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MAGNESIUM SULFATE IN WATER FOR is a brand name for Magnesium Sulfate, supplied as a solution. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Magnesium Sulfate in Water for Injection may be of therapeutic value in the following conditions: • as an anticonvulsant for preeclampsia and eclampsia • as an electrolyte replenisher for hypomagnesemia and magnesium deficiency to maintain normal neuromuscular irritability. 1.1 Pediatrics Pediatrics (<18 years of…
Verbatim from this product's HC label. Tap a section to expand.
1 Dosing Considerations This product is a sterile ready-to-use product. Renal Parenteral use in the presence of renal insufficiency may lead to magnesium intoxication. In patients with severe renal impairment, dosage should not exceed 20 g Magnesium Sulfate in Water for Injection Page 5 of 19 in 48 hours.
Serum magnesium should be monitored in such patients. (See 7 WARNINGS AND PRECAUTIONS, Renal, Aluminum toxicity). 2 Recommended Dose and Dosage Adjustment Usual Dose Range A total daily (24 hr) dose of 30 to 40 g magnesium sulfate should not be exceeded.
88 mL/min 80 mg/mL solution) until relaxation is obtained. IV use in eclampsia should be reserved for immediate control of life-threatening convulsions. See 7 WARNINGS AND PRECAUTIONS, For Pre-eclampsia or Eclampsia. 6 mL/min 80 mg/mL solution).
5 mg/dL) 2 to 4 g over 2 to 12 hours Severe deficiency (eg, serum magnesium <1 mg/dL) 4 to 8 g over 4 to 24 hours Symptomatic patients (eg, tetany, arrhythmias, seizures)* Hemodynamically unstable 1 to 2 g administered as a bolus over 2 to 15 minutes; may repeat as needed if patient remains unstable; once patient is stable, administer an additional 4 to 8 g over 12 to 24 hours.
Hemodynamically stable 1 to 2 g over 5 to 60 minutes, followed by an additional 4 to 8 g over 12 to 24 hours. *Note: Continuous cardiac monitoring strongly recommended. Subsequent dosing may be based on serum magnesium levels assessed 6 to 12 hours after initial dosing.
Repletion may take several days. Magnesium Sulfate in Water for Injection Page 6 of 19 The above table provides a reference for dosing recommendations that may vary between patients and institutional practices. Refer to clinical practice guidelines or institutional medical protocols for recommended dosing and administration of intravenous magnesium sulfate in the treatment of hypomagnesemia.
Monitor patient’s clinical status to avoid symptoms of hypomagnesemia or hypermagnesemia or until symptoms of hypomagnesemia resolve. Monitor serum magnesium concentrations during therapy until serum magnesium concentration has returned to the normal reference range.
• For Pre-eclampsia or Eclampsia Magnesium sulfate should be used for treatment of preeclampsia and eclampsia of pregnancy only if clearly needed and for the shortest time required. See 7 WARNINGS AND PRECAUTIONS. In severe pre-eclampsia or eclampsia, the total initial dose is 10 to 14 g of magnesium sulfate.
1 Adverse Reaction Overview Principal adverse reactions are related to the high plasma levels of magnesium and include flushing, sweating, hypotension, circulatory collapse, and cardiac and central nervous system depression. Respiratory depression is the most life-threatening effect.
Hypocalcemia with signs of tetany secondary to magnesium sulfate therapy for eclampsia has been reported.
, Renal, Aluminum toxicity). 2 Recommended Dose and Dosage Adjustment Usual Dose Range A total daily (24 hr) dose of 30 to 40 g magnesium sulfate should not be exceeded. 88 mL/min 80 mg/mL solution) until relaxation is obtained. IV use in eclampsia should be reserved for immediate control of life-threatening convulsions.
See 7 WARNINGS AND PRECAUTIONS, For Pre-eclampsia or Eclampsia. 6 mL/min 80 mg/mL solution). 5 mg/dL) 2 to 4 g over 2 to 12 hours Severe deficiency (eg, serum magnesium <1 mg/dL) 4 to 8 g over 4 to 24 hours Symptomatic patients (eg, tetany, arrhythmias, seizures)* Hemodynamically unstable 1 to 2 g administered as a bolus over 2 to 15 minutes; may repeat as needed if patient remains unstable; once patient is stable, administer an additional 4 to 8 g over 12 to 24 hours.
Hemodynamically stable 1 to 2 g over 5 to 60 minutes, followed by an additional 4 to 8 g over 12 to 24 hours. *Note: Continuous cardiac monitoring strongly recommended. Subsequent dosing may be based on serum magnesium levels assessed 6 to 12 hours after initial dosing.
Repletion may take several days. Magnesium Sulfate in Water for Injection Page 6 of 19 The above table provides a reference for dosing recommendations that may vary between patients and institutional practices. Refer to clinical practice guidelines or institutional medical protocols for recommended dosing and administration of intravenous magnesium sulfate in the treatment of hypomagnesemia.
