magnesium salts (oral)

REMS

Treatment/prevention of hypomagnesemia.
As a:
- Laxative
- Bowel evacuant in preparation for surgical/radiographic procedures.
Milk of magnesia has also been used as an antacid.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypermagnesemia;
Hypocalcemia;
Anuria;
Heart block;
OB: Unless used for preterm labor, use during active labor or within 2 hr of delivery may ↑ potential for magnesium toxicity in newborn.

Use Cautiously in:

Renal impairment.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: flushing, sweating

GI: diarrhea

Interactions ⬆ ⬇

Drug-drug:

Potentiates neuromuscular blocking agents.
May ↓ absorption of fluoroquinolones, nitrofurantoin, tetracyclines, and penicillamine.

Availability ⬆ ⬇

Magnesium Chloride

(Generic available)

Sustained-release tablets: 535 mg (64 mg magnesium)^OTC

Magnesium Citrate

(Generic available)

Oral solution: 240-, 296-, and 300-mL bottles (77 mEq magnesium/100 mL)^OTC

Magnesium Gluconate

(Generic available)

Tablets: 500 mg^OTC

Magnesium Hydroxide

(Generic available)

Liquid: 400 mg/5 mL (164 mg magnesium/5 mL)^OTC
Concentrated liquid: 800 mg/5 mL (328 mg magnesium/5 mL)^OTC
Chewable tablets: 400 mg (173 mg magnesium)^OTC

Magnesium Oxide

(Generic available)

Tablets: 400 mg (241.3 mg magnesium)^OTC

Route/Dosage ⬆ ⬇

Prevention of Deficiency (in mg of Magnesium)

PO (Adults and Children >10 yr): Adolescent and adult men: 270–400 mg/day; Adolescent and adult women: 280–300 mg/day; Pregnant women: 320 mg/day; Breastfeeding women: 340–355 mg/day.
PO (Children 7–10 yr): 170 mg/day.
PO (Children 4–6 yr): 120 mg/day.
PO (Children ≤3 yr): 40–80 mg/day.

Treatment of Deficiency (in mg of Magnesium)

PO (Adults ): 200–400 mg/day in 3–4 divided doses.
PO (Children 6–11 yr): 3–6 mg/kg/day in 3–4 divided doses.

Laxative

PO (Adults ): Magnesium citrate: 240 mL as a single dose; Magnesium hydroxide: 30–60 mL (as a single dose or in divided doses) or 10–20 mL as concentrate.
PO (Children 6–12 yr): Magnesium citrate: 100 mL as a single dose; Magnesium hydroxide: 15–30 mL as a single dose or in divided doses.
PO (Children 2–5 yr): Magnesium hydroxide: 5–15 mL as a single dose or in divided doses.

US Brand Names ⬆ ⬇

magnesium chloride (12% Mg; 9.8 mEq Mg/g): Slo-Mag,

magnesium citrate (16.2% Mg; 4.4 mEq Mg/g): Citroma,

magnesium hydroxide (41.7% Mg; 34.3 mEq Mg/g): Milk of Magnesia,

magnesium oxide (60.3% Mg; 49.6 mEq Mg/g): Mag-Oxide

Action ⬆ ⬇

Essential for the activity of many enzymes.
Play an important role in neurotransmission and muscular excitability.
Are osmotically active in GI tract, drawing water into the lumen and causing peristalsis.

Therapeutic effects:

Replacement in deficiency states.
Evacuation of the colon.

Classifications ⬆ ⬇

Therapeutic Classification: mineral and electrolyte replacements/supplements, laxatives

Pharmacologic Classification: salines

Pharmacokinetics ⬆ ⬇

Absorption: Up to 30% may be absorbed orally.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Excreted primarily by the kidneys.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

( laxative effect)

ROUTE		ONSET		PEAK		DURATION
PO		3–6 hr		unknown		unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy.
Advise patient not to take this medication within 2 hr of taking other medications, especially fluoroquinolones, nitrofurantoin, and tetracyclines.
Antacids: Caution patient to consult health care provider before taking antacids for >2 wk if problem is recurring, if relief is not obtained, or if symptoms of gastric bleeding (black, tarry stools; coffee-ground emesis) occur.
Laxatives: Advise patient that laxatives should be used only for short-term therapy. Long-term therapy may cause electrolyte imbalance and dependence.
- Encourage patient to use other forms of bowel regulation, such as ↑ dietary fiber, fluid intake, and mobility.
- Advise patient to notify health care provider if unrelieved constipation, rectal bleeding, or symptoms of electrolyte imbalance (muscle cramps or pain, weakness, dizziness) occur.
Rep: Advise patient to notify health care provider if pregnancy is planned or suspected or if breastfeeding.

Pronunciation ⬆

magnesium chloride (12% Mg; 9.8 mEq Mg/g): mag-NEE-zhum KLOR-ide

magnesium citrate (16.2% Mg; 4.4 mEq Mg/g): mag-NEE-zhum SI-trate

magnesium gluconate (5.4% Mg; 4.4 mEq/g): mag-NEE-zhum GLOO-con-ate

magnesium hydroxide (41.7% Mg; 34.3 mEq Mg/g): mag-NEE-zhum hye-DROX-ide

magnesium oxide (60.3% Mg; 49.6 mEq Mg/g): mag-NEE-zhum OX-ide

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Indications ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Availability ⬆ ⬇

Route/Dosage ⬆ ⬇

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Classifications ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Pronunciation ⬆