutes: 1-2 mg/kg: 10% Calcium Chloride: Dose expressed in mg of calcium gluconate: Dogs over 20 lb, 1 mL per 10 lb initial dose; 1 - 3 mL per dose thereafter. Intestinal Tract Disease (Lymphangiectasia), Food Sensitivity and Allergies in French Bulldogs, Calcium absorbed in the chewable supplements is increased when Vitamin D3 is added, Chews and other forms of supplementation can contain both vitamins D and K, Pet owners who feel calcium addition is needed must speak to their veterinary caregiver for advice and verification of the need, Calcium chews are often chocolate flavored; chocolate can be poisonous though most chews contain only enough chocolate to make your dog very sick, Excessive calcium causes electrolyte changes, Kidney damage can be acute but can lead to chronic kidney disease, Puppies and dogs with previous or concurrent kidney issues will be predisposed to poisoning, The heart and gastrointestinal tract can be affected, Vitamin D3 is absorbed by the gastrointestinal tract increasing serum calcium levels and the kidney cannot eliminate or regulate it, If a dog eats a lot of calcium chew wrappers there is a chance of obstruction. Bone meal has also been used as a calcium source; however, the effects are similar when compared to the manufactured . . Please confirm that you are a health care professional. Calcium carbonate is cheapest and therefore often a good first . Primary hyperparathyroidism is caused by an autonomously hyperfunctioning adenoma of the chief cells of the parathyroid gland. Calcium can make it harder for your body to absorb certain medicines. Although uncommon in queens, hypocalcemia may occur during early lactation. If tetany recurs during the same lactation, the litter should be removed from the bitch or queen and either hand-raised (<4 weeks old) or weaned (>4 weeks old). o [ canine influenza] SeeCalcium Acetate forcontraindications, . Description Chemical name. The dosage of elemental calcium for hypocalcemia is 515 mg/kg per hour. Ventilate intubated dogs and cats at a rate of 10 breaths per minute. Calcium gluconate is the calcium salt of gluconic acid, an intravenous medication used to treat conditions arising from calcium deficiencies such as hypocalcemic tetany, hypocalcemia related to hypoparathyrodism, and hypocalcemia due to rapid growth or pregnancy. 9 to 18 years: 1300 mg/day Dogs need calcium for all the same processes that humans do. It is a rare disorder but is seen sporadically in calves; the cause is unknown. Use cautiously in patients receiving digitalis glycosides, or with cardiac or renal disease. Approval was partially successful, following selected items could not be processed due to error, http://instance.metastore.ingenta.com/content/formulary/backmatter/canine-and-felineemergencydosesfordogsandcats, Asystole or pulseless electrical activity, Raised intracranial pressure (impending herniation), BSAVA Small Animal Formulary Part A: Canine and Feline. It must be noted that every animal is different, and the return of normal parathyroid gland function is impossible to predict. The mechanism of these effects is not known, but they occur before there is any measurable improvement in serum potassium concentration. Calcium Gluconate - an overview | ScienceDirect Topics Calcium supplement poisoning in dogs can occur when a canine ingests a large amount of this product; for example, in the form of non-prescription calcium chews taken by people as an aid to boost their calcium. During these temporary reprieves from the hyperkalemia, additional measures must be initiated to provide long-term regulation of serum potassium. is 13% calcium, and 1 g yields 6.5 mEq. Calcium-containing crystals, isosthenuria, hematuria, and/or pyuria can be present. Calcium gluconate does not affect potassium levels but instead antagonizes potassium's effect on cardiomyocytes. Calcium administration during peak lactation may be helpful in bitches with a history of eclampsia. Predisposing causes include prolonged delivery, dystocia, and retained fetuses or placentas. intravenous/Dog : Because of the loss of stabilizing membrane-bound calcium ions, nerve membranes become more permeable to sodium ions and require a stimulus of lesser magnitude to depolarize. The body of ratio of 1.2 to 1. Calcium chloride contains three . Potassium balance is typically preserved in patients with chronic kidney disease, but hyperkalemia can develop in response to acute decompensation of stable I.R.I.S. As chronic kidney disease progresses to an advanced state (less than 5% to 10% of normal renal function) compensatory adjustments for potassium homeostasis become ineffective and potassium retention and hyperkalemia may develop. Calcium Chloride Intravenous Infusion, 10% w/v - medicines Children: 45 to 65 mg/kg/day in 4 divided doses The duration of treatment for