Initial treatment of hypercalcemia
| Severity | Serum calcium level (mg/dL) | Treatment |
|---|---|---|
| Mild | 10.2–12.0 | Stop causative medications and encourage oral hydration |
| Moderate | 12.0–14.0 | Start intravenous (IV) normal saline at maintenance dose if symptoms have been present without resolution |
| Severe | > 14.0 | Start IV normal saline at maintenance dose, consider combined calcitonin and bisphosphonate therapy If no improvement, consider denosumab or a glucocorticoid |
| Very severe | > 18.0 | Consider dialysis in patients with worsening renal failure or neurologic symptoms (or both) |