April 29, 2016

Magnesium

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Are there any interactions with medications?



Antacids
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Antacids might reduce the laxative effects of magnesium. People taking magnesium as a laxative might require a higher dose.

Some antacids include calcium carbonate (Tums, others), dihydroxyaluminum sodium carbonate (Rolaids, others), magaldrate (Riopan), magnesium sulfate (Bilagog), aluminum hydroxide (Amphojel), and others.



Antibiotics (Aminoglycoside antibiotics)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some antibiotics can affect the muscles. These antibiotics are called aminoglycosides. Magnesium can also affect the muscles. Taking these antibiotics and getting a magnesium shot might cause muscle problems.

Some aminoglycoside antibiotics include amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), streptomycin, tobramycin (Nebcin), and others.



Antibiotics (Quinolone antibiotics)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Magnesium might decrease how much antibiotic the body absorbs. Taking magnesium along with some antibiotics might decrease the effectiveness of some antibiotics. To avoid this interaction, take these antibiotics at least 2 hours before, or 4 to 6 hours after, magnesium supplements.

Some of these antibiotics that might interact with magnesium include ciprofloxacin (Cipro), enoxacin (Penetrex), norfloxacin (Chibroxin, Noroxin), sparfloxacin (Zagam), trovafloxacin (Trovan), and grepafloxacin (Raxar).



Antibiotics (Tetracycline antibiotics)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Magnesium can attach to tetracyclines in the stomach. This decreases the amount of tetracyclines that the body can absorb. Taking magnesium along with tetracyclines might decrease the effectiveness of tetracyclines. To avoid this interaction, take calcium 2 hours before, or 4 hours after, taking tetracyclines.

Some tetracyclines include demeclocycline (Declomycin), minocycline (Minocin), and tetracycline (Achromycin).



Bisphosphonates
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Magnesium can decrease how much bisphosphate the body absorbs. Taking magnesium along with bisphosphates can decrease the effectiveness of bisphosphate. To avoid this interaction, take bisphosphonate at least two hours before magnesium or later in the day.

Some bisphosphonates include alendronate (Fosamax), etidronate (Didronel), risedronate (Actonel), tiludronate (Skelid), and others.



Digoxin (Lanoxin)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Digoxin (Lanoxin) helps the heart beat more strongly. Magnesium might decrease how much digoxin (Lanoxin) the body absorbs. By decreasing how much digoxin (Lanoxin) the body absorbs, magnesium might decrease the effects of digoxin (Lanoxin).



Gabapentin (Neurontin)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Magnesium might decrease how much gabapentin (Neurontin) the body absorbs. By decreasing how much gabapentin (Neurontin) the body absorbs, magnesium might decrease the effects of gabapentin (Neurontin). Take gabapentin (Neurontin) at least 2 hours before, or 4 to 6 hours after taking magnesium supplements.



Medications for diabetes (Sulfonylureas)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some magnesium salts might increase how much sulfonylurea the body absorbs. By increasing how much sulfonylurea the body absorbs, magnesium might increase the risk of low blood sugar in some patients.

Some sulfonylurea agents include carbutamide, acetohexamide, chlorpropamide, tolbutamide, gliclazide, glibornuride, glyclopyramide, and glimepiride.



Medications for high blood pressure (Calcium channel blockers)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications for high blood pressure work by blocking calcium from entering cells. These medications are called calcium channel blockers. Magnesium might also block calcium from entering cells. Taking magnesium with these medications might cause blood pressure to go too low.

Some of these medications include nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), and others.



Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Magnesium might slow blood clotting. Taking magnesium along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, indomethacin (Indocin), ticlopidine (Ticlid), warfarin (Coumadin), and others.



Muscle relaxants
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Magnesium seems to help relax muscles. Taking magnesium along with muscle relaxants can increase the risk of side effects of muscle relaxants.

Some muscle relaxants include carisoprodol (Soma), pipecuronium (Arduan), orphenadrine (Banflex, Disipal), cyclobenzaprine, gallamine (Flaxedil), atracurium (Tracrium), pancuronium (Pavulon), succinylcholine (Anectine), and others.



Water pills (Potassium-sparing diuretics)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some "water pills" can increase magnesium levels in the body. Taking some "water pills" along with magnesium might cause too much magnesium to be in the body.

Some "water pills" that increase magnesium in the body include amiloride (Midamor), spironolactone (Aldactone), and triamterene (Dyrenium).

Dosing considerations for Magnesium.

