review of drug-induced hypocalcemia

• Published in: Journal of bone and mineral metabolism Vol. 27; no. 6; pp. 635 - 642
• Main Authors: Liamis, George, Milionis, Haralampos J, Elisaf, Moses
• Format: Journal Article
• Language: English
• Published: Japan Japan : Springer Japan 01.11.2009; Springer Japan; Springer; Springer Nature B.V
• Subjects: Biological and medical sciences; Calcium; Calcium - blood; Calcium - metabolism; Diphosphonates - therapeutic use; Diseases of the osteoarticular system; Diuretics - metabolism; Drug therapy; Drug-Related Side Effects and Adverse Reactions; Estrogens - metabolism; Glucocorticoids - metabolism; Humans; Hyperphosphatemia - metabolism; Hypocalcemia - chemically induced; Hypocalcemia - diagnosis; Hypocalcemia - therapy; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Orthopedics; Parathyroid Hormone - metabolism; Review Article; Substance abuse treatment; Vitamin D; Vitamin D Deficiency - metabolism; Adverse drug reaction; Tetany; Hypocalcemia; Calcium homeostasis; Hydroelectrolytic balance disorder; Calcium; Toxicity; Rheumatology; Homeostasis; Review; Inorganic element; Metabolic disorder; Bibliographic review
• ISSN: 0914-8779; 1435-5604
• DOI: 10.1007/s00774-009-0119-x

Hypocalcemia (defined as total serum calcium lower than 8.5 mg/dl or as ionized serum calcium lower than 4.7 mg/dl) is a relatively common metabolic abnormality observed in hospitalized patients. Although it is associated with certain pharmacological agents such as bisphosphonates and cisplatin, hypocalcemia may occasionally develop in the course of treatment with drugs used in everyday clinical practice, including antiepileptics, aminoglycosides, and proton pump inhibitors. Hypocalcemia associated with drug treatment can be easily missed as a consequence of coexistence of multiple factors contributing to low serum calcium levels. Drug-related hypocalcemia is usually mild and asymptomatic but may be severe as well. Effective clinical management can be handled through awareness of this adverse effect induced by certain pharmaceutical compounds on serum calcium concentrations. Herein, we review pertinent clinical information on the incidence of hypocalcemia associated with specific drug treatment and discuss the underlying pathophysiological mechanisms.