Hypercalcaemia guide history

Document Title

Management of Hypercalcaemia of Malignancy

Document Date

January 2023

Document Purpose and Intended Audience

To support specialist palliative care clinicians in hospices and hospital trusts to manage and treat hypercalcaemia related to malignancy.


Radka Klezlova, Consultant in Palliative Medicine, Walsall Healthcare NHS Trust

Chantal Meystre, Consultant in Palliative Medicine, HEFT NHS Trust


Palliative Care Formulary 8th Edition 2022 Twycross, R. Symptom Management in Advanced Cancer British National Formulary 71st Edition 2016 NHS Scotland – Scottish Palliative Care Guidelines – accessed via



Consultation Process

Circulated to SPAGG group for comments and approval


This guideline will be audited by members of the group every 3 years.

Review Date

(must be within three years)

January 2026

Michelle Aslett Pharmacist, Marie Curie

Nik Sanyal Consultant in Palliative Medicine, Coventry and Warwickshire

Laura Dewhirst Palliative Care Registrar

Alice Gray Palliative Care Registrar

Approval Signatures:

SPAGG chair

Dr Jon Tomas

SPAGG secretary

Dr Emma Wooldridge

Date Approved by SPAGG: 10/7/2019

Date submitted to Area Prescribing Committee: N/A

Version History

Version 0.1


Sept 2015

Summary of change/ process

Guidelines written by Dr Chantal Meystre and Dr Radka Klezlova amalgamated into SPAGG format. For circulation to SPAGG.

Version 0.2


April 2016

Summary of change/ process

Guidelines reviewed by Michelle Aslett and Jo Bartlett and changes made based on comments from the group. For presentation at SPAGG on 20/4/16.

Version 0.3


May 2019

Summary of change/ process

Guidelines were reviewed by Brenda Ward and Radka Klezlova. Paragraphs about aetiology of hypercalcaemia of malignancy and other treatment options - Calcitonin and Denosumab were added.

Version 0.4


Jan 2023

Summary of change/ process

Guidelines reviewed by Laura Dewhirst and Alice Gray changes made based on comments from the group. Emphasis placed on reviewing the need for treating hypercalcaemia and flow chart updated

Disclaimer (SPAGG - Rewrite)

This Guide is intended for use by healthcare professionals and the expectation is that they will use clinical judgement, medical, and nursing knowledge in applying the general principles and recommendations contained within. They are not meant to replace the many available texts on the subject of palliative care.

Some of the management strategies describe the use of drugs outside their licensed indications. They are, however, established and accepted good practice. Please refer to the current BNF for further guidance.

While WMPCPS takes every care to compile accurate information , we cannot guarantee its correctness and completeness and it is subject to change. We do not accept responsibility for any loss, damage or expense resulting from the use of this information.