Review Article

The Importance of Magnesium in Clinical Healthcare

Table 8

Magnesium and drug interactions.

Medications that reduce magnesium levels:
 (i) H2 blockers: for example, cimetidine and nizatidine
 (ii) Proton pump inhibitors: for example, esomeprazole, omeprazole, and pantoprazole (FDA WARNING: supplementing magnesium will not correct deficiency; you must stop the drug)
 (iii) Antacids: aluminum and magnesium hydroxide and sodium bicarbonate
 (iv) Antibiotics: for example, amoxicillin, azithromycin, doxycycline, minocycline, levofloxacin, ciprofloxacin, cephalexin,
sulfamethoxazole and trimethoprim, and tetracycline
 (v) Antihistamines: for example, astemizole and terfenadine
 (vi) Antivirals: for example, delavirdine, lamivudine, and zidovudine
 (vii) Antiepileptic medications: phenytoin and phenobarbital
 (viii) Blood pressure drugs: hydralazine and combination of ACE inhibitors with HCTZ (enalapril and HCTZ)
 (ix) Diuretics: for example, furosemide, ethacrynic acid, chlorothiazide, chlorthalidone, metolazone, and indapamide
 (x) Cardiac glycoside: digoxin
 (xi) Cardiac drugs: sotalol, amiodarone, bretylium, and quinidine
 (xii) CNS stimulants: methylphenidate
 (xiii) Cholesterol agents: cholestyramine and colestipol
 (xiv) Corticosteroids: betamethasone, dexamethasone, hydrocortisone, prednisone, and triamcinolone
 (xv) Inhaled corticosteroids: fluticasone, flunisolide, and triamcinolone
 (xvi) Estrogens: DES, estradiol, estring, and estrogen-containing drugs: HRT and BCP
 (xvii) Immunosuppressants: cyclosporine and tacrolimus
 (xviii) Nonsteroidal aromatase inhibitors for breast cancer: anastrozole
 (xix) Osteoporosis: raloxifene
   (a) On the other hand, magnesium decreases bisphosphonate absorption
 (xx) SERMs (selective estrogen receptor modulators): raloxifene, tamoxifen, and toremifene
 (xxi) Sulfonamides: antibiotics and some diabetic medications
 (xxii) Nutraceuticals: for example, high-dose calcium, high-dose vitamin D, and caffeine

Medications that may increase serum magnesium:
 (i) Lithium carbonate
 (ii) Antidepressants: for example, sertraline and amitriptyline
 (iii) Potassium sparing diuretics: amiloride and spironolactone reduce magnesium excretion