Magnesium Citrate

Pronunciation

Pronunciation: mag-NEE-zee-uhm SIH-trate
Class: Mineral, Laxative

Trade Names

Citrate of Magnesia
- Solution 1.745 g per 30 mL

Citrodan (Canada)
Citro-Mag (Canada)

Pharmacology

Attracts and retains water in intestinal lumen, thereby increasing intraluminal pressure and inducing urge to defecate.

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Pharmacokinetics

Absorption

Up to 20% magnesium citrate is absorbed.

Elimination

Magnesium citrate is excreted by renal elimination.

Onset

Onset is 0.5 to 5 h.

Indications and Usage

Short-term treatment of constipation; evacuation of colon for rectal and bowel evaluations.

Contraindications

Hypersensitivity to any ingredient; nausea, vomiting or other symptoms of appendicitis; acute surgical abdomen; fecal impaction; intestinal obstruction; undiagnosed abdominal pain; intestinal bleeding; renal disease.

Dosage and Administration

Adults

PO 1 glassful (approximately 240 mL) prn.

Children (6 to 12 yr of age)

PO 50 to 100 mL. Repeat if necessary.

Children (2 to 6 yr of age)

PO 4 to 12 mL.

Storage/Stability

Store in tightly closed container in cool dry place.

Drug Interactions

Nitrofurantoin

Reduced anti-infective action.

Penicillamine

Reduced action of penicillamine.

Tetracyclines

Impaired absorption of tetracyclines.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Palpitations.

CNS

Dizziness; fainting.

GI

Excessive bowel activity (eg, cramping, diarrhea, nausea, vomiting); perianal irritation; bloating; flatulence; abdominal cramping.

Miscellaneous

Sweating; weakness; fluid and electrolyte imbalance.

Precautions

Pregnancy

Pregnancy category undetermined.

Lactation

Undetermined.

Children

Exercise caution; consult health care provider. One 6-wk old infant developed magnesium poisoning after several doses for constipation.

Renal Function

Avoid in patients with renal dysfunction. Hypermagnesemia and toxicity may occur due to decreased clearance of magnesium ion.

Abuse/dependency

Chronic use of laxatives may lead to laxative dependency, which may result in fluid and electrolyte imbalances, steatorrhea, osteomalacia and vitamin and mineral deficiencies.

Fluid and electrolyte imbalance

Excessive laxative use may lead to significant fluid and electrolyte imbalance.

Rectal bleeding or failure to respond

May indicate serious condition requiring further attention.

Overdosage

Symptoms

Severe/protracted diarrhea, fluid and electrolyte disturbances, hypermagnesemia.

Patient Information

  • Explain that drug should not be used routinely for constipation; dependence can result.
  • Instruct patient to report any of the following symptoms to health care provider: unrelieved constipation, vomiting, diarrhea, abdominal fullness, rectal bleeding, dizziness and muscle cramps.
  • Review information on proper use and storage of medication.

Copyright © 2009 Wolters Kluwer Health.

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