Magnesium (medical use) explained

Drug Name:Magnesium
Inn:Magnesium ion
Routes Of Administration:By mouth, injection, topical
Atc Prefix:A12
Atc Suffix:CC
Cas Number:7439-95-4
Unii:I38ZP9992A
Pubchem:888
Chemspiderid:865
Mg:1
Charge:+2

Magnesium salts are available as a medication in a number of formulations. They are used to treat magnesium deficiency, low blood magnesium, eclampsia, and several other conditions. Magnesium is an essential nutrient.

Usually in lower dosages, magnesium is commonly included in dietary mineral preparations, including many multivitamin preparations. Chelated magnesium is sometimes used to aid in absorption.

In 2021, it was the 313th most commonly prescribed medication in the United States, with more than 300,000 prescriptions[1] [2] and magnesium salts were the 211th most commonly prescribed medication, with more than 2million prescriptions.[3]

Medical uses

Side effects

More common side effects from magnesium include upset stomach and diarrhea, and calcium deficiency if calcium levels are already low.[7]

Overdose

Overdose of magnesium (hypermagnesemia) is only possible in special circumstances. It can cause diarrhea,[8] nausea, vomiting, severely lowered blood pressure, confusion, slowed heart rate, respiratory paralysis.[7] In very severe cases, it can cause coma, cardiac arrhythmia, cardiac arrest and death.[7]

Magnesium overdose can be counteracted by administering calcium gluconate.[9]

Types of preparations

In practice, magnesium is given in a salt form together with any of several anionic compounds serving as counter-ions, such as chloride or sulfate. Nevertheless, magnesium is generally presumed to be the active component. An exception is the administration of magnesium sulfate in barium chloride poisoning,[25] where sulfate binds to barium to form insoluble barium sulfate.

Magnesium is absorbed orally at about 30% bioavailability from any water soluble salt, such as magnesium chloride or magnesium citrate. The citrate is the least expensive soluble (high bioavailability) oral magnesium salt available in supplements, with 100 mg and 200 mg magnesium typically contained per capsule, tablet or 50 mg/mL in solution.[26]

Magnesium aspartate, chloride, lactate, citrate and glycinate each have bioavailability 4 times greater than the oxide form and are equivalent to each other per amount of magnesium, though not in price.[27] [28]

The ligand of choice for large-scale manufacturers of multivitamins and minerals containing magnesium is the magnesium oxide due to its compactness, high magnesium content by weight, low cost, and ease-of-use in manufacturing. However it is insoluble in water. Insoluble magnesium salts such as magnesium oxide or magnesium hydroxide (milk of magnesia) depend on stomach acid for neutralization before they can be absorbed, and thus are relatively poor oral magnesium sources, on average.

Magnesium sulfate (Epsom salts) is soluble in water. It is commonly used as a laxative, owing to the poor absorption of the sulfate component. In lower doses, they may be used as an oral magnesium source, however.

Intravenous or intramuscular magnesium is generally in the form of magnesium sulfate solution. Intravenous or intramuscular magnesium is completely bioavailable, and effective. It is used in severe hypomagnesemia and eclampsia.

Research

Research on topical magnesium (for example epsom salt baths) is very limited.[29]

Studies have revealed that magnesium sulfate can be nebulized to reduce the symptoms of acute asthma.[4]

Notes and References

  1. Web site: The Top 300 of 2021 . ClinCalc . 14 January 2024 . 15 January 2024 . https://web.archive.org/web/20240115223848/https://clincalc.com/DrugStats/Top300Drugs.aspx . live .
  2. Web site: Magnesium - Drug Usage Statistics . ClinCalc . 14 January 2024.
  3. Web site: Magnesium Salts - Drug Usage Statistics . ClinCalc . 14 January 2024.
  4. Blitz M, Blitz S, Hughes R, Diner B, Beasley R, Knopp J, Rowe BH . Aerosolized magnesium sulfate for acute asthma: a systematic review . Chest . 128 . 1 . 337–344 . July 2005 . 16002955 . 10.1378/chest.128.1.337 .
  5. Committee Opinion No 652: Magnesium Sulfate Use in Obstetrics . Obstetrics and Gynecology . 127 . 1 . e52–e53 . January 2016 . 26695587 . 10.1097/AOG.0000000000001267 . 33483604 .
  6. Crowther CA, Brown J, McKinlay CJ, Middleton P . Magnesium sulphate for preventing preterm birth in threatened preterm labour . The Cochrane Database of Systematic Reviews . 8 . CD001060 . August 2014 . 25126773 . 10.1002/14651858.CD001060.pub2 . 10838393 .
  7. Web site: Magnesium . https://web.archive.org/web/20110127183926/http://www.umm.edu/altmed/articles/magnesium-000313.htm . 27 January 2011 . at University of Maryland Medical Center (UMMCb. 17 June 2011 . Ehrlich SD .
  8. Web site: Health Risks from Excessive Magnesium . U.S. National Institutes of Health (NIH) . Office of Dietary Supplements (ODS) .
  9. Omu AE, Al-Harmi J, Vedi HL, Mlechkova L, Sayed AF, Al-Ragum NS . Magnesium sulphate therapy in women with pre-eclampsia and eclampsia in Kuwait . Medical Principles and Practice . 17 . 3 . 227–232 . 2008 . 18408392 . 10.1159/000117797 .
  10. Web site: Magnesium Aspartate HCl Oral . WebMD .
  11. Web site: Magnesium Carbonate Oral . WebMD .
  12. Web site: Magnesium Chloride Oral . WebMD .
  13. Web site: Magnesium Gluconate . MedlinePlus .
  14. Web site: Magnesium Glycinate Oral . WebMD .
  15. Web site: Magnesium Lactate Oral . WebMD .
  16. Web site: Mg-Orotate Oral . WebMD .
  17. Web site: Magnesium Oxide Oral . WebMD .
  18. Web site: Magnesium Carbonate - an overview . ScienceDirect .
  19. Web site: Magnesium Citrate Oral . WebMD .
  20. Web site: Magnesium Citrate . MedlinePlus .
  21. Web site: Magnesium Citrate - an overview . ScienceDirect.
  22. Web site: Magnesium Hydroxide Oral . WebMD .
  23. Web site: Magnesium Oxide . MedlinePlus .
  24. Web site: Health Benefits of Magnesium Oxide . WebMD .
  25. Web site: BARIUM CHLORIDE DIHYDRATE 4. First Aid Measures . Jtbaker.com . 6 July 2009.
  26. Web site: Rougier Pharma Citro Mag Laxatif/purgatif – CTC Health . 2022-11-30 . ctchealth.ca.
  27. Firoz M, Graber M . Bioavailability of US commercial magnesium preparations . Magnesium Research . 14 . 4 . 257–62 . December 2001 . 11794633 .
  28. Lindberg JS, Zobitz MM, Poindexter JR, Pak CY . Magnesium bioavailability from magnesium citrate and magnesium oxide . Journal of the American College of Nutrition . 9 . 1 . 48–55 . February 1990 . 2407766 . 10.1080/07315724.1990.10720349 .
  29. Web site: Rath . Linda . Why Take an Epsom Salts Bath? . WebMD .