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magnesium citrate

A12C - Other mineral supplements ATC A12CC04 Small molecule Natural product

JFDA label: Epimag Eff

Mechanism of Action

— Osmotic laxative; — Supplement

Indications

Approved

  • Dietary supplement; antacid

Contraindications

Source: Lexicomp

  • OTC labeling: When used for self-medication, do not use if on low salt diet Absolute
  • There are no contraindications in the manufacturer's labeling Absolute

Adverse Reactions

Very Common >10%Common 1–10%Uncommon 0.1–1% Rare 0.01–0.1%Very Rare <0.01%Not Known

Other (6)

Not Known diarrhea · flatulence · Gastrointestinal: Abdominal pain · Gastrointestinal: Diarrhea (excessive oral doses) · nausea · vomiting

Dosing

Source: Lexicomp

OTC labeling: Antacid (dosage in terms of magnesium oxide salt): Oral: One tablet (400 mg) twice daily; maximum: 2 tablets (800 mg)/24 hours Dietary supplement (dosage in terms of magnesium oxide salt): Oral: 1 to 2 tablets (400 to 800 mg) daily; maximum: 2 tablets (800 mg)/24 hours
(For additional information see "Magnesium oxide: Pediatric drug information") Children ≥12 years: Refer to adult dosing
Refer to adult dosing.
There are no dosage adjustments provided in the manufacturer's labeling; however, magnesium is renally excreted. Use with caution; accumulation in renal impairment may lead to magnesium toxicity.
There are no dosage adjustments provided in the manufacturer's labeling.

Warnings & Precautions

Source: Lexicomp

Constipation (self-medication, OTC use)

Appropriate use: For occasional use only; serious side effects may occur with prolonged use. For use only under the supervision of a physician in patients with kidney dysfunction, sodium- or magnesium-restricted diets, abdominal pain/nausea/vomiting, with a sudden change in bowel habits which has persisted for >2 weeks, or use of a laxative for >1 week. If rectal bleeding develops or a bowel movement does not occur after use, discontinue use and consult a health care provider.

Neuromuscular disease

Use with extreme caution in patients with myasthenia gravis or other neuromuscular disease.

Renal impairment

Use with caution in patients with renal impairment; accumulation of magnesium may lead to magnesium intoxication.

Acid indigestion/upset stomach (self-medication, OTC use)

Appropriate use: For occasional use only; serious side effects may occur with prolonged use. For use only under the supervision of a physician in patients with kidney dysfunction or who are pregnant or breast-feeding. Unless directed by a physician, do not use for >2 weeks or exceed the recommended daily dose.

Constipation (self-medication, OTC use)

Appropriate use: For occasional use only; serious side effects may occur with prolonged use. For use only under the supervision of a physician in patients with kidney dysfunction, sodium- or magnesium-restricted diets, abdominal pain/nausea/vomiting, a sudden change in bowel habits which has persisted for >2 weeks, or who are pregnant or breastfeeding. If rectal bleeding develops or a bowel movement does not occur after use, discontinue use and consult health care provider.

Neuromuscular disease

Use with extreme caution in patients with myasthenia gravis or other neuromuscular disease.

Renal impairment

Use with caution in patients with renal impairment; accumulation of magnesium may lead to magnesium intoxication.

Pregnancy & Lactation

Pregnancy

Magnesium crosses the placenta; serum concentrations in the fetus are similar to those in the mother (Idama, 1998; Osada, 2002). The American Gastroenterological Association considers the use of magnesium citrate as a laxative to be low risk in pregnancy, but long term use should be avoided (not the preferred treatment of chronic constipation) (Mahadevan, 2006).

Lactation

Magnesium is found in breast milk; concentrations remain constant during the first year of lactation and are not influenced by dietary intake under normal conditions (IOM, 1997).

