Magnesium L-aspartate hydrochloride: Drug information

(For additional information see "Magnesium L-aspartate hydrochloride: Patient drug information" and see "Magnesium L-aspartate hydrochloride: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)

Brand Names: US

Maginex DS [OTC];
Maginex [OTC]

Pharmacologic Category

Electrolyte Supplement, Oral;
Magnesium Salt

Dosing: Adult

Dietary supplement

Dietary supplement (dosage in terms of magnesium-L-aspartate hydrochloride salt): OTC labeling: Oral: Two tablets daily or 1 packet up to 3 times daily.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling; however, magnesium is renally excreted. Use caution; accumulation of magnesium in renal impairment may lead to magnesium toxicity.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Magnesium L-aspartate hydrochloride: Pediatric drug information")

Note: 1,000 mg of magnesium L-aspartate = 99.18 mg elemental magnesium = 8.16 mEq elemental magnesium.

Hypomagnesemia

Hypomagnesemia: Limited data available: Infants, Children, and Adolescents: Dose expressed as elemental magnesium: Oral: 10 to 20 mg/kg/dose up to 4 times daily; usual adult dose: 300 mg 4 times daily (Ref). Note: Achieving optimal magnesium levels using oral therapy may be difficult due to the propensity for magnesium to cause diarrhea; IV replacement may be more appropriate particularly in situations of severe deficit.

Dosing: Kidney Impairment: Pediatric

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

Frequency not defined: Gastrointestinal: Abdominal cramps, diarrhea (excessive oral doses), flatulence

Warnings/Precautions

Disease-related concerns:

• Renal impairment: Use with caution in patients with renal impairment; accumulation of magnesium may lead to magnesium intoxication.

Warnings: Additional Pediatric Considerations

Multiple salt forms of magnesium exist; close attention must be paid to the salt form when ordering and administering magnesium; incorrect selection or substitution of one salt for another without proper dosage adjustment may result in serious over- or underdosing.

Dosage Forms Considerations

1 g magnesium L-aspartate Hydrochloride ≈ elemental magnesium 99.18 mg = magnesium 8.16 mEq = magnesium 4.08 mmol

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Granules for solution, oral [preservative free]:

Maginex DS: 1230 mg/packet (30s) [sugar free; lemon flavor; equivalent to elemental magnesium 122 mg]

Tablet, enteric coated, oral [preservative free]:

Maginex: 615 mg [sugar free; equivalent to elemental magnesium 61 mg]

Generic Equivalent Available: US

Administration: Adult

Packet: Mix contents of 1 packet in water or juice.

Tablet: Do not crush or chew.

Administration: Pediatric

Oral:

Granules: Mix each packet prior to administration

Tablet: Do not crush or chew

Use: Labeled Indications

Dietary supplement: Dietary magnesium supplement.

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Alfacalcidol: May increase the serum concentration of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving alfacalcidol. If magnesium-containing products must be used with alfacalcidol, serum magnesium concentrations should be monitored closely. Risk D: Consider therapy modification

Alpha-Lipoic Acid: Magnesium Salts may decrease the absorption of Alpha-Lipoic Acid. Alpha-Lipoic Acid may decrease the absorption of Magnesium Salts. Management: Separate administration of alpha-lipoic acid from that of any magnesium-containing compounds by several hours. If alpha-lipoic acid is given 30 minutes before breakfast, then administer oral magnesium-containing products at lunch or dinner. Risk D: Consider therapy modification

Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. Risk X: Avoid combination

Bictegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Bictegravir. Management: Administer bictegravir under fasting conditions at least 2 hours before or 6 hours after polyvalent cation containing products. Coadministration of bictegravir with or 2 hours after most polyvalent cation products is not recommended. Risk D: Consider therapy modification

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. Risk D: Consider therapy modification

Cabotegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Cabotegravir. Management: Administer polyvalent cation containing products at least 2 hours before or 4 hours after oral cabotegravir. Risk D: Consider therapy modification

