Magnesium Lactate - Uses, Dose, Side effects, MOA, Brands

Magnesium lactate is available as oral capsules used in the treatment of patients with magnesium deficiency or those who are at risk of developing a magnesium deficiency.

Magnesium L-lactate Uses:

  • When a patient has a nutritional deficit or is at risk of acquiring one, it is given as a dietary supplement.

Magnesium L-lactate dose in Adults:

Magnesium Lactate Dose as Dietary supplement:

  • 1 to 2 caplets orally twice daily.

Use in Children:

Not indicated.


Pregnancy Category D (Previously A)

  • It can cross the placental boundary. It can cross the placental barrier.

Use during breastfeeding:

  • It can be found in breast milk. It is found in breast milk.
  • The concentrations in lactating and nonlactating females are identical.

Dose in Kidney Disease:

  • There are no dosage adjustments provided in the manufacturer’s labelling.
  • However, since it is excreted via the kidneys, it should be used with caution, especially in patients with a CrCl of 30 ml/minute or less.
  • The drug may get accumulated in patients with renal impairment resulting in magnesium toxicity.

Dose in Liver disease:

No dosage recommendations have been recommended.


Side effects of Magnesium Lactate:

  • Gastrointestinal:

    • Diarrhoea (excessive oral doses)
    • Nausea
    • vomiting
    • abdominal pain
  • Other:

    • Weakness
    • lethargy

Contraindication to Magnesium L-lactate Include:

  • Allergic reactions to any ingredient in the formulation

Caution and Alert

  • Constipation (self-medication, OTC):

    • It should only be used occasionally if it is being used to treat constipation. 
    • If the medication is taken in large amounts or for a long time, patients may experience serious side effects.
    • Patients with kidney disease should not use it unless a healthcare provider has advised them.
    • Patients who are on a diet low in sodium or magnesium, or who have nausea, vomiting, stomach discomfort, or changed bowel habits that last more than two weeks, shouldn't use over-the-counter medications.
    • They should seek professional care.
    • A healthcare provider should be consulted if there is blood in the stool or bowel movements that are not consistent after using it.
  • Neuromuscular disease

    • Patients suffering from neuromuscular diseases such as myasthenia gravis or other similar conditions should be cautious.
  • Renal impairment

    • Patients with kidney disease may be more susceptible to magnesium accumulation. These patients should be cautious when using magnesium.

Magnesium L-aspartate hydrochloride: Drug Interaction

C - Risk Factor (Monitor therapy)

Calcium Channel Blockers

Magnesium salts' harmful or hazardous effects could be amplified. Calcium Channel Blockers' hypotensive effects may be strengthened by magnesium salts.

Neuromuscular-Blocking Agents

Magnesium salts may strengthen the neuromuscular-blocking action of neuromuscular-blocking agents.

Risk Factor D (Consider therapy modification)

Alpha-Lipoic Acid

This may be less readily absorbed when taken with magnesium salts. Magnesium salts may be less readily absorbed when alpha-lipoic acid is present.

Bictegravir

Products containing polyvalent cations may lower bictegravir's serum levels. Treatment: When utilising goods containing polyvalent cations, bicategravir should be taken while fasting at least two hours before or six hours after using those items. It is not advised to use bictegravir at the same time as or two hours after most polyvalent cation products.

Alfacalcidol May raise the level of magnesium salts in the serum.

Bisphosphonate Derivatives

Products containing polyvalent cations may lower the level of bisphosphonate derivatives in the serum. The following oral drugs should not be used within the following time frames: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Pamidronate and zoledronic acid are exceptions.

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.

Dolutegravir

Magnesium salts may reduce the serum concentration of dolutegravir. Dolutegravir should be administered at least two hours prior to or six hours following the use of oral magnesium salts. Give the dolutegravir/rilpivirine combo product at least 4 hours before or 6 hours after taking oral magnesium salts.

Calcitriol (Systemic)

May increase the serum's level of magnesium salts. Treatment: If a patient is also taking calcitriol, you might want to use a phosphate-binding drug or an antacid that doesn't include magnesium. If magnesium-containing products must be used with calcitriol, serum magnesium levels should be closely monitored.

