MAGNESIUM SULFATE

Posology Dosage should be tailored according to the individual patient's needs and responses. Plasma magnesium concentrations should be measured to determine the rate and duration of infusion and should be monitored throughout therapy.

Treatment of magnesium deficiency in hypomagnesaemia Up to 40 g or 160 mmols of magnesium ions (200ml of a 20% solution) by slow intravenous infusion (in glucose 5%) over up to 5 days, may be required to replace the deficit (allowing for urinary losses).

Elderly No special recommendation. Use with caution due to risk of renal impairment in this age group, see below. Renal impairment Doses must be reduced in renal impairment. Caution must be observed to prevent exceeding the renal excretory capacity.

The dosage should not exceed 20g in 48 hours (100ml of a 20% solution or 80mmols of magnesium ions). Prevention of recurrent seizures in eclampsia A loading dose of 4g (16 mmols) of magnesium ions IV (20ml of a 20% solution) or in some cases 5g (20 mmols) og magnesium ions IV (25 ml of a 20% solution), given over 5-15 minutes, is followed by an infusion of 1g (4mmols)/h (5ml of a 20% solution) continued for 24h after the last fit.

Recurrent Convulsions:

If convulsions recur, a further 2-4g (8-16 mmols) of magnesium ions (10-20 ml of a 20% solution,depending on the woman's weight, 2g (8 mmols) if less than 70Kg) is given IV over 5 min. Appropriate reductions in dosage should be made for patients with renal impairment; a suggested dose reduction in severe renal impairment is a maximum of 20g (80 mmols of magnesium ions) over 48 hours.

6. Paediatric population No special recommendation. Method of administration Intravenous infusion.

Immune system disorders Hypersensitivity reactions. 6). Nervous system disorders Respiratory depression Nausea, vomiting, drowsiness and confusion Coma Slurred speech, double vision Cardiac disorders Cardiac arrhythmias, cardiac arrest ECG changes (prolonged PR, QRS and QT intervals), bradycardia Vascular disorders Flushing of the skin and hypotension due to peripheral vasodilatation Musculoskeletal and connective tissue disorders Loss of tendon reflexes due to neuromuscular blockade, muscle weakness Other undesirable effects Thirst There have been isolated reports of maternal and foetal hypocalcaemia with high doses of magnesium sulfate.

Especially in patients with impaired renal function, there may be sufficient accumulation of magnesium sulfate to produce toxic effects. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.

It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

Magnesium salts should be administered with caution to patients with impaired renal function and appropriate dosage reduction should be made. 2. Magnesium sulfate should not be used in hepatic coma if there is a risk of renal failure.

Respiratory depression may occur and caution is required in patients with respiratory disease. Parenteral magnesium should be used with caution in individuals with myasthenia gravis, to prevent an exacerbation of the condition or the precipitation of a myasthenic crisis.

A risk-benefit assessment should be performed in individual cases prior to initiation of treatment. Serum calcium levels should be routinely monitored in patients receiving magnesium sulfate.

Hypersensitivity to magnesium and its salts. Renal failure. Hepatic encephalopathy, hepatic failure. Parenteral magnesium salts should generally be avoided in patients with heart block.