Chromium

Pronunciation: KROM-ee-um
Class: Trace metal

Trade Names

Chromic Chloride
- Injection chromium 4 mcg/mL (as chromic chloride 20.5 mcg/mL)

Pharmacology

Helps maintain normal glucose metabolism and peripheral nerve function.

Pharmacokinetics

Absorption

Bound to transferrin (siderophilin) in the beta globulin fraction. Typical blood levels range from 1 to 5 mcg/L, but blood levels are not considered a meaningful index of tissue stores.

Elimination

Primarily via the kidney.

Indications and Usage

As a supplement to TPN to help maintain chromium serum levels and to prevent depletion of endogenous stores and subsequent deficiency syndromes.

Contraindications

Do not give undiluted by direct IM or IV injection into a peripheral vein; do not give by bolus injection.

Dosage and Administration

IV 10 to 15 mcg/day of chromium added to the TPN. Metabolically stable adults with intestinal fluid loss may require 20 mcg/day.

IV 0.14 to 0.2 mcg/kg/day of chromium added to the TPN.

Adjust or omit dose as needed in severe kidney disease.

General Advice

• Do not give undiluted by direct injection into a peripheral vein.
• Do not give by direct IM or IV injection.
• Add to TPN solution.

Storage/Stability

Store at 59° to 86°F.

Drug Interactions

None well documented.

Adverse Reactions

None well documented.

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Renal Function

Primarily excreted by the kidneys; adjust or omit dose as needed in severe kidney disease.

Aluminum toxicity

Parenteral products may contain aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk.

Diabetes mellitus

In assessing the contribution of chromium supplements to maintenance of glucose homeostasis, consider the possibility that the patient is diabetic, in which case an antidiabetic agent may be indicated.

Overdosage

Symptoms

Coma, convulsions, GI ulcers, nausea, renal and hepatic damage, vomiting.

Patient Information

• Advise patient that medication will be prepared and administered by a health care provider in a hospital setting.

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