Calcitriol (Systemic): May increase the serum concentration of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving calcitriol. If magnesium-containing products must be used with calcitriol, serum magnesium concentrations should be monitored closely. Risk D: Consider therapy modification

Deferiprone: Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Risk D: Consider therapy modification

Dolutegravir: Magnesium Salts may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral magnesium salts. Administer the dolutegravir/rilpivirine combination product at least 4 hours before or 6 hours after oral magnesium salts. Risk D: Consider therapy modification

Doxercalciferol: May enhance the hypermagnesemic effect of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving doxercalciferol. If magnesium-containing products must be used with doxercalciferol, serum magnesium concentrations should be monitored closely. Risk D: Consider therapy modification

Eltrombopag: Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. Risk D: Consider therapy modification

Elvitegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Elvitegravir. Management: Administer elvitegravir 2 hours before or 6 hours after the administration of polyvalent cation containing products. Risk D: Consider therapy modification

Gabapentin: Magnesium Salts may enhance the CNS depressant effect of Gabapentin. Specifically, high dose intravenous/epidural magnesium sulfate may enhance the CNS depressant effects of gabapentin. Magnesium Salts may decrease the serum concentration of Gabapentin. Management: Administer gabapentin at least 2 hours after use of a magnesium-containing antacid. Monitor patients closely for evidence of reduced response to gabapentin therapy. Monitor for CNS depression if high dose IV/epidural magnesium sulfate is used. Risk D: Consider therapy modification

Levonadifloxacin: Magnesium Salts may decrease the serum concentration of Levonadifloxacin. Risk X: Avoid combination

Levothyroxine: Magnesium Salts may decrease the serum concentration of Levothyroxine. Management: Separate administration of oral levothyroxine and oral magnesium salts by at least 4 hours. Risk D: Consider therapy modification

Multivitamins/Fluoride (with ADE): Magnesium Salts may decrease the serum concentration of Multivitamins/Fluoride (with ADE). Specifically, magnesium salts may decrease fluoride absorption. Management: To avoid this potential interaction separate the administration of magnesium salts from administration of a fluoride-containing product by at least 1 hour. Risk D: Consider therapy modification

Neuromuscular-Blocking Agents: Magnesium Salts may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Risk C: Monitor therapy

PenicillAMINE: Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. Risk D: Consider therapy modification

Phosphate Supplements: Magnesium Salts may decrease the serum concentration of Phosphate Supplements. Management: Administer oral phosphate supplements as far apart from the administration of an oral magnesium salt as possible to minimize the significance of this interaction. Risk D: Consider therapy modification

Quinolones: Magnesium Salts may decrease the serum concentration of Quinolones. Management: Administer oral quinolones several hours before (4 h for moxi/pe/spar/enox-, 2 h for others) or after (8 h for moxi-, 6 h for cipro/dela-, 4 h for lome/pe/enox-, 3 h for gemi-, and 2 h for levo-, nor-, or ofloxacin or nalidixic acid) oral magnesium salts. Risk D: Consider therapy modification

Raltegravir: Magnesium Salts may decrease the serum concentration of Raltegravir. Management: Avoid the use of oral / enteral magnesium salts with raltegravir. No dose separation schedule has been established that adequately reduces the magnitude of interaction. Risk X: Avoid combination

Roxadustat: Polyvalent Cation Containing Products may decrease the serum concentration of Roxadustat. Management: Administer roxadustat at least 1 hour after the administration of oral polyvalent cation containing products. Risk D: Consider therapy modification

Tetracyclines: Magnesium Salts may decrease the absorption of Tetracyclines. Only applicable to oral preparations of each agent. Management: Avoid coadministration of oral magnesium salts and oral tetracyclines. If coadministration cannot be avoided, administer oral magnesium at least 2 hours before, or 4 hours after, oral tetracyclines. Monitor for decreased tetracycline therapeutic effects. Risk D: Consider therapy modification

Trientine: Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant use of trientine and polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. For other oral polyvalent cations, give trientine 1 hour before, or 1 to 2 hours after the polyvalent cation. Risk D: Consider therapy modification

Unithiol: May diminish the therapeutic effect of Polyvalent Cation Containing Products. Risk X: Avoid combination

Pregnancy Considerations

Magnesium crosses the placenta; serum concentrations in the fetus are similar to those in the mother (Idama 1998; Osada 2002).