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:
  • The daily Recommended Dietary Allowances (RDA) for elemental magnesium are: 19-30 years, 400 mg (men) and 310 mg (women); 31 years and older, 420 mg (men) and 320 mg (women). For pregnant women age 14-18 years, the RDA is 400 mg; 19-30 years, 350 mg; 31-50 years, 360 mg. For lactating women age 14-18 years, the RDA is 360 mg; 19-30 years, 310 mg; 31-50 years, 320 mg. The daily upper intake level (UL) for magnesium is 350 mg for anyone over 8 years old, including pregnant and breast-feeding women.
  • For constipation: 8.75-25 grams of magnesium citrate has been used, usually as 150-300 mL in a 290 mL solution. 2.4-4.8 grams of magnesium hydroxide has also been used. 10-30 grams of magnesium sulfate has also been used. Magnesium salts should only be used for occasional treatment of constipation, and doses should be taken with a full 8 oz glass of water.
  • For indigestion: 400-1200 mg of magnesium hydroxide has been used up to four times daily. 800 mg of magnesium oxide daily has also been used.
  • For magnesium deficiency: 3 grams of magnesium sulfate, taken every 6 hours for four doses, has been used. A 5% solution of magnesium chloride has been used by mouth daily for 16 weeks. Magnesium-rich mineral water (Hepar) containing 110 mg/L has also been used. 10.4 mmol of magnesium lactate, taken by mouth daily for 3 months, has been used. Avoid magnesium oxide and magnesium carbonate.
  • For irregular heartbeat (arrhythmias): 2.163 mg of magnesium-DL-hydrogen aspartate and 2.162 mg of potassium-DL-hydrogen aspartate given daily for 21 days has been used.
  • For chest pain due to clogged arteries: 800-1200 mg of magnesium oxide taken daily for 3 months has been used.
  • For diabetes: For type 2 diabetes, 2.5 grams of magnesium chloride in a 50 mL solution daily for 16 weeks has been used. 300 mL of salt lake water with naturally high magnesium content diluted with distilled water to contain 100 mg of magnesium per 100 mL of water has been used daily for 30 days. 360 mg of magnesium daily for 4 to 16 weeks has been used. For type 1 diabetes, 300 mg of a specific magnesium gluconate supplement (Ultramagnesium) daily for 5 years has been used.
  • For fibromyalgia: Magnesium hydroxide plus malic acid (Super Malic tablets) has been used. 300 mg of magnesium citrate daily for 8 weeks has also been used.
  • For hearing loss: 167 mg of magnesium aspartate mixed in 200 mL lemonade, taken daily for 8 weeks or as a single dose, has been used.
  • For high cholesterol: 1 gram of magnesium oxide daily for 6 weeks has been used.
  • For metabolic syndrome: 365 mg of a specific magnesium aspartate product (Magnesiocard) taken daily for 6 months has been used.
  • For disease of heart valves (mitral valve prolapse): 1200-1800 mg of magnesium carbonate taken daily for 5 weeks has been used.
  • For osteoporosis: 300-1800 mg of magnesium hydroxide taken daily for 6 months, followed by 600 mg of magnesium hydroxide taken daily for 18 months, has been used. 1830 mg of magnesium citrate has been used daily for 30 days. In addition to estrogen, 600 mg of magnesium plus 500 mg of calcium and a multivitamin supplement has been used daily for one year.
  • Pain after surgery: A specific magnesium lozenge (Magnesium-Diasporal lozenge, Med Ilac, Istanbul, Turkey) containing 610 mg magnesium citrate salt, taken 30 minutes before surgery, has been used.
  • For premenstrual syndrome (PMS): 333 mg of magnesium oxide taken daily for two menstrual cycles has been used. A higher dose of 360 mg elemental magnesium three times daily has been used from the 15th day of the menstrual cycle until menstrual period begins. 360 mg of elemental magnesium taken three times daily for 2 months has been used. A combination of 200 mg of magnesium daily plus 50 mg of vitamin B6 daily has been used.
BY IV:
  • For magnesium deficiency: A typical starting dose for mild deficiency is 1 gram of magnesium sulfate intramuscularly (IM) every 6 hours for 4 doses. For more severe deficiency, 5 grams of magnesium sulfate may be given as an intravenous (IV) infusion over 3 hours. To prevent magnesium deficiency, adults typically receive 60-96 mg of elemental magnesium daily.