Monitor patient’s clinical status to avoid symptoms of hypomagnesemia or hypermagnesemia or until symptoms of hypomagnesemia resolve. Monitor serum magnesium concentrations during therapy until serum magnesium concentration has returned to the normal reference range.
• For Pre-eclampsia or Eclampsia Magnesium sulfate should be used for treatment of preeclampsia and eclampsia of pregnancy only if clearly needed and for the shortest time required. See 7 WARNINGS AND PRECAUTIONS. In severe pre-eclampsia or eclampsia, the total initial dose is 10 to 14 g of magnesium sulfate.
Magnesium Sulfate in Water for Injection should not be administered parenterally in patients with: • heart block • myocardial damage • hypersensitivity to this drug or to any ingredient in the formulation, including any non- medicinal ingredient, or component of the container.
For a complete listing, see 6 DOSAGE FORMS, STRENGTHS, COMPOSITION AND PACKAGING. Intravenous magnesium should not be given to mothers with toxemia of pregnancy during the two hours preceding delivery.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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To initiate therapy, 4 g of Magnesium Sulfate in Water for Injection may be administered intravenously. V. 75 mL of a 4% concentration (or its equivalent) per minute, except in severe eclampsia with seizures. 6 mEq) of magnesium sulfate may be administered intramuscularly into each buttock using undiluted 50% Magnesium Sulfate Injection, USP.
V. V. infusion. Subsequent intramuscular doses of 4 to 5 g of magnesium sulfate may be injected into alternate buttocks every four hours, depending on the continuing presence of the patellar reflex, adequate respiratory function, and absence of signs of magnesium toxicity.
Therapy should continue until paroxysms cease. A serum magnesium level of 6 mg/100 mL is considered optimal for control of seizures. Parenteral drug products should be visually inspected for particulate matter and discolouration prior to administration whenever solution and container permit.
Considerations for special populations: • Pediatrics Health Canada has not authorized an indication for pediatric use. • Geriatrics Geriatric patients often require reduced dosage because of impaired renal function. In patients with severe impairment, dosage should not exceed 20 g in 48 hours.
Serum magnesium should be monitored in such patients.
To initiate therapy, 4 g of Magnesium Sulfate in Water for Injection may be administered intravenously. V. 75 mL of a 4% concentration (or its equivalent) per minute, except in severe eclampsia with seizures. 6 mEq) of magnesium sulfate may be administered intramuscularly into each buttock using undiluted 50% Magnesium Sulfate Injection, USP.
V. V. infusion. Subsequent intramuscular doses of 4 to 5 g of magnesium sulfate may be injected into alternate buttocks every four hours, depending on the continuing presence of the patellar reflex, adequate respiratory function, and absence of signs of magnesium toxicity.
Therapy should continue until paroxysms cease. A serum magnesium level of 6 mg/100 mL is considered optimal for control of seizures. Parenteral drug products should be visually inspected for particulate matter and discolouration prior to administration whenever solution and container permit.
Considerations for special populations: • Pediatrics Health Canada has not authorized an indication for pediatric use. • Geriatrics Geriatric patients often require reduced dosage because of impaired renal function. In patients with severe impairment, dosage should not exceed 20 g in 48 hours.
Serum magnesium should be monitored in such patients. 5 OVERDOSAGE Hypermagnesemia is manifested by muscle weakness, hypotension, ECG changes, sedation, and confusion. As plasma concentrations of magnesium begin to exceed 4 mEq/L, the deep- Magnesium Sulfate in Water for Injection Page 7 of 19 tendon reflexes are decreased and may be absent at levels approaching 10 mEq/L.
At 12 to 15 mEq/L, respiratory paralysis is a potential hazard; the respiratory effects can be antagonized to some extent by the intravenous administration of calcium salts. In cases of severe renal impairment, symptomatic hypermagnesemia may be an indication for dialysis.
There are occasional instances when cardiac consequences may be seen in the form of complete heart block at concentrations well below 10 mEq/L. Before the parenteral administration of each dose, the respiratory rate should be at least 16 per minute and urinary function should be adequate.
In the event of overdosage, assisted ventilation must be provided until calcium can be given intravenously. Peritoneal dialysis or hemodialysis may be required in cases of extreme hypermagnesemia. Hypermagnesemia in the newborn may require resuscitation and assisted ventilation via endotracheal intubation or intermittent positive pressure ventilation as well as IV calcium.
When Magnesium Sulfate in Water for Injection is administered parenterally in doses that are sufficient to induce hypermagnesemia, the drug has a depressant effect on the central nervous system and, via the peripheral neuromuscular junction, on muscle.
For management of a suspected drug overdose, contact your regional poison control centre. 6 DOSAGE FORMS, STRENGTHS, COMPOSITION AND PACKAGING Table – Dosage Forms, Strengths, Composition and Packaging Description Magnesium Sulfate in Water for Injection is a sterile, nonpyrogenic solution of magnesium […]