Breastfeeding Considerations

Magnesium is found in breast milk; concentrations remain constant during the first year of lactation and are not influenced by dietary intake under normal conditions. Magnesium requirements are the same in lactating and nonlactating females (IOM 1997).

Dietary Considerations

Take with food. Whole grains, legumes, and dark-green leafy vegetables are dietary sources of magnesium.

Adequate intake (AI) (elemental magnesium) (IOM 1997):

1 to 6 months: 30 mg/day

7 to 12 months: 75 mg/day

Dietary reference intake (elemental magnesium) (IOM 1997):

1 to 6 months: Adequate intake: 30 mg daily

7 to 12 months: Adequate intake: 75 mg daily

1 to 3 years: RDA: 80 mg daily

4 to 8 years: RDA: 130 mg daily

9 to 13 years: RDA: 240 mg daily

14 to 18 years: RDA:

Females: 360 mg daily

Pregnancy: 400 mg daily

Lactation: 360 mg daily

Males: 410 mg daily

19 to 30 years: RDA:

Females: 310 mg daily

Pregnancy: 350 mg daily

Lactation: 310 mg daily

Males: 400 mg daily

≥31 years: RDA:

Females: 320 mg daily

Pregnancy: 360 mg daily

Lactation: 320 mg daily

Males: 420 mg daily

Reference Range

Serum magnesium: 1.5 to 2.5 mg/dL; slightly different ranges are reported by different laboratories

Mechanism of Action

Magnesium is important as a cofactor in many enzymatic reactions in the body involving protein synthesis and carbohydrate metabolism (at least 300 enzymatic reactions require magnesium). Actions on lipoprotein lipase have been found to be important in reducing serum cholesterol and on sodium/potassium ATPase in promoting polarization (eg, neuromuscular functioning).

Pharmacokinetics (Adult Data Unless Noted)

Absorption: Oral: Up to 30%

Excretion: Urine (IOM 1997); feces (as unabsorbed drug)

Brand Names: International

International Brand Names by Country

For country code abbreviations (show table)

(AT) Austria: Emgecard | Magnesiocard;
(CH) Switzerland: Magnesiocard | Magnesiocard citron | Magnesiocard grapefruit | Magnesiocard orange;
(DE) Germany: Magnesiocard;
(GB) United Kingdom: Magnesiocard;
(GR) Greece: Trofocard

Gal P, Reed M. Medications. In: Kliegman RM, Behrman RE, Jenson HB, et al, eds. Nelson Textbook of Pediatrics. 18th ed. Saunders Elsevier; 2007:2955-2999.
Idama TO, Lindow SW. Magnesium Sulphate: A Review of Clinical Pharmacology Applied to Obstetrics. Br J Obstet Gynaecol. 1998;105(3):260-268. [PubMed 9532984]
IOM (Institute of Medicine). Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. National Academy of Sciences; 1997.
Kliegman RM, Stanton BMD, St. Geme J, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Saunders Elsevier; 2016.
Maginex [prescribing information]. Amityville, NY; Hi-Tech Pharmacal Co Inc; October 2010.
Maginex DS [prescribing information]. Amityville, NY; Hi-Tech Pharmacal Co Inc; October 2010.
Osada H, Watanabe Y, Nishimura Y, et al. Profile of Trace Element Concentrations in the Feto-Placental Unit in Relation to Fetal Growth. Acta Obstet Gynecol Scand. 2002;81(10):931-937. [PubMed 12366483]

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Magnesium L-aspartate hydrochloride: Drug information