Chemistry & Properties

2D structure
FormulaC12H10Mg3O14
Molecular weight451.11 g/mol
IUPAC nametrimagnesium bis(2-hydroxypropane-1,2,3-tricarboxylate)
CAS3344-18-1
PubChem CID6099959
InChIKeyPLSARIKBYIPYPF-UHFFFAOYSA-H
SMILESO=C([O-])CC(O)(CC(=O)[O-])C(=O)[O-].O=C([O-])CC(O)(CC(=O)[O-])C(=O)[O-].[Mg+2].[Mg+2].[Mg+2]

Biology & Pharmacokinetics

Pharmacokinetics predicted

Bioavailability70.0%
Half-life2.138 h
Volume of distribution0.951 L/kg
Protein binding10.9%
BBB penetrantNo

Enzyme interactions

EnzymeRoleDetail
CYP3A4Substrate —

Transporters

BCRP (Inhibitor)BSEP (Inhibitor)MRP1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)P-gp (Inhibitor)P-gp (Substrate)

Drug–drug interactions (100+, DDInter)

Interacting drugSeverityManagement
Bictegravir major
Dolutegravir major
Erdafitinib major
Abarelix moderate
Abiraterone moderate
Acetazolamide moderate
Alendronic acid moderate
Alfuzosin moderate
Alimemazine moderate
Amiloride moderate
Amiodarone moderate
Amisulpride moderate
Anagrelide moderate
Apalutamide moderate
Apomorphine moderate
Arsenic trioxide moderate
Asenapine moderate
Astemizole moderate
Atomoxetine moderate
Azithromycin moderate
Baloxavir marboxil moderate
Bedaquiline moderate
Bendroflumethiazide moderate
Benzthiazide moderate
Bepridil moderate
Betamethasone moderate
Bicalutamide moderate
Bosutinib moderate
Bumetanide moderate
Buprenorphine moderate
Cabozantinib moderate
Calcifediol moderate
Calcitriol moderate
Ceritinib moderate
Chlorothiazide moderate
Chlorpromazine moderate
Chlorthalidone moderate
Cholecalciferol moderate
Cilostazol moderate
Cinoxacin moderate

Showing 40 of 100+.

Registered Products (14)

