From the Guidelines
To increase magnesium levels, oral magnesium supplements, particularly magnesium oxide (MgO), are an effective and recommended option, with typical dosing ranging from 500 mg/d to 1.5 g/d, as supported by recent clinical guidelines 1. When considering magnesium supplementation, it's crucial to choose the right form of magnesium, as bioavailability can vary significantly. Magnesium citrate, glycinate, lactate, and malate have higher bioavailability compared to magnesium oxide or hydroxide, as noted in a study on Bartter syndrome management 1. Key points to consider when supplementing magnesium include:
- Starting with lower doses (around 200-400mg of elemental magnesium daily) and gradually increasing as needed and tolerated.
- Dividing the daily dose into 2-3 smaller doses to minimize gastrointestinal side effects like diarrhea.
- Avoiding magnesium supplements in patients with significant renal impairment (creatinine clearance <20 mg/dL) due to the risk of hypermagnesemia 1.
- Recognizing that while magnesium oxide is commonly used and studied, other forms like magnesium citrate and glycinate may offer better absorption and fewer side effects 1. In clinical practice, the choice of magnesium supplement and dosing strategy should be individualized based on the patient's specific needs, renal function, and tolerance, with the goal of maintaining optimal magnesium levels without causing adverse effects.
From the FDA Drug Label
When repeated doses of the drug are given parenterally, knee jerk reflexes should be tested before each dose and if they are absent, no additional magnesium should be given until they return. Serum magnesium levels usually sufficient to control convulsions range from 3 to 6 mg/100 mL (2. 5 to 5 mEq/L). The normal serum level is 1.5 to 2. 5 mEq/L.
The medications that would increase magnesium levels are magnesium sulfate (IV) and possibly other magnesium containing medications.
- Magnesium sulfate (IV) can increase magnesium levels, as evidenced by the need to monitor serum magnesium levels and adjust dosage accordingly 2.
- Other medications that may increase magnesium levels are not explicitly mentioned in the label, but it can be inferred that any medication containing magnesium could potentially increase magnesium levels.
From the Research
Medications to Increase Magnesium Levels
The following medications can help increase magnesium levels:
- Magnesium citrate: This formulation has been shown to increase plasma and urine magnesium levels 3
- Magnesium oxide: Although it had similar effects on plasma magnesium as magnesium citrate, it did not lead to as pronounced an increase in 24-hour urinary magnesium excretion 3
- Magnesium sulfate: Similar to magnesium oxide, it had similar effects on plasma magnesium as magnesium citrate, but did not increase 24-hour urinary magnesium excretion to the same extent as magnesium citrate 3
Key Findings
- Magnesium citrate increased plasma magnesium by +0.04 mmol/L and urine magnesium by +3.12 mmol/24 h compared to placebo 3
- The effects on plasma magnesium were similar among the magnesium supplementation groups, but magnesium citrate had a more pronounced effect on 24-hour urinary magnesium excretion 3