The table below outlines the treatments for hypercalcaemia.

Treatment Notes
Rehydrate Rehydration, both orally and intravenously, enhances calcium excretion.

Several litres of normal saline may be required. Pay strict attention to fluid balance and consider Central Venous Pressure (CVP) monitoring.

Continuous ECG monitoring and regular 12 ECGs will be required.

Bisphosphonates Useful in malignancy and other aetiologies.

Pamidronate is the most common agent used at present. Bisphosphonates usually take 2-4 days to have an effect.

Calcitonin It has been used acutely if a rapid decrease is required but tachyphylaxis occurs over several days. It is most effective in malignancy and hyperparathyroidism.

Usually Prednisolone is only slightly helpful in myeloma and sarcoid but most often not of great use.

Oral phosphate IV phosphate is not dangerous per se – usually needs to be given over 24 hours.
Furosemide It can be used to increase renal excretion of calcium.
Dialysis Dialysis is rarely required to remove calcium. Renal and cardiac failure patients will require dialysis as they are unable to cope with the large volumes required.