From the Guidelines
Magnesium sulfate is the drug that, when given intravenously besides corticosteroids, can prevent hospital admissions in asthma. This is based on a Cochrane meta-analysis of 7 studies that concluded IV magnesium sulfate improves pulmonary function and reduces hospital admissions, particularly for patients with the most severe exacerbations of asthma 1. The use of IV magnesium sulfate can moderately improve pulmonary function in patients with asthma when combined with nebulized β-adrenergic agents and corticosteroids. Key points to consider when administering magnesium sulfate include:
- The standard adult dose is 2 g administered over 20 minutes
- Magnesium causes relaxation of bronchial smooth muscle independent of serum magnesium level, with only minor side effects such as flushing and light-headedness
- IV magnesium sulfate is particularly beneficial for patients with severe refractory asthma. Overall, the addition of magnesium sulfate to the treatment regimen of patients with acute asthma exacerbations, alongside corticosteroids, can be a valuable strategy to prevent hospital admissions and improve patient outcomes, as supported by the evidence from the 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Drug Options for Preventing Hospital Admissions in Asthma
- Besides Cortizone, intravenous magnesium sulfate is a drug that has been shown to prevent hospital admissions in asthma patients 2, 3, 4.
- The use of intravenous magnesium sulfate in acute asthma has been demonstrated to improve lung function and reduce the need for hospitalization 2, 3, 4.
- Inhaled magnesium sulfate has also been studied as a potential treatment for acute asthma, but the evidence for its effectiveness is less clear and it is not recommended for routine use 5, 6.
Mechanism of Action
- Magnesium sulfate works by relaxing the smooth muscles in the airways, which helps to improve lung function and reduce symptoms of asthma 2, 3.
- It also has anti-inflammatory properties, which can help to reduce airway inflammation and improve outcomes in asthma patients 2, 3.
Clinical Evidence
- A study published in 2010 found that the addition of inhaled magnesium sulfate to standard treatment improved lung function and reduced hospital admissions in patients with severe asthma 2.
- Another study published in 2011 found that intravenous magnesium sulfate improved lung function and reduced the need for hospitalization in children with severe asthma 3.
- A 2024 review of acute asthma management strategies found that the addition of magnesium sulfate infusion to standard treatment was associated with fewer hospitalizations 4.