Formula
Corrected calcium (mg/dL) = total calcium + 0.8 × (4 − albumin in g/dL) [1]. When albumin is very abnormal or there is an acid-base disorder, ionised calcium is more accurate.
Treating hypercalcaemia of malignancy
- Hydration: intravenous normal saline to correct dehydration; loop diuretics only for volume overload.
- Antiresorptive: the Endocrine Society guideline (2023) recommends denosumab or an intravenous bisphosphonate (e.g., zoledronic acid) [2].
- Severe or symptomatic: calcitonin with the antiresorptive in the first hours, as it acts fast but briefly [2].
- Refractory or recurrent on bisphosphonates: denosumab [2].
- High calcitriol (e.g., lymphoma) or granulomatous disease: glucocorticoids [2].
References
2 referencesShow all referencesClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1Interpretation of serum calcium in patients with abnormal serum proteins
- 2
This page is based on reputable scientific sources and was last updated on 27 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
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