iatrogenic hypocalcemia is variable. The aim of longterm treatment is to maintain the serum calcium concentration at mildly low to low-normal concentrations (89.5 mg/dL). The etiology, clinical manifestations, and diagnostic approach to hypocalcemia are reviewed . Calcium carbonate is a good choice because of its high percentage of elemental calcium, general availability in drugstores in the form of antacids, low cost, and lack of gastric irritation. Divide subcutaneous injections over several sites. Learn about the foods that contain calcium. Most simple cases of calcium supplement ingestion will end in a positive way as long as the situation was treated as needed. In more acute situations, the injectable variety is preferable. Cows also have increased volatile fatty acids (which are inhibitory at neuromuscular synapses), and the threshold potential at neuromuscular junctions is higher in cows than in dogs. Use calcium gluconate exactly as directed on the label, or as prescribed by your doctor. To immediately resolve these threats, calcium gluconate (10% solution) is administered at 0.5-1.0 ml/kg as a slow intravenous bolus over 10-15 minutes to increase the threshold potential for cardiac excitation. Azotemia can be present because of the deleterious effects of hypercalcemia on the kidney (renal mineralization). 6 Treatment should be slowed or stopped if further bradycardia or other arrhythmias develop. Some products with added calcium and Vitamin D which could also be palatable to your dog are Tums tablets and Citracal gummies. This is administered at the vets only. Warm solution to body temperature prior to use, and inject slowly. Hypocalcemia at parturition interferes with the release of acetylcholine at the neuromuscular junction, which is normally mediated by extracellular calcium entering presynaptic nerve terminals through voltage-gated calcium channels and triggering the fusion of acetylcholine-filled synaptic vesicles with the presynaptic nerve terminus. Canine Hypocalcemia (Eclampsia) - Dog Discoveries While this disorder is uncommon, some breeds are predisposed. 2007) Rodents: 1-2mg/kg PO, SQ q24 (a compounded sustainedrelease meloxicam a light-headed feeling, like you might pass out; high levels of calcium in your blood--nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, confusion, lack of energy, or feeling tired. Calcium gluconate is available in 500 975 mg calcium gluconate (45-90 mg of elemental calcium) tablets. Ohio Veterinarian of the Year awarded, and new president named, News wrap-up: This weeks headlines, plus Virox and NAVTA announce infection prevention program, Hypoadrenocorticism in the emergency setting, Point-of-care thyroid diagnostic device is shaking up the endocrinology world. The phosphonate drug pamidronate can also be used to decrease bone resorption, so it is a logical choice in the treatment of hypercalcemia of malignancy. Panting and restlessness are early clinical signs of eclampsia. Still, hypervitaminosis D is a rare cause of hypercalcemia. The use of calcium does not reduce the serum potassium level, but counteracts the effects of hyperkalemia on cardiac excitability. 4 CONTRAINDICATIONS. Summary. Inadequate production of parathyroid hormone (PTH) during the hypocalcemic crisis is not responsible for eclampsia in dogs. The breed of dog is also a consideration. Acvim 2008 - Vin Calcium Gluconate: Uses, Dosage & Side Effects - Drugs.com Furthermore, it has a long half-life, so should vitamin D toxicity occur, it takes longer to subside. Calcium should be monitored closely following any thyroidectomy, and treatment of hypocalcemia is the same as for post-parathyroidectomy hypocalcemia. Copyright 1996-2023 Cerner Multum, Inc. Do not exceed 1 g/day Breed. 48(4):663681. The serum chemistry profile, besides hypercalcemia, shows a normal or low serum phosphorus concentration. Capsicum, fluid extract of . For continuous infusions, adjust rate as needed based on serum calcium levels. Subcutaneous masses, erythema, bullae, granulomata, and skin sloughing may develop at sites of subcutaneous injection. How Much Calcium To Give A Nursing Dog Dihydroxyaluminum sodium carbonate . Cardiac arrest in the presence of hyperkalemia or hypocalcemia, magnesium toxicity, or calcium antagonist toxicity: The material is metabolized by the animal, with the calcium entering the blood stream and some being expressed as milk. Calcium chloride contains about 3 times more elemental calcium than an equal volume of calcium gluconate: 1 g of calcium chloride has 270 mg (13.5 mEq) of elemental calcium, whereas 1 g of calcium gluconate has 90 mg (4.5 mEq). Even if your pet feels better, the entire treatment plan should be completed to prevent relapse. It may be administered on an emergency basis at a dosage of 0.5 to 1.5 mL/kg, diluted and given over several