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Magnesium L-lactate

Generic name: magnesium lactate systemic

Brand names: Mag-Tab SR

Dosage Forms

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

Tablet Extended Release, Oral:

Mag-Tab SR: Elemental magnesium 84 mg [7 mEq] [scored]

Generic: Elemental magnesium 84 mg [7 mEq]

Pharmacology

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/Pharmacodynamics

Absorption

Oral: Inversely proportional to amount ingested; 40% to 60% under controlled dietary conditions; 15% to 36% at higher doses; majority occurs in jejunum and ileum.

Distribution

Bone (50% to 60%); extracellular fluid (1% to 2%)

Excretion

Urine (as magnesium)

Protein Binding

30%, to albumin

Use: Labeled Indications

Dietary supplement

Contraindications

Hypersensitivity to any component of the formulation

Magnesium L-lactate Images

Dosage and Administration

Dosing: Adult

Dietary supplement: Oral:1 to 2 caplets every 12 hours

Dosing: Geriatric

Refer to adult dosing.

Administration

Should be administered with food.

Dietary Considerations

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

Dietary recommended daily allowance (RDA) (elemental magnesium) (IOM 1997):

1 to 3 years: 80 mg/day

4 to 8 years: 130 mg/day

9 to 13 years: 240 mg/day

14 to 18 years:

Females: 360 mg/day

Pregnancy: 400 mg/day

Lactation: 360 mg/day

Males: 410 mg/day

19 to 30 years:

Females: 310 mg/day

Pregnancy: 350 mg/day

Lactation: 310 mg/day

Males: 400 mg/day

≥31 years:

Females: 320 mg/day

Pregnancy: 360 mg/day

Lactation: 320 mg/day

Males: 420 mg/day

Drug Interactions

Alfacalcidol: May increase the serum concentration of Magnesium Salts. 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. Consider therapy modification

Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. 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. 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. Exceptions: Pamidronate; Zoledronic Acid. 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. Consider therapy modification

Calcium Channel Blockers: May enhance the adverse/toxic effect of Magnesium Salts. Magnesium Salts may enhance the hypotensive effect of Calcium Channel Blockers. Monitor therapy

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. 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. 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. 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. 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. Consider therapy modification

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. 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. Consider therapy modification

Mycophenolate: Magnesium Salts may decrease the serum concentration of Mycophenolate. Management: Separate doses of mycophenolate and oral magnesium salts. Monitor for reduced effects of mycophenolate if taken concomitant with oral magnesium salts. Consider therapy modification

Neuromuscular-Blocking Agents: Magnesium Salts may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. 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. 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. Exceptions: Sodium Glycerophosphate Pentahydrate. 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-, 2 h for others) or after (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) oral magnesium salts. Exceptions: LevoFLOXacin (Oral Inhalation). 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. Avoid combination

Tetracyclines: Magnesium Salts may decrease the absorption of Tetracyclines. Only applicable to oral preparations of each agent. Exceptions: Eravacycline. Consider therapy modification

Trientine: Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant administration of trientine and oral products that contain polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. If other oral polyvalent cations are needed, separate administration by 1 hour. Consider therapy modification

Adverse Reactions

Frequency not defined: Gastrointestinal: Diarrhea

Warnings/Precautions

Disease-related concerns:

  • Constipation (self-medication, OTC use): Appropriate use: For occasional use only; serious side effects may occur with prolonged use. For use only under the supervision of a healthcare provider in patients with kidney dysfunction, or with a sudden change in bowel habits which persist for >2 weeks. Do not use if abdominal pain, nausea, or vomiting are present.
  • Neuromuscular disease: Use with extreme caution in patients with myasthenia gravis or other neuromuscular disease.
  • Renal impairment: Use with caution in patients with renal impairment; accumulation of magnesium may lead to magnesium intoxication.

Pregnancy

Pregnancy Considerations

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

Patient Education

  • Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
  • Have patient report immediately to prescriber severe nausea, severe vomiting, or severe diarrhea (HCAHPS).
  • Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

Source: Wolters Kluwer Health. Last updated November 28, 2019.