BrandForm / strengthPackAgentCitizen (JOD)
Epsom Salts Powder Powder 25 g 25 g MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN 0.180
Epimag Eff Effervescent Tablet 2.125 g/5 g 10 sachet AL-Faiasel Drug Store 1.090
Epimag Effervescent Effervescent Tablet 2.125 g/5 g 20 sachet AL-Faiasel Drug Store 2.070
Mamera Caplet Tablet 1 mg, 30 mcg, 100 mg, 30 IU, 3000 IU, 200 IU, 3 mg, 3.4 mg, 20 mg, 20 mcg, 10 mg, 12 mcg, 200 mg, 25 mcg, 150 mcg, 25 mcg, 22.5 mg, 27 mg, 2 mg, 10 mg, 25 mg, 2.3 mg 30 tab Jordan Sweden Medical & Sterilization Co. 2.420
Pronatal Tablet 0.6 mg, 2.6 mcg, 18 mg, 0.03 mg, 2 mg, 85 mg, 15 mg, 0.06 mg, 150 mg, 0.03 mg, 0.2 mg, 0.05 mg, 11 mg, 1.9 mg, 27 mg, 1 mg, 53 mg, 1.4 mg, 200 IU, 1.4 mg 30 tab THE ARAB DRUG STORE P.S.C 5.570
Pharmaton Capsules Capsule 20 mg, 15 mg, 10 mg, 60 mg, 400 IU, 2 mg, 4000 IU, 1 mcg, 90.3 mg, 1 mg, 10 mg, 1 mg, 10 mg, 40 mg, 10 mg, 1 mg, 2 mg, 8 mg, 66 mg, 1 mg, 26 mg, 70 mg, 0.2 mg 30 cap THE ARAB DRUG STORE P.S.C 6.700
Elevit Pronatal film-coated tablets Film-Coated Tablet 0.80 mg, 4.00 mcg, 19.00 mg, 10.00 mg, 200 mcg, 100.00 mg, 1080 mcg, 12.5 mcg, 125.00 mg, 7.50 mg, 2.60 mg, 60.00 mg, 1.00 mg, 125 mg, 1.00 mg, 1.80 mg, 100.00 mg, 1.60 mg, 15.00 mg 30 tab The Jordan Drugstore Co 8.330
Cardioplegia INF Ampoule 5.965 %, Hexahydrate 16.265 %, 1.364 % 10 amp AL Razi Drug Store —
Olimel N12E Solution Alanine 10.99 g/1000 ml, Arginine 7.44 g/1000 ml, L-Aspartic acid 2.20 g/1000 ml, Glutamic acid 3.79 g/1000 ml, Glycine 5.26 g/1000 ml, HISTIDINE 4.53 g/1000 ml, isoleucine 3.79 g/1000 ml, Leucine 5.26 g/1000 ml, Lysine acetate 8.43 g/1000 ml, methionine 3.79 g/1000 ml, phenylalanine 5.26 g/1000 ml, proline 4.53 g/1000 ml, Serine 3 g/1000 ml, threonine 3.79 g/1000 ml, Tryptophan 1.26 g/1000 ml, Tyrosine 0.2 g/1000 ml, valine 4.86 g/1000 ml, Sodium Acetate Trihydrate 1.5 g/1000 ml, Sodium Glycerophosphate (Liq 50 %) 3.67 g/1000 ml, Potassium Chloride 2.24 g/1000 ml, Magnesium Chloride Hexahydrate 0.81 g/1000 ml, Calcium Chloride Dihydrated 0.52 g/1000 ml, Glucose Monohydrate 80.67 g/1000 ml, Olive Oil 28 g/1000 ml, Soyabean Oil 7 g/1000 ml 1000 ml Khoury Drug Store —
Olimel N12E Solution Alanine 7.14 g/650 ml, Arginine 4.84 g/650 ml, L-Aspartic acid 1.43 g/650 ml, Glutamic acid 2.46 g/650 ml, Glycine 3.42 g/650 ml, HISTIDINE 2.94 g/650 ml, isoleucine 2.46 g/650 ml, Leucine 3.42 g/650 ml, Lysine acetate 5.48 g/650 ml, methionine 2.46 g/650 ml, phenylalanine 3.42 g/650 ml, proline 2.94 g/650 ml, Serine 1.95 g/650 ml, threonine 2.46 g/650 ml, Tryptophan 0.82 g/650 ml, Tyrosine 0.13 g/650 ml, valine 3.16 g/650 ml, Sodium Acetate Trihydrate 0.97 g/650 ml, Sodium Glycerophosphate (Liq 50 %) 2.39 g/650 ml, Potassium Chloride 1.45 g/650 ml, Magnesium Chloride Hexahydrate 0.53 g/650 ml, Calcium Chloride Dihydrated 0.34 g/650 ml, Glucose Monohydrate 52.43 g/650 ml, Olive Oil 18.2 g/650 ml, Soyabean Oil 4.55 g/650 ml 650 ml Khoury Drug Store —
PeriOlimel N4E Solution Arginine 3.72 g/1500 ml, L-Aspartic acid 1.1 g/1500 ml, Glutamic acid 1.90 g/1500 ml, Glycine 2.63 g/1500 ml, HISTIDINE 2.26 g/1500 ml, isoleucine 1.90 g/1500 ml, Leucine 2.63 g/1500 ml, Lysine acetate 4.21 g/1500 ml, methionine 1.90 g/1500 ml, phenylalanine 2.63 g/1500 ml, proline 2.26 g/1500 ml, Serine 1.5 g/1500 ml, threonine 1.9 g/1500 ml, Tryptophan 0.64 g/1500 ml, Tyrosine 0.1 g/1500 ml, valine 2.43 g/1500 ml, Sodium Acetate Trihydrate 1.73 g/1500 ml, Sodium Glycerophosphate (Liq 50 %) 2.87 g/1500 ml, Potassium Chloride 1.79 g/1500 ml, Magnesium Chloride Hexahydrate 0.67 g/1500 ml, Calcium Chloride Dihydrated 0.440 g/1500 ml, Glucose Monohydrate 123.75 g/1500 ml, Olive Oil 45 g/1500 ml, Soyabean Oil 45 g/1500 ml, Alanine 5.5 g/1500 ml 1500 ml Khoury Drug Store —
Peritoneal dialysis Tablet 538 mg, 5.08 mg, 25.7 mg, 1.5 mg 2 l مستودع ادوية الثائر —
Peritoneal dialysis Tablet 538 mg, 5.08 mg, 25.7 mg, 2.5 mg 2 l مستودع ادوية الثائر —
Peritoneal dialysis Tablet 538 mg, 5.08 mg, 25.7 mg, 4.25 mg 2 l مستودع ادوية الثائر —