MAGNESIUM SULFATE

Posology Therapeutic levels are reached almost immediately with appropriate intravenous doses and within 60 minutes following intramuscular injection. Adults Hypomagnesaemia The dose is strictly individual. As a general guideline, 8-12 g of magnesium sulfate (32-48 mmol Mg2+) can be administered in the first 24 hours followed by 4-6 g/day (16-24 mmol Mg2+/day) for 3 or 4 days, to replete body stores.

Maximum infusion rates should not exceed 2 g/hour (8 mmol Mg2+/hour). 4 mmol/l. Prevention and treatment of hypomagnesemia in total parenteral nutrition The dose is strictly individual. As a general recommendation, 1-3 g/day (4-12 mmol Mg2+/day) intravenous magnesium sulfate can be administered.

9% sodium chloride solution at maximum 4 ml/min (= 64 mg/min)), may be infused. 4), depending on the continuing presence of the patellar reflex and adequate respiratory function and urine output. Therapy should continue until paroxysms cease.

It is important that in the administration of magnesium sulfate by any of these schedules, certain clinical observations should be made before each injection: - deep tendon reflexes must be present; - respiration must be at least 16 breaths/minute; - 100 ml of urine must have been excreted since the preceding injection.

In addition, 1 g of calcium gluconate should be available as an antidote for hypermagnesemia. Paediatric population Hypomagnesaemia Magnesium sulfate may be administered intravenously to children. 001 g/kg/minute magnesium). Prevention and treatment of hypomagnesemia in total parenteral nutrition The dose strictly is individual.

As a general recommendation, the following intravenous magnesium sulfate doses can be administered: Table 1. 0096 mmol Mg2+) Renal insufficiency Patients with renal insufficiency should receive 25-50% of the initial dose recommended for patients with normal kidney function.

ECG monitoring is recommended with high doses and in the elderly. Hepatic impairment Because of insufficient data there are no recommended special dosage instructions for patients with impaired liver function. Elderly Parenteral magnesium sulfate should be used with caution in the elderly, because renal disorders are more frequent in this age group and the tolerance to adverse effects may be lower.

Method of administration For intravenous (injection or infusion) or intramuscular use, in line with the information provided for each indication. 6.

The frequency of undesirable effects is not known (cannot be estimated from the available data). Immune system disorders Hypersensitivity reactions. 9). Electrolyte/fluid abnormalities (hypophosphatemia, hypertonic dehydration). There have been isolated reports of maternal and foetal hypocalcaemia with high doses of magnesium sulfate.

Nervous system disorders - Respiratory depression. - Nausea, vomiting, drowsiness and confusion. - Coma. - Slurred speech, double vision. - Loss of tendon reflexes due to neuromuscular blockade. Cardiac disorders Cardiac arrhythmias, cardiac arrest.

ECG abnormal (prolonged PR, QRS and QT intervals), bradycardia. Vascular disorders Flushing of the skin and hypotension due to peripheral vasodilatation. Musculoskeletal and connective tissue disorders Muscle weakness. General disorders and administration site conditions Thirst.

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. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.

Increased risk of hypotension and bradycardia During administration of magnesium sulfate, vital function monitoring is needed as the risk of profound hypotension and bradycardia is increased. An antidote of injectable 1 g calcium gluconate solution should be immediately available.

2). Calcium-magnesium-ammonium-phosphate stone diathesis In such cases, the product should be avoided, mainly in patients with renal impairment. Myasthenia gravis 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 and a benefit-risk assessment should be performed in individual cases prior to initiation of treatment.

Hepatic impairment Liver diseases are often accompanied by hypoalbuminemia, which per se may have an effect on the level of total serum magnesium. Known increased risk of heart block/heart block Magnesium can cause heart block, the risk being higher in patients who are already on calcium or beta receptor antagonists.

Serum calcium levels should be routinely monitored in patients receiving magnesium sulfate. Serum magnesium levels should be monitored during the treatment. Monitoring of the absence of respiratory depression: the breath rate should not be under 16 breaths/min.

The excretion of urine should not be under 25 ml/h, as it could lead to hypermagnesemia. The presence of the patellar reflex should be checked. 5). Monitoring of the absence of respiratory depression: the breath rate should not be under 16 breaths/min.

Method of administration The medicine should be administered with caution if flushing and sweating occurs. Too rapid administration can lead to quickly developing vasodilatation, reduced blood pressure. As all parenteral medicines, magnesium sulfate injections may be irritant to veins; extravasation may cause tissue damage.

Intramuscular injections The medicine should not be administered into muscles which are emaciated or atrophied. For intramuscular administration, dorsogluteal muscle and sciatic nerve should be avoided. If the total dose to be administered exceeds 5 ml, the injection volume should be divided between more than one deep muscular injection site.

5% of cases. The intravenous route is therefore preferred. However, the intramuscular regimen becomes the better option when intravenous infusion pumps are not available or continuous monitoring is not feasible. Use caution in older or thin patients who may only tolerate up to 2 ml in a single injection.

Do not use an injection site that has evidence of infection or injury. If repeating an intramuscular dose, rotate injection sites to avoid injury or discomfort to the muscles.

1 - Hypermagnesemia. - Severe renal impairment or renal failure if the dialysis or other blood purification methods are unachievable.