Magnesium gluconate supplements are used as dietary supplements in patients who are deficient or may develop deficiency. Magnesium deficiency may manifest as numbness, tingling, spasticity, muscle cramps, behavioral changes, cardiac arrhythmias, and seizures.
Magnesium gluconate Uses:
-
Dietary supplement:
- It is taken as a nutritional supplement to make up for a lack of magnesium.
Read: Magnesium Sulfate
Magnesium gluconate Dose in Adults:
OTC labeling:
Magnesium gluconate Dose as Dietary supplement:
- Oral: 550 mg equivalent to 30 mg elemental magnesium once or two times a day.
Magnesium gluconate Dose in Children:
Note:
- 1 g of magnesium gluconate is equal to 2.22 mmol elemental magnesium which is equal to 4.44 elemental magnesium or 54 mg.
Hypomagnesemia: Limited data available:
-
Infants, Children, and Adolescents:
- Dose described as elemental magnesium:
- The usual adult dose is 300 mg four times per day.
- 10-20 mg per kg per dose orally up to four times per day.
- Dose described as elemental magnesium:
Note:
- Intravenous replacement is a more appropriate option in patients with severe deficiency.
- Since magnesium may cause diarrhea, it is difficult to achieve optimal magnesium levels using an oral treatment.
Pregnancy Risk Category: C
- Magnesium crosses the placental barrier.
- The mother and fetus have almost identical serum concentrations.
Magnesium gluconate use during breastfeeding:
- Magnesium can be found in breastmilk.
- Normal conditions mean that serum levels are constant in the first year of lactation.
- They do not change due to dietary intake.
- Both lactating and nonlactating women require magnesium in the same way.
Dose in Kidney Disease:
- There are no dosage adjustments provided in the manufacturer's labeling; however, magnesium is renally excreted.
- Use with care; magnesium toxicity could result from buildup in renal impairment.
Dose in Liver disease:
There are no dosage adjustments provided in the manufacturer's labeling.
Side effects of Magnesium gluconate:
-
Gastrointestinal:
- Diarrhea if excessively used orally.
- Paralytic ileus
-
Neurologic
- Depression
- Lethargy
- Muscle weakness
- Confusion
-
Cardiac:
- Hypotension
- Shock
- Cardiac arrhythmias
-
Other:
- Flushing
- Breathing difficulty
Contraindication to Magnesium gluconate:
Hypersensitivity to any ingredient of the formulation
Warnings and precautions
-
Constipation (self-medication, OTC):
- This medication is only for occasional use. Long-term, continuous use can cause serious side effects.
- People with kidney disease should not use OTC and consult a healthcare professional.
- Patients with constipation or abdominal pain that suddenly occurs should consult a healthcare professional.
- Avoid its use if you experience nausea or abdominal pain.
-
Neuromuscular disease
- Patients suffering from myasthenia gravis and other neuromuscular disorders should be cautious.
-
Renal impairment
- Patients with kidney impairment, especially those on hemodialysis, should not use it. Magnesium intoxication may occur in patients with renal impairment.
Magnesium gluconate: Drug Interaction
Note: Drug Interaction Categories:
- Risk Factor C: Monitor When Using Combination
- Risk Factor D: Consider Treatment Modification
- Risk Factor X: Avoid Concomitant Use
Risk Factor C (Monitor therapy) |
|
| Neuromuscular-Blocking Agents | The neuromuscular-blocking effect of neuromuscular-blocking agents may be strengthened by magnesium salts. |
| Calcium Channel Blockers | Magnesium salts' harmful or hazardous effects could be amplified. Calcium Channel Blockers' hypotensive effects may be strengthened by magnesium salts. |
Risk Factor D (Consider therapy modification) |
|
| Alpha-Lipoic Acid | Alpha-Lipoic Acid may be less readily absorbed when taken with magnesium salts. Magnesium salts may be less readily absorbed when alpha-lipoic acid is present. |
| Alfacalcidol | May raise the level of magnesium salts in the serum. |
| Bictegravir | Products containing polyvalent cations may lower bictegravir's serum levels. Treatment: Bicategravir should be administered while fasting at least two hours before or six hours after using products containing polyvalent cations. It is not advised to take bictegravir at the same time as or two hours after most polyvalent cation products. |
| Bisphosphonate Derivatives | Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Exceptions: Pamidronate; Zoledronic Acid. |
| Dolutegravir | Magnesium salts may lower the level of dolutegravir in the serum. Treatment: Dolutegravir should be given at least two hours before or six hours after taking oral magnesium salts. When taking oral magnesium salts, provide the dolutegravir/rilpivirine combination product at least 4 hours before or 6 hours after. |
| Calcitriol (Systemic) | May raise the level of magnesium salts in the serum. Treatment: If a patient is also taking calcitriol, consider using a non-magnesium antacid or phosphate-binding medication. Serum magnesium concentrations should be carefully watched if magnesium-containing products must be used with calcitriol. |
| Deferiprone | Products containing polyvalent cations may lower the level of deferiprone in the serum. Treatment: Give deferiprone at least four hours apart from oral drugs or dietary supplements containing polyvalent cations. |
