Calcium Gluconate
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
- Calcium Gluconate
- Calcium Gluconate: From Osteoporosis and Calcium/Phosphorus Disorders to Calcium-Alkali Syndrome
Calcium Gluconate: From Osteoporosis and Calcium/Phosphorus Disorders to Calcium-Alkali Syndrome
One-Sentence Summary
Calcium gluconate is a calcium salt originally listed for osteoporosis, postmenopausal osteoporosis, hypercalcemia disease, nephrocalcinosis and phosphorus metabolism disease. The TxGNN model predicts it may be associated with calcium-alkali syndrome, but there are 0 clinical trials and 0 publications for this prediction, and the association is most likely adverse rather than therapeutic.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Osteoporosis, postmenopausal osteoporosis, hypercalcemia disease, nephrocalcinosis, phosphorus metabolism disease (from the knowledge graph; the Singapore licences carry no indication text) |
| Predicted New Indication | Calcium-alkali syndrome |
| TxGNN Prediction Score | 98.88% |
| Evidence Level | L5 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 3 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available. Based on known information, calcium gluconate is a calcium salt used to replace or supplement calcium, and it is listed in the knowledge graph for bone and mineral metabolism disorders.
Calcium-alkali syndrome is caused by excess intake of calcium and absorbable alkali. Calcium gluconate is therefore a potential cause of this condition, not a treatment for it. The high score (98.88%) most likely reflects a causal or adverse-effect link in the knowledge graph, not therapeutic benefit. The association is probably contraindicating, so this prediction should not be read as a repurposing opportunity.
For context, the other top-ranked predictions are also weak:
- Primary bone dysplasia with defective bone mineralization (98.70%): biologically plausible because calcium supplies substrate for mineralization, but these dysplasias are usually genetic and not corrected by calcium alone. No trials or literature were found.
- Hypophosphatemia (89.98%): the evidence is mostly case reports, a conference abstract and veterinary or historical items. Calcium treats the accompanying hypocalcemia, not the low phosphate itself.
- Dyspepsia, duodenal ulcer, urolithiasis: the literature suggests calcium may stimulate gastrin and gastric acid secretion, or promote stone formation. These signals lean toward risk.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available for calcium-alkali syndrome.
The literature found for lower-ranked predictions is summarised below. None of it supports a therapeutic effect.
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 37042078 | 2023 | Review | J Neuroendocrinol | Update on gastrinoma and Zollinger-Ellison syndrome; not specific to calcium gluconate (duodenal ulcer prediction) |
| 627316 | 1978 | Diagnostic study | Digestion | IV calcium gluconate sharply raised serum gastrin in Zollinger-Ellison syndrome, so it is a provocative stimulus, not a treatment |
| 15613438 | 2005 | Physiological study | J Clin Endocrinol Metab | Oral calcium (1 g calcium gluconate) increased gastrin and calcitonin secretion in patients with hypercalciuria |
| 10424248 | 1999 | Physiological study | Biomed Pharmacother | Calcium supplements can improve bone metabolism but may raise renal stone risk (urolithiasis) |
| 31449775 | 2019 | Animal study | Am J Pathol | Vitamin D plus calcium supplementation accelerated Randall's plaque formation in mice |
| 37501199 | 2023 | Case report | J Med Case Rep | Hypocalcemic tetany after cimetidine plus nifedipine; a drug-interaction report (dyspepsia prediction) |
| 39839473 | 2024 | Case report | Front Endocrinol | Hungry bone syndrome after parathyroidectomy in X-linked hypophosphatemia |
Singapore Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| SIN05659P | Calcium Gluconate Injection 10% (B. Braun Melsungen AG) | Injection | Not stated in registration data |
| SIN05221P | Hydrofluoric Acid Antidote Gel 2.5% w/w (Beacons Pharmaceuticals Pte. Ltd.) | Gel | Not stated in registration data |
| SIN08451P | Calcium Gluconate Injection USP 10% (American Pharmaceutical Partners Inc) | Injection | Not stated in registration data |
Safety Considerations
- Contraindication-related diseases (knowledge graph, not label text): The knowledge graph links calcium gluconate to many conditions where it may be contraindicated. Key examples:
- Calcium and mineral disorders: hypercalcemia disease, humoral hypercalcemia of malignancy, hyperparathyroidism, nephrocalcinosis, phosphorus metabolism disease, sarcoidosis
- Kidney: kidney disease, impaired renal function, nephrolithiasis
- Cardiovascular: heart disease, cardiovascular disease, hypertension, sudden cardiac arrest
- Others: liver disease and liver failure, peptic ulcer disease, gout, epilepsy, thrombocytopenia, hemophilia
- Drug Interactions: 83 interactions were identified; the first 20 are shown in the compiled data.
- Major: dolutegravir, bictegravir, ceftriaxone (the ceftriaxone interaction is a recognised precipitation risk with IV calcium)
- Moderate: tetracyclines (doxycycline, tetracycline); bisphosphonates (alendronic acid, risedronic acid, ibandronate); calcium channel blockers (nifedipine, amlodipine, diltiazem); beta-blockers (acebutolol, atenolol, betaxolol, bisoprolol, carvedilol); hydrochlorothiazide; topical vitamin D analogues (calcipotriol, calcitriol); baloxavir marboxil
Package insert warnings and contraindications were not available. Please refer to the package insert for label safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The top prediction, calcium-alkali syndrome, is a condition caused by excess calcium, so the high score most likely reflects an adverse association rather than a treatment opportunity. There are no trials or literature, and the evidence is model prediction only (L5). The other predictions have only indirect, mostly case-report, animal or veterinary evidence, and several point toward risk.
To proceed, the following is needed:
- Confirm the direction of the knowledge-graph association (causal or adverse-effect versus therapeutic) for calcium-alkali syndrome, and probably reclassify it as a safety signal
- Package insert warnings and contraindications from the HSA website
- Mechanism of action data (for example from DrugBank)
- Approved indication text for the three Singapore licences
- If a different candidate is pursued (for example primary bone dysplasia with defective mineralization or hypophosphatemia), targeted literature review and, where appropriate, clinical trials
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.