Magnesium Deficiency

Magnesium depletion may occur in patients receiving cyclosporin and/or tacrolimus, aminoglycosides, e.g. gentamicin/tobramycin, amphotericin B, pentamidine, diuretics, e.g. frusemide/thiazide, cisplatin and excessive IV fluids. Patients receiving these medications should have magnesium levels regularly monitored plus receive adequate magnesium supplementation to maintain normal concentrations of serum magnesium.

side effects of hypomagnesaemia include hypocalcaemia, hypokalaemia, muscle cramping, weakness, tremors, confusion, disorientation, arrythmias, seizures, cessation of bone growth with decreased osteoblast and osteoclast activity, peripheral vitamin D resistance and resistance to parathyroid hormone, augmentation of cyclosporin induced nephrotoxicity and augmentation of gentamicin induced ototoxicity.

Side effects of magnesium supplementation may include diarrhoea, hypotension, bradycardia, flushing, sweating, nausea, double vision and circulatory collapse. Magnesium may cause diarrhoea so begin at a lower dose and increase as tolerated. As magnesium causes diarrhoea and aluminium (contained in mylanta) causes constipation, mylanta may be more appropriate in patients prescribed magnesium only and who are experiencing diarrhoea. Magnesium oral preparations are not funded on the pharmaceutical schedule.


About this Canterbury DHB document (7811):
Document Owner:	Sean Macpherson (see Who's Who)
Last Reviewed:	January 2019
Next Review:	January 2022
Keywords:
Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer The Haematology Department Protocols and Guidelines (the Red Book) are intended as a guide for registered health professionals to communicate guidelines and share best practices with supporting health professionals within New Zealand district health boards. They are not intended to be provided to or used as a reference for patients or non-registered health professionals. All health professionals must exercise their own clinical judgement and use pertinent clinical data when treating patients. The authors and editors of this publication have checked with sources believed to be reliable in their effort to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical science, neither the authors, editors, publisher, nor any other party who has been involved in preparing or publishing this work warrants that the information contained in it is accurate or complete in every respect. They therefore have no liability (whether in tort (including negligence) or otherwise) for any loss or damage arising out of any reliance on this information. This publication has been compiled by the staff and contractors of Canterbury District Health Board (CDHB) and as such CDHB has copyright for this book. Amendments must be authorised in accordance with the documented process. No release of part of, or all of, this publication to any other party or organisation is permissible without the prior approval of the designated document owner.
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