CHROMIC CHLORIDE IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for CHROMIC CHLORIDE IN PLASTIC CONTAINER (CHROMIC CHLORIDE IN PLASTIC CONTAINER).
Chromium is an essential trace element that potentiates insulin action, improves glucose tolerance, and enhances protein and lipid metabolism. It is a component of chromodulin, a low-molecular-weight chromium-binding substance that binds to the insulin receptor and activates tyrosine kinase activity, increasing insulin sensitivity.
| Metabolism | Chromium (III) is poorly absorbed (0.5-2%) and is excreted primarily unchanged in urine; a small amount is excreted in feces. No significant hepatic metabolism. |
| Excretion | Renal excretion of absorbed chromium is the primary route of elimination, accounting for approximately 60-80% of the absorbed dose. Biliary/fecal excretion accounts for <10%. |
| Half-life | The terminal elimination half-life of chromium (as Cr(III)) from plasma is approximately 15-41 hours, with a mean of about 24 hours. This long half-life reflects slow clearance from deep tissue compartments. |
| Protein binding | Approximately 80-95% of chromium in plasma is bound to proteins, primarily transferrin (about 80%) and albumin (about 15%), with small amounts bound to other globulins. |
| Volume of Distribution | The apparent volume of distribution (Vd) for chromium is wide, ranging from 0.3 to 0.8 L/kg, indicating extensive distribution into tissues, including liver, kidney, spleen, and bone. |
| Bioavailability | Oral bioavailability of chromium from chromic chloride is approximately 0.5-2% due to poor gastrointestinal absorption. Bioavailability by intravenous administration is 100%. |
| Onset of Action | Chromic chloride is a trace element supplement; clinical effect (normalization of chromium-dependent glucose metabolism) occurs over days to weeks of continuous supplementation. No immediate onset is observed. |
| Duration of Action | Duration of action is sustained over the dosing interval (typically 24-48 hours with daily or alternate-day administration). Pharmacodynamic effects persist as long as steady-state concentrations are maintained. |
Intravenous: 10-15 mcg/kg/day of elemental chromium added to parenteral nutrition.
| Dosage form | INJECTABLE |
| Renal impairment | No specific guidelines; monitor serum chromium and reduce dose with severe renal impairment to avoid accumulation. |
| Liver impairment | No specific Child-Pugh based modifications; use caution with severe hepatic impairment. |
| Pediatric use | Intravenous: 0.14-0.20 mcg/kg/day of elemental chromium added to parenteral nutrition. |
| Geriatric use | No specific adjustments; use standard dosing with monitoring for renal function. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for CHROMIC CHLORIDE IN PLASTIC CONTAINER (CHROMIC CHLORIDE IN PLASTIC CONTAINER).
| Breastfeeding | Chromium passes into breast milk; M/P ratio not determined. Chromium is essential for infant development; recommended dietary allowance during lactation is 45 mcg/day. Intravenous supplementation at physiological doses is compatible with breastfeeding. |
| Teratogenic Risk | Trimester 1: No evidence of teratogenicity in animal studies; chromium is an essential trace element, and deficiency may increase risk of neural tube defects. Trimester 2-3: No known fetal risks with recommended intakes; high doses may cause maternal toxicity and potential fetal harm, but therapeutic doses are safe. |
■ FDA Black Box Warning
None
| Serious Effects |
Absolute: Hypersensitivity to chromium or any component of the formulation. Relative: Significant renal impairment (CrCl <30 mL/min) without careful monitoring; pre-existing glucose intolerance or diabetes should be monitored for hypoglycemia.
| Precautions | Renal impairment: Accumulation may occur in patients with renal dysfunction. Hypoglycemia: May enhance hypoglycemic effects in diabetic patients. Allergic reactions: Rare, but possible. Not for use in patients with known hypersensitivity to chromium. |
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| Fetal Monitoring | Monitor maternal serum chromium levels if toxicity suspected (e.g., occupational exposure). Assess for signs of maternal chromium deficiency (e.g., impaired glucose tolerance). No specific fetal monitoring required at therapeutic doses. |
| Fertility Effects | No adverse effects on fertility at recommended dietary intakes. High-dose chromium supplementation may affect insulin sensitivity and ovarian function, but clinical significance unknown. |