What is Milk of magnesia (magnesium hydroxide)?

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From the Guidelines

Milk of Magnesia (Magnesium Hydroxide) is an osmotic laxative used to treat constipation.

Key Characteristics

  • It works by creating an osmotic gradient in the GI tract, leading to net secretion of water and electrolytes, which helps to relieve constipation-related symptoms 1
  • The typical dose used in clinical practice is 500 mg/d to 1 g/d, although higher doses of 1.5 g/d have been used in trials 1
  • It is available over-the-counter (OTC) and is considered a low-cost option for treating constipation 1
  • However, its use should be avoided in patients with significant renal impairment due to the risk of hypermagnesemia 1

Clinical Use

  • Milk of Magnesia is suggested as a first-line option for individuals with chronic idiopathic constipation (CIC) due to its efficacy, tolerability, and low cost 1
  • It can be used in combination with other agents, such as fiber supplements or stimulant laxatives, to manage constipation symptoms 1
  • The American Gastroenterological Association recommends starting with a lower dose and increasing as needed, while also avoiding use in patients with renal insufficiency 1

From the FDA Drug Label

PRINCIPAL DISPLAY PANEL - 30 mL Cup Tray Label NDC 0121-0431-30 Milk of Magnesia USP ANTACID, SALINE LAXATIVE Active ingredient (in each 5 mL) Magnesium hydroxide 400 mg Other information each teaspoonful (5 mL) contains:magnesium 400 mg Milk of Magnesia (Magnesium Hydroxide) is an antacid and saline laxative that contains Magnesium Hydroxide as its active ingredient 2, 2, 2.

  • It is used to neutralize stomach acid and stimulate bowel movements.
  • The typical dosage contains 400 mg of Magnesium Hydroxide per 5 mL.

From the Research

Definition and Composition

  • Milk of magnesia, also known as magnesium hydroxide, is a compound used as a laxative to treat constipation and fecal incontinence 3, 4.
  • It is composed of magnesium hydroxide, which can help stimulate bowel movements and soften stool.

Medical Uses

  • Milk of magnesia is used to treat constipation, fecal incontinence, and abdominal pain in children and adults 3, 4.
  • It is also used as an antacid to neutralize stomach acid and relieve heartburn and indigestion.
  • In some cases, milk of magnesia is used to prevent postoperative ileus after major surgical procedures, such as gynecologic operations 5.

Side Effects and Interactions

  • Excessive ingestion of milk of magnesia can lead to hypermagnesemia, a condition characterized by elevated magnesium levels in the blood 6, 7.
  • Hypomagnesemia, or low magnesium levels, can also occur due to excessive diarrhea caused by milk of magnesia 6.
  • Milk of magnesia can interact with other medications, such as lithium, and decrease their absorption 7.

Efficacy and Safety

  • Studies have shown that milk of magnesia is effective in treating constipation and fecal incontinence in children and adults 3, 4.
  • However, its efficacy and safety may vary depending on the individual and the dosage used 4.
  • Milk of magnesia is generally considered safe when used as directed, but it can cause adverse effects, such as diarrhea, abdominal pain, and nausea, in some individuals 3, 4.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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