| Eltrombopag | Products containing polyvalent cations may lower the serum concentration of eltrombopag. Treatment: Give eltrombopag at least two hours before or four hours after taking any oral medication containing polyvalent cations. |
| Doxercalciferol | Magnesium salts' hypermagnesemic impact might be enhanced. When treating individuals who are also on doxercalciferol, take into account utilising an antacid or phosphate-binding medicine that doesn't contain magnesium. Serum magnesium concentrations should be carefully watched if magnesium-containing products must be taken with doxercalciferol. |
| Gabapentin | Gabapentin's CNS depressive effects may be strengthened by magnesium salts. Magnesium sulphate at large doses administered intravenously or epidurally, in particular, may increase the CNS depressive effects of gabapentin. Magnesium salts may lower the level of gabapentin in the blood. Treatment: Give gabapentin at least 2hrs after taking an antacid that contains magnesium. Keep a watchful eye on the patients for signs of diminished response to gabapentin medication. If a high dosage of IV/epidural magnesium sulphate is given, keep an eye out for CNS depression. |
| Multivitamins/Fluoride (with ADE) | Magnesium Salts may lower the serum levels of Fluoride and Multivitamins (with ADE). Magnesium salts in particular may lessen the absorption of fluoride. Treatment: Give magnesium salts at least 1 hour apart from taking a fluoride-containing product to prevent this potential interaction. |
| Levothyroxine | Magnesium salts may lower the level of levothyroxine in the blood. Treatment: Give oral magnesium salts at least 4hrs apart from oral levothyroxine. |
| Mycophenolate | Magnesium salts may lower the level of mycophenolate in the serum. Treatment: Different doses of mycophenolate and magnesium salts taken orally. If mycophenolate and oral magnesium salts are taken at the same time, watch out for any diminished effects. |
| Phosphate Supplements | The serum content of supplements containing phosphate may be lowered by magnesium salts. Management: To reduce the importance of this interaction, administer oral phosphate supplements as far apart as you can from the administration of an oral magnesium salt. Sodium Glycerophosphate Pentahydrate is an exception. |
| PenicillAMINE | Products containing polyvalent cations may lower the level of penicillAMINE in the serum. Treatment: Give oral medications containing polyvalent cations and penicillamine at least an hour apart. |
| Quinolones | Quinolone serum levels may be lowered by magnesium salts. Treatment: Give oral quinolones before or after oral magnesium salts, depending on the drug (6 hrs for cipro/dela, 3 hrs for gemi, 4 hrs for lome/pe, 8 hrs for moxi, and 2 hrs for levo, nor, or ofloxacin or nalidixic acid). Other than LevoFLOXacin (Oral Inhalation). |
| Trientine | Products containing polyvalent cations may lower the level of trientine in the serum. Management: Steer clear of combining the use of oral medications containing polyvalent cations with trientine. If you need to take oral iron supplements, space out the administration by two hours. Separate administration of other oral polyvalent cations by one hour if necessary. |
| Tetracyclines | Tetracyclines may be less readily absorbed when magnesium salts are present. applies only to oral forms of each drug. Eravacycline is an exception. |
Risk Factor X (Avoid combination) |
|
| Raltegravir | Magnesium salts may lower the level of raltegravir in the blood. Avoid using magnesium salts orally or intravenously while taking raltegravir. There is currently no dosage separation schedule in place that sufficiently lowers the amount of interaction. |
| Baloxavir Marboxil | Products containing polyvalent cations may lower the level of baloxavir marboxil in the serum. |
Monitoring Parameters:
Monitor ECG and serum electrolytes (when excessive doses are used or with prolonged use).
How to administer Magnesium gluconate?
It may be administered with or after meals to reduce gastrointestinal side effects.
Mechanism of action of Magnesium gluconate:
- Magnesium acts as a cofactor and regulates many of the body's enzymatic processes.
- It indirectly plays a role in carbohydrate metabolism and protein synthesis.
- Magnesium is required for proper functioning of around 300 enzymes and more.
- It can also alter neuronal function, acting on sodium/potassiumATPas and promoting polarization.
- It reduces serum cholesterol and acts on lopprotein lipase.
Distribution:
- Extracellular fluid (1% to 2%)
- Bone (50% to 60%)
Absorption:
- Orally administered, absorption is proportional to the amount consumed.
- It is generally between 40% and 60% in controlled diets, and 15% to 36% for higher doses.
Excretion:
- Faeces (as an unabsorbed drug)
- Urine (as magnesium)
Protein binding:
- 30%, primarily bound to albumin
International Brand Names of Magnesium gluconate:
- Mag-G
- Magonate
- Biogam Mg
- Gammadyn Mg
- Magnerot[inj.]
- Magnesio
- Magnesium Gluconicum
- Magnesium Oligosol
- Mikroplex Magnesium
- Oligogranul Magnesium
- Oligosol Mg
- Oligostim Magnesium
- Provitina Magnesium
- Ultra Mg
- Ultra-Mag
- Ultra-Mg
Magnesium gluconate Brand Names in Pakistan:
No Brands Available in Pakistan.
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