Doxercalciferol

The hypermagnesemic impact could be enhanced. When treating individuals who are also on doxercalciferol, take into account utilising an antacid or phosphate-binding medicine that doesn't include magnesium. If doxercalciferol must be used with magnesium-containing products, serum magnesium levels should be closely monitored.

Eltrombopag

Products with polyvalent cations may reduce the level of eltrombopag in the serum. Eltrombopag should be used either two or four hours before or after any oral treatment containing polyvalent cations.

Gabapentin

Gabapentin's CNS depressive effects may be strengthened by magnesium salts. Magnesium sulphate at large doses administered intravenously or epidurally, in particular, may intensify gabapentin's CNS depressive effects. Magnesium salts can reduce blood's concentration of gabapentin. Treatment: Give gabapentin at least two hours 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.

Levothyroxine

Magnesium salts may reduce the blood's amount of levothyroxine. Treatment: Give oral magnesium salts and oral levothyroxine at least 4 hours apart.

Multivitamins/Fluoride (with ADE)

Fluoride and multivitamin serum levels may be reduced by magnesium salts (with ADE). Magnesium salts in particular may decrease the absorption of fluoride. Treatment: Give magnesium salts at least 1 hour apart from taking a fluoride-containing product to prevent this possible interaction.

Mycophenolate

Magnesium salts may lower the level of mycophenolate in the serum. Treatment: Different dosages of mycophenolate and magnesium salts are taken orally. If mycophenolate and oral magnesium salts are used at the same time, watch out for any diminished effects.

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.

Phosphate Supplements

The serum content of supplements containing phosphate may be lowered by magnesium salts. Management: Give supplements of oral phosphate as widely apart as you can from giving magnesium salt orally to lessen the significance of this interaction. Sodium Glycerophosphate Pentahydrate is an exception.

Quinolones

Quinolone serum levels may be lowered by magnesium salts. Treatment: Give oral quinolones before or after oral magnesium salts, depending on the drug (8 h for moxi, 6 h for cipro/dela, 4 h for lome/pe, 3 h for gemi, and 2 h for levo, nor, or ofloxacin or nalidixic acid). Other than LevoFLOXacin (Oral Inhalation).

Tetracyclines

Tetracyclines may be less readily absorbed when magnesium salts are present. applies only to oral forms of each drug. Eravacycline is an exception.

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 delivery of additional oral polyvalent cations by one hour if necessary.

Risk Factor X (Avoid combination)

Baloxavir Marboxil

Products containing polyvalent cations may lower the level of baloxavir marboxil in the serum.

Raltegravir

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. Magnesium salts may lower the level of raltegravir in the blood.

 

Monitoring Parameters:

  • May need to monitor ECG and electrolyte levels.
  • Monitor magnesium levels in patients with kidney disease.

How to administer Magnesium L-lactate?

It should be administered with food.


Mechanism of action of Magnesium L-lactate:

  • Magnesium is a cofactor of many enzymes. 
  • Magnesium is required for the proper functioning of around 300 enzymes.
  • It is a cofactor of enzymes involved in carbohydrate, protein, and lipid synthesis. 
  • It reduces serum cholesterol and acts on lipoprotein lipases. 
  • It can also act on the sodium/potassium ATPase, resulting in the polarization and reorganization of neurons.

Absorption

Oral:

    • It is proportional to how much you ingest.
    • Under carefully monitored dietary settings, 40% to 60% 
    • The drug's absorption might range from 15% to 36% at higher dosages. 
    • The majority of the drug is absorbed by the ileum and jejunum.

Distribution:

  • Extracellular fluid (1% to 2%)
  • Bone (50% to 60%);

Bioavailability:

  • 41%

Protein binding:

  • 30% of the drug is bound to proteins primarily albumin

Excretion:

  • Urine (as magnesium)

Brands of magnesium L-lactate sold internationally:

  • Mag-Tab SR

Magnesium L-lactate Brands Names in Pakistan:

No Brands Available in Pakistan.

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