MAGNESIUM SULFATE

Posology For intravenous administration (IV): a) Treatment of magnesium deficiency in hypomagnesaemia: Adults and the Elderly: Dosage should be individualised according to patient’s needs and responses. Plasma magnesium levels should be monitored throughout therapy.

Up to 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). There are no data for the use by the IM route of the 20% solution.

4mmols/kg of magnesium ions) as a single dose, repeated every 12 hours as necessary. 16 mmols/kg of magnesium ions) repeated every 4-6 hours as necessary. There is very limited published data to suggest that an IM dosage should not exceed a concentration of 20%.

Renal Failure:

Doses must be reduced in renal failure. 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). b) To prevent further seizures associated with eclampsia: Intravenous Maintenance Regimen A loading dose of 4g/20ml or 16 mmols/20ml of magnesium ions IV (20ml of a 20% solution) or in some cases 5g/25ml or 20 mmols/25ml IV, as described above, is followed by an infusion of 1g/h continued for 24h after the last fit.

Recurrent Convulsions:

In the IV regimen, if convulsions recur, a further 2-4g/10- 20ml or 8-16 mmols/10-20ml of magnesium ions (depending on the woman’s weight, 2g 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.

Method of administration Magnesium sulfate injection may be administered by intramuscular or intravenous routes. Intramuscular therapy should be used only when peripheral venous access is impossible. Intramuscular therapy should be used only when peripheral venous access is impossible.

Hypersensitivity reactions. Hypocalcaemia. 6). 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.

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Magnesium sulfate must be used with caution in patients suspected of or known to have renal impairment. Magnesium sulfate should not be used in hepatic coma if there is a risk of renal failure. Parenteral magnesium salts should be used with caution in patients with myasthenia gravis.

Serum calcium levels should be routinely monitored in patients receiving magnesium sulfate.

1. Magnesium sulfate is contraindicated in patients with severely impaired renal function.