minutes, or it is added to . Managing calcium disorders (Proceedings) - DVM 360 Therapeutic effects begin within 10 minutes and may persist for 1 to 2 hours. Tell your doctor about all your current medicines. Options for the acute management of hyperkalemia are to antagonize the increased resting membrane potential in cardiac myocytes, redistribute potassium from the extracellular to the intracellular fluid compartments, and to eliminate the potassium load from the body. Oral Cal Plus Gel | Oral Calcium for Dogs and Cats - Breeder's Edge 2.2 Recommended Dosage . Hypocalcemia most likely results from loss of calcium into the milk and from inadequate dietary calcium intake. In the past, vitamin D-containing rodenticides were used and were a more common cause of hypervitaminosis D, but those products are no longer marketed. Rarely, mastitis is seen in lactating read more , should also be excluded. Glucose stimulates insulin release and promotes the transcellular uptake of potassium. However, to avoid acute problems of hypocalcemic tetany, oral calcium supplementation should continue throughout lactation. The dosage of calcium can be gradually tapered to avoid unnecessary treatment; commercial pet food usually contains sufficient calcium to meet the needs of dogs and cats. Your dose may need to be adjusted as you make changes to your diet. Calcium chloride is not appropriate because of its potency, acidifying tendency, and irritation if injected extravascularly. In cats with hypocalcemia, 46 to 70 mg per . Eclampsia in Small Animals - MSD Veterinary Manual Calcium is necessary for many normal functions of the body, especially bone formation and maintenance. This protocol effectively supports serum calcium concentrations while waiting for oral vitamin D and calcium treatment to have effect. Currently formulated commercial renal diets likely provide excessive dietary loads of potassium (when consumed to meet daily nutrient requirements) that cannot be excreted effectively in animals with moderate/severe renal dysfunction. Use intravenously in horses. Doses of calcium gluconate vary widely depending on the reason for prescribing and response top initial doses. 1 to 10 years: 800 mg/day Dogs up to 20 lb, 2 mL initial dose; 1 mL per dose thereafter. 100 mg/minute in pediatric patients.
If you suspect that your pet has consumed a large number of your calcium supplement chews or tablets, or if you have been adding supplements to his diet and notice that he is drinking excessively, is lethargic, or seems depressed, these signs along with other behavioral changes indicate that your dog should be seen by the veterinarian. It contains less elemental calcium than other kinds of calcium supplements and may be less bioavailable. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Most breeders do fine with Tums. Pets who have existing kidney issues, as well as young dogs, are more at risk of toxicity from eating calcium supplement chews. Many drugs can interact with calcium gluconate, especially: This list is not complete and many other drugs may interact with calcium gluconate. Last updated on Jun 22, 2022. During this period, they should be fed a milk substitute or other appropriate diet; if mature enough, they should be weaned. Enter search terms to find related veterinary topics, multimedia and more. The brand most pet owners may be aware of is Caltrate; other brands are Viactiv and Nature Made. Calcium Gluconate for Dogs and Cats - PetPlace The veterinary team may induce vomiting (which could bring up chew wrappers) or perform gastric lavage to flush out the stomach. Historically, seizures occur in about 50% of cases. Hyperphosphatemia also stimulates PTH secretion from the parathyroid glands which can increase serum calcium concentrations. PetPlace may be compensated when you click on or make a purchase using the links in this article. Hypocalcemia may also occur during parturition and may precipitate dystocia. Muscle relaxation should be immediate. Tortoises: 7.5-10 mg/kg diluted with normal saline IM. 60 to 100 mg/kg/dose; may repeat in 10 minutes if necessary. The incidence is higher in small breeds of dogs, although eclampsia can occur in any breed, with any size of litter, and at any time during lactation. Furosemide can also be used to promote urinary calcium loss. Phosphate < 2 mmol / L Phosphate 2 - 3 mmol / L Phosphate > 3 mmol / L Mild (asymptomatic) 0.80-0.99 mmol/L Consider oral In more severe cases of poisoning, such as in the case of hypercalcemia or kidney trouble, the veterinarian may need to commence more intensive treatment. We comply with the HONcode standard for trustworthy health information. DHT is the precursor to active vitamin D (1, 25-dihydroxycholecalciferol, or aka vitamin D3), and must be hydroxylated in the kidney to become active. Heavy lactational