Drug Interaction Report

GENERALLY AVOID: The administration of parenteral calcium preparations, particularly by rapid IV injection, may precipitate serious cardiac arrhythmias in digitalized patients. The mechanism is probably related to the additive or synergistic inotropic effects of calcium and digitalis glycosides on the myocardium.

MANAGEMENT: Intravenous calcium should preferably not be used in patients receiving digitalis glycosides, or it should be given slowly or in small amounts to avoid high serum calcium concentrations. Patients should be monitored for development of arrhythmias.

ADJUST DOSING INTERVAL: Administration with food may increase the absorption of calcium. However, foods high in oxalic acid (spinach or rhubarb), or phytic acid (bran and whole grains) may decrease calcium absorption.

MANAGEMENT: Calcium may be administered with food to increase absorption. Consider withholding calcium administration for at least 2 hours before or after consuming foods high in oxalic acid or phytic acid.