Compatibility of Magnesium 1g in D5W with 0.9% NaCl
Yes, magnesium sulfate 1g in D5W is compatible with 0.9% sodium chloride (normal saline). This compatibility has been confirmed through stability studies, making this combination safe for clinical use 1.
Evidence for Compatibility
Research specifically examining magnesium sulfate in various solutions demonstrates:
- Magnesium sulfate shows stability in 0.9% sodium chloride solutions with no precipitation or significant changes in concentration over time 1
- When properly diluted, magnesium sulfate can be safely administered in various solutions including D5W and normal saline 2
Administration Guidelines
Proper Preparation
- For IV administration, magnesium sulfate solutions must be diluted to a concentration of 20% or less prior to administration 2
- Common diluents specifically mentioned in guidelines include both 5% Dextrose Injection (D5W) and 0.9% Sodium Chloride Injection (normal saline) 2
Important Considerations
- While magnesium in D5W is compatible with normal saline, caution should be exercised when mixing multiple medications
- A key distinction: mixing at the Y-site of an IV administration set (compatible) versus mixing in the same container (potentially incompatible with certain medications) 3
Clinical Applications
Magnesium sulfate is commonly used in various clinical scenarios:
- For hypomagnesemia treatment: 1g (approximately 8.12 mEq) of magnesium sulfate can be administered IV 2
- For severe magnesium deficiency: up to 5g (approximately 40 mEq) can be added to one liter of either D5W or 0.9% sodium chloride for slow IV infusion over three hours 2
- For cardiac arrhythmias associated with torsades de pointes: 1-2g diluted in 10mL D5W administered as an IV/IO bolus 4
Monitoring Recommendations
When administering magnesium sulfate:
- Monitor for signs of hypermagnesemia, especially in patients with renal impairment
- After IV replacement, recheck magnesium levels in 1-2 weeks 5
- For patients on parenteral nutrition, monitor magnesium levels every 1-2 days initially, then 1-2 times weekly 5
Conclusion
The compatibility of magnesium sulfate 1g in D5W with 0.9% NaCl is well-established. This combination can be safely administered for various clinical indications requiring magnesium supplementation, with appropriate monitoring for adverse effects.