demands from large puppies or a large litter are often noted. Dosage and Administration Dosing: Adult. A pretreatment total serum calcium concentration of <7 mg/dL in dogs or < 6 mg/dL in cats confirms the diagnosis; noting that reference values vary between laboratories. Corticosteroids lower serum calcium and, therefore, are contraindicated. Calcium infusion should be regarded as a "stop-gap" to counteract the conduction disturbances until longer-lasting controls can be initiated. In dairy cows with a similar condition, parturient paresis Parturient Paresis in Cows Parturient paresis (milk fever, hypocalcemia, paresis puerperalis, parturient apoplexy) is a disease of adult dairy cows in which acute hypocalcemia causes acute to peracute, afebrile, flaccid read more , production of PTH is adequate; however, the pool of osteoclasts for PTH to stimulate is not. Since it is soluble to the extent of only one part in 30 parts of cold water, the 10% solution is supersaturated and is stabilized by the addition of . First pregnancy or subsequent ones. It is a positive inotrope and has variable effect on systemic vascular resistance. Kidney function can also be evaluated by blood tests like complete blood count (to look for anemia) as well as urinalysis to verify the urine concentration. Ionised calcium less than 0.65mmol/L (<0.75mmol/L if symptomatic) Hyperkalaemia Contraindications Contraindicated in patients with ventricular fibrillation or hypercalcaemia Dose Note: Prescribe calcium salt in full (i.e. Low or undetectable serum PTH concentration in a hypocalcemic animal is strongly suggestive of primary hypoparathyroidism Hypoparathyroidism in Dogs Hypoparathyroidism of various causes is primarily recognized in dogs and is characterized by insufficient PTH secretion by parathyroid glands. Acute Toxicity Data and References. Rapid injection of calcium solutions may cause hypotension and cardiac arrhythmias; therefore, arterial blood pressure and ECG monitoring should be established during calcium administration. The severity of the hyperkalemia generally is proportionate to the degree of azotemia and decrement of urine formation. Idiopathic hypercalcemia has been described in cats, with Persians being over-represented. Daily maintenance calcium: It is important to base the dosage of calcium on a calculation of elemental (available) calcium because different products vary in the amount of calcium available. Calcium gluconate will treat or prevent the deleterious effects of hypocalcemia. D-gluconic acid calcium salt (2:1). Infants and Children 25 kg and less: 1 to 2 mEq/kg/day Granular dosage forms containing . PDF U.S. Food and Drug Administration Non-Monograph Conditions NM900: Drug Hypercalcemia; concomitant use of IV calcium gluconate with ceftriaxone in neonates (28 days of age). Oral: (Dosage expressed in mg of elemental calcium): The authors concluded that calcium chloride was more toxic to rats than calcium gluconate. Find details on Calcium gluconate. Dogs should be given 1 4 grams a calcium daily, and cats are given 1 gm/day. Check the label on your brand of this medicine to see if it should be taken with or without food. The daily dose of calcium should be based on the amount of . Dose should be expressed as 'mmol' IV: Urgent correction: Objectives: Intravenous (IV) calcium salts are routinely recommended as a cardio-protective therapy in the emergency treatment of severe hyperkalemia. Common Reptile Drugs and Dosages - anapsid.org The intravenous calcium should be administered slowly, carefully and in the right amount (usually dogs need 1 milliliter of 10% calcium gluconate per kilo). RTECS:EW2100000 - Calcium gluconate - The Registry of Toxic Effects of 10%). Simultaneous treatment with calcium gluconate and cardiac glycosides is not recommended as toxic effects of the glycoside and potential for cardiac arrhythmias are markedly increased when these two drugs are co-administered. Differential diagnoses include other causes of seizures, such as hypoglycemia, toxicoses, and primary neurologic disorders such as idiopathic epilepsy Congenital and Inherited Cerebral Disorders in Animals Anencephaly means that the brain is largely absent at birth. Correction:This paper has been updated to correct the calcitriol dose units, which should have been mcg/kg/day (ng/kg/day), not mg/kg/day. We comply with the HONcode standard for trustworthy health information. Hyperkalaemia, pt 2: treatment | Vet Times British Small Animal Veterinary Association, Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester, GL2 2AB, United Kingdom. No specific research to support recommendations for use of this drug is available for dogs and cats, although our success with calcium carbonate has been excellent. Oral: Treatment of hypercalcemia associated with Addison's disease is not necessary. When expressed at the sinus node and on myocardial cells these perturbations cause classic electrocardiographic abnormalities associated with the severity of hyperkalemia. o Add prescribed dose to 24-hour compatible maintenance fluid Example preparation o Make up to total of 100 mL with compatible maintenance fluid (in a burette) This calcium preparation must be given slowly and the veterinarian should monitor for cardiac arrhythmia. 