limited time: blossoming deals SAVE up to 40% NOW
Medicine (MD/DO)
Mineral & Bone Disorders
Hypercalcemia Treatments

Master Hypercalcemia Treatments with Picmonic for Medicine

With Picmonic, facts become pictures. We've taken what the science shows - image mnemonics work - but we've boosted the effectiveness by building and associating memorable characters, interesting audio stories, and built-in quizzing.

Hypercalcemia Treatments

Recommended Picmonics

picmonic thumbnail
picmonic thumbnail
Hypercalcemia Causes
picmonic thumbnail
Acromegaly Assessment
picmonic thumbnail
Hypocalcemia Causes
picmonic thumbnail

Hypercalcemia Treatments

The treatment of hypercalcemia depends on the cause, severity, and comorbid conditions of the patient. It should be aimed at lowering the calcium level as well as correcting the underlying cause where possible. The level of plasma calcium and the rate of rise are both important in determining severity of hypercalcemia and the need for treatment. Patients with asymptomatic mild hypercalcemia (<12 mg/dL) do not need immediate treatment. Adequate oral hydration is often sufficient for control, and can be tried initially. A calcium level of 12-14 mg/dL warrants intervention if the elevation was acute or the patient is symptomatic. Patients with severe hypercalcemia of >14 mg/dL need emergent intervention to lower their plasma calcium. The initial treatment for severe hypercalcemia is a combination of volume expansion with normal saline, calcitonin, and a bisphosphonate. Definitive treatment often involves treating the underlying cause.
Treat Underlying Disorder
Underlying Diseased-guy

Most cases of hypercalcemia occur secondary to an underlying disease state. For these cases, the preferred approach is treatment of the underlying condition. Where primary hyperparathyroidism is the cause, surgical parathyroidectomy can be curative. In cases of hypercalcemia of malignancy, tumor resection is the most effective treatment.

Hydrating with water

Volume expansion with a normal saline (NS) bolus is given to correct any volume depletion that may exist secondary to calcium-induced renal salt wasting and restore euvolemia. An initial rate of 200-300 mL/hr via IV should be started on all patients with symptomatic moderate hypercalcemia or severe hypercalcemia in the absence of underlying cardiac or renal disease.


As a last resort, dialysis can be used in patients with severe hypercalcemia refractory to treatment, or patients with renal or heart failure.

Calcium Restriction
Calcium-cow with Restricting-belt

Dietary calcium restriction to less than 1,000 mg/day can be effective in controlling plasma calcium levels in patients with mild hypercalcemia. It generally must be combined with other lifestyle modifications such as adequate hydration and avoidance of inactivity to have a significant effect.


Bisphosphonates are used to treat any hypercalcemia caused by excessive bone resorption. As phosphate analogs, they bind to bone and inhibit the resorptive action of osteoclasts. Commonly used preparations are intravenous zoledronate and pamidronate. Although generally well tolerated, they can be nephrotoxic.


Calcitonin decreases plasma calcium in two ways. Its major effects come from inhibition of osteoclast function, decreasing bone resorption and the subsequent release of calcium. Secondarily, it inhibits renal reabsorption of calcium and phosphate.


The calcimimetic agent cinacalcet is a treatment option for patients with hypercalcemia secondary to primary or secondary hyperparathyroidism. It works by activating the calcium-sensing receptors on chief cells within the parathyroid gland so that less PTH is released and serum calcium levels can normalize. It is often used in patients with parathyroid carcinoma, and dialysis patients with secondary hyperparathyroidism.


Patients with lymphomas or chronic granulomatous diseases such as sarcoidosis have hypercalcemia that is caused by excess calcitriol production. Glucocorticoids inhibit calcitriol production by activated mononuclear cells. Prednisone 20 - 40 mg per day is generally effective to decrease serum calcium within one week.


A monoclonal antibody against RANKL, denosumab binds to RANKL and inhibits the activation of osteoclasts leading to decreased bone resorption. It is often used in patients with hypercalcemia of malignancy that is resistant to bisphosphonate use. As it is not renally excreted, it is safe for use in those with kidney disease.


Take the Hypercalcemia Treatments Quiz

Picmonic's rapid review multiple-choice quiz allows you to assess your knowledge.

It's worth every penny

Our Story Mnemonics Increase Mastery and Retention

Memorize facts with phonetic mnemonics

Unforgettable characters with concise but impactful videos (2-4 min each)

Memorize facts with phonetic mnemonics

Ace Your Medicine (MD/DO) Classes & Exams with Picmonic:

Over 1,880,000 students use Picmonic’s picture mnemonics to improve knowledge, retention, and exam performance.

Choose the #1 Medicine (MD/DO) student study app.

Picmonic for Medicine (MD/DO) covers information that is relevant to your entire Medicine (MD/DO) education. Whether you’re studying for your classes or getting ready to conquer the USMLE Step 1, USMLE Step 2 CK, COMLEX Level 1, or COMLEX Level 2, we’re here to help.

Works better than traditional Medicine (MD/DO) flashcards.

Research shows that students who use Picmonic see a 331% improvement in memory retention and a 50% improvement in test scores.