Calcium gluconate injection in small-volume glass containers: new contraindications due to aluminium exposure risk

Aluminium can be leached from glass after contact with calcium gluconate solution, leading to a risk of exposure to aluminium. Accumulation of aluminium might have adverse effects on bone mineralisation and neurological development in children and those with renal impairment. Calcium gluconate injection packed in small-volume glass containers is now contraindicated for use as repeated or prolonged treatment, including as an intravenous infusion, in children younger than 18 years and in patients with renal impairment. To limit the exposure of patients to aluminium, especially in those with impaired renal function and in children, calcium gluconate injection in small-volume glass containers is also contraindicated in the preparation of total parenteral nutrition solutions. Use of calcium gluconate injection packed in plastic containers is recommended to reduce aluminium burden in vulnerable patients