  • For high blood pressure during pregnancy (pre-eclampsia and eclampsia): 4-5 grams of magnesium sulfate by IV infusion, followed by 4-5 grams of magnesium sulfate every 4 hours, or 1 to 3 grams of magnesium sulfate per hour by constant IV infusion has been used. Doses should not exceed 30 to 40 grams of magnesium sulfate daily. A higher dose of magnesium sulfate (9-14 grams) followed by a smaller dose (2.5-5 grams every 4 hours for 24 hours) has also been used.
  • For irregular heartbeat (torsades de pointes): 1 to 6 grams of magnesium sulfate given by IV over several minutes, followed by an IV infusion has been used.
  • For irregular heartbeat (arrhythmias): For reducing irregular heartbeat after a heart attack, 8 grams of magnesium sulfate in 250 mL of solution over 12 hours has been used. For irregular or rapid heartbeat, an IV infusion of 5 grams of magnesium sulfate in 100 mL of solution has been used. Half of the dose is given over 20 minutes, followed by the remainder over 2 hours. For faster heartbeat, a single IV dose of 1-4 grams of magnesium chloride given over 5 minutes has been used. For abnormal heartbeat caused by a pacemaker, 2 grams of magnesium sulfate in 10 mL of solution has been given by IV over 1-10 minutes, followed by 5-10 grams of magnesium sulfate in 250-500 mL of solution over 5 hours.
  • For pain caused by nerve damages associated with cancer: Single doses of 0.5-1 gram of magnesium sulfate have been given as 1 mL or 2 mL of a 50% magnesium sulfate injection over 5-10 minutes.
  • For a lung disease called chronic pulmonary disease (COPD): 1.2 grams of magnesium sulfate has been given by IV after using an inhaler. 1.2-2 grams of magnesium sulfate in 100-150 mL of solution over 20 minutes has been used.
  • For cluster headache: 1 gram of magnesium sulfate over 5 minutes has been used. Single 1 gram doses of magnesium sulfate have also been used.
  • For pain after a hysterectomy: 3 grams of magnesium sulfate in an IV solution has been used followed by 0.5 grams of magnesium sulfate by IV per hour for 20 hours.
  • For pain after surgery: 5-50 mg/kg of magnesium by IV followed by a continuous IV solution at 6 mg/kg or 500 mg hourly has been used for the duration of the operation up to 48 hours. Also 3.7-5.5 grams of magnesium in addition to pain medication has been used within 24 hours after surgery.
  • For chest pain due to blood vessel spasms (vasospastic angina): 65 mg/kg of body weight of magnesium given by IV over 20 minutes has been used.
  • For asthma: Doses of 1-2 grams of magnesium sulfate have been given over 20 to 30 minutes. A dose of 78 mg/kg/hour of magnesium sulfate has been given by IV during, and for 30 minutes before, a lung function test.
INJECTED AS A SHOT:
  • For high blood pressure during pregnancy (pre-eclampsia and eclampsia): 4 grams of magnesium sulfate diluted in saline over 10–15 minutes given intravenously (by IV) followed by 5 grams of magnesium sulfate injected as a shot into each buttock, and 2.5 or 5 grams of magnesium sulfate injected as a shot every 4 hours for 24 hours has been used.
  • For chronic fatigue syndrome (CFS): Solution containing 1 gram of magnesium sulfate has been given as a shot once weekly for 6 weeks.
INHALED:
  • For a lung disease called chronic pulmonary disease (COPD): 2.5 mg of the drug salbutamol along with 2.5 mL of magnesium sulfate (151 mg per dose), inhaled three times at 30 minute intervals, has been used.

CHILDREN

BY MOUTH:
  • The daily Recommended Dietary Allowances (RDA) for elemental magnesium are: Age 1-3 years, 80 mg; 4-8 years, 130 mg; 9-13 years, 240 mg; 14-18 years, 410 mg (boys) and 360 mg (girls). For infants less than one year of age, adequate intake (AI) levels are 30 mg from birth to 6 months and 75 mg from 7 to 12 months. The daily upper intake level (UL) for magnesium is 65 mg for children age 1-3 years, and 110 mg for 4-8 years.
  • For cystic fibrosis: 300 mg of magnesium-glycine taken daily for 8 weeks has been used.
BY IV:
  • For asthma: 40 mg/kg of magnesium sulfate, up to a maximum of 2 grams, has been given by IV in 100 mL of solution over 20 minutes.

Therapeutic Research Faculty copyright

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