Treatment of hypercalcemia

The indications, effectiveness, and adverse effects of the numerous treatment modalities for hypercalcemia are presented. Results of a retrospective chart review of 72 admissions (53 patients) for hypercalcemia-related diseases are presented to emphasize the therapeutic principles that should be applied in the management of these patients. Hydration, forced diuresis, oral phosphates, and glucocorticosteroid drugs are common therapeutic approaches. Combination therapy with glucocorticosteroid drugs, oral phosphates, and forced diuresis is utilized to take advantage of multiple mechanisms of action. Outpatient therapy for hypercalcemia consists primarily of glucocorticosteroid agents and oral phosphates. Most patients are treated if the serum calcium level is greater than or equal to 12 mg/dL. An algorithm is presented to assist the clinician in selecting the most efficacious treatment plan.