1 to 6 months: 400 mg/day This imbalance in calcium metabolism occurs because calcium mobilization from bone into the serum pool is insufficient to compensate for the efflux of calcium via the mammary glands during lactation. 500 to 3000 mg (5 to 30 mL) IV one time at a rate not to exceed 0.5 to 2 mL/min. Renal hydroxylation of vitamin D, however, is often impaired in renal disease, leading to relative vitamin D deficiency. In these cases, ionized calcium concentrations are normal. A solution of 10% calcium gluconate (90 mg of elemental calcium per 10 mL) can be used to prepare the continuous infusion. Treatment and Prevention of Eclampsia in Small Animals. Hyperkalemia is a more prevalent and serious feature of acute uremia in cats with the increasing prevalence of acute ureteral obstruction over the past 10 years. Five conditioned dogs under halothane anesthesia received calcium chloride (4, 8, 12 mg/kg) and calcium gluconate (14, 28, 42 mg/kg) intravenously. When you bring your furry family member home, keep an eye on him and provide a restful place for him to sleep. These tumors are thought to secrete cytokines that activate osteoclasts, thereby resorbing bone and elevating serum calcium concentrations. At the time of surgery, all four parathyroid glands must be inspected, although solitary gland involvement is by far the most common finding. Hyperkalemia is a known complication of ACEi usage in human patients with kidney disease; a similar effect in animal patients may restrict or preclude their use. Hypertonic (20%) glucose can be administered at 0.5 to 1.5 g/kg intravenously as an alternative to sodium bicarbonate. Physical examination findings in dogs and cats with primary hypoparathyroidism are usually normal. The calcium would not cause harm at this low dose. Hemodialysis eliminates potassium from both extracellular and intracellular pools and provides the most effective way to alleviate excessive potassium loads. When treating calcium channel blocker toxicity, a dose of calcium gluconate can be given as a bolus or continuous infusion. When should you use calcium? For basic homemade diets, it's usually sufficient to add a couple teaspoons of egg or bone powder to a meat-heavy meal. This Is How Much Calcium To Give A Dog For Whelping - Paws Insider Vitamin B is not a fat soluble vitamin, and she should urinate any excess out. 3. However, this recommendation is supported by a low level of evidence and is anecdotal. Calcium gluconate is also available as 10% and 23% solutions in water. Calcium borogluconate is preferred to calcium gluconate because it is more soluble (Budavari, 1996). Exchange resins may be effective to control mild hyperkalemia, but have little efficacy or indications in the management of potassium associated cardiotoxicity. The physical examination findings in animals with primary hyperparathyroidism are usually normal. While generally safe and effective when prescribed by a veterinarian, calcium gluconate can cause side effects in some animals. Some pet owners also choose to supplement their pets diet with calcium; this is generally not necessary if proper food is the mainstay of the diet. Route of administration is IM or ICe. Calcium can make it harder for your body to absorb certain medicines. Deficiency of PTH results in an inability to adequately read more . Dosage Considerations - Should be Given as Follows: Calcium Supplementation . Vitamin D supplementation is used to increase calcium absorption from the intestines. Calcium gluconate: Uses, Interactions, Mechanism of Action - DrugBank The bottom line, however, is that hypercalcemia of Addison's disease is usually mild, and the ionized calcium concentration is usually normal. When the hypocalcemia is slowly evolving, oral calcium gluconate can be used. In addition, calcium is involved in the proper conduction of nervous impulses and regulates the secretory activity of exocrine glands. Calcium complexes tetracycline antibiotics, rendering them inactive. You may report side effects to FDA at 1-800-FDA-1088. All information is peer reviewed. The positive charge of these calcium ions alters the electrical state of the sodium-channel protein, thus altering the voltage level required to open the channel. 1000 to 1500 mg/day orally in divided doses. Oral calcium supplementation during gestation is not indicated and may cause rather than prevent postpartum hypocalcemia.