Magnesium citrate Side Effects
Not all side effects for magnesium citrate may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.
For the Consumer
Applies to magnesium citrate: solution
Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur while taking magnesium citrate:
Diarrhea; stomach discomfort.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blood in the stool; cramps; dizziness; fainting; irregular heartbeat; severe diarrhea; sweating; weakness.
For Healthcare Professionals
Applies to magnesium citrate: compounding powder, oral liquid, oral tablet
Mild hypermagnesemia is generally well-tolerated. Moderate or severe hypermagnesemia affects the nervous and cardiovascular systems primarily.[Ref]
Nervous system side effects have included a decrease in tendon reflexes, muscle weakness, mental confusion, sedation, mental depression, areflexia, coma and respiratory paralysis. CNS depression, often presenting as somnolence, may be more likely and more severe in patients with renal dysfunction.[Ref]
Nervous system side effects from hypermagnesemia result from suppression of neuromuscular transmission in the CNS and at the neuromuscular junction (which can be antagonized by calcium). Clinically, if serum magnesium (Mg) levels increase to 4 to 7 mEq/L, there may be a decrease in tendon reflexes, muscle weakness, and/or mental confusion or sedation. At levels of 5 to 10 mEq/L, the respiratory rate slows and blood pressure falls. At levels of 10 to 15 mEq/L, there is usually profound mental depression, areflexia, coma and respiratory paralysis. Mg also has a curare-like effect at the neuromuscular junction at serum levels above 10 mEq/L. Death is not uncommon when serum Mg levels rise to 15 mEq/L.[Ref]
The cardiovascular consequences of hypermagnesemia are due to peripheral vasodilation. Hypotension may be observed when serum Mg levels rise to 5 to 10 mEq/L. Hypotension, depressed myocardial conductivity, and bradyarrhythmias may be associated with levels greater than 10 mEq/L. While some patients are inexplicably able to tolerate extraordinarily high Mg levels, there is a significant risk of asystole when levels rise to 25 mEq/L. The risk of cardiotoxicity from hypermagnesemia is increased in the presence of hypocalcemia, hyperkalemia, acidosis, digitalis therapy, and renal insufficiency.[Ref]
Cardiovascular side effects have included hypotension, depressed myocardial conductivity, asystole, and bradyarrhythmias.[Ref]
A metabolic concern in the case of acute hypermagnesemia is hypocalcemia. Elevated Mg may cause hypocalcemia due to suppression of the release of parathyroid hormone (PTH) and competition for renal tubular reabsorption between calcium (Ca) and Mg. The latter can lead to decreased Ca reabsorption and hypercalciuria, which aggravates the hypocalcemia produced by decreased release of PTH.[Ref]
Metabolic side effects have included hypocalcemia. The effects of hypermagnesemia may be worsened by the presence of hypocalcemia, especially in patients with uremia.[Ref]
Gastrointestinal side effects include nausea when serum Mg levels rise to 4 to 5 mEq/L.
Rare cases of paralytic ileus associated with serum Mg levels greater than 5 mEq/L have been reported.[Ref]
Gastrointestinal side effects have included nausea, and paralytic ileus (rarely).[Ref]
1. Lembcke B, Fuchs C "Magnesium load induced by ingestion of magnesium-containing antacids." Contrib Nephrol 38 (1984): 185-94
2. Schrier RW, Gottschalk CW, Eds. "Diseases of the Kidney, 5th Edition." Boston, MA: Little, Brown and Company 1-3 (1993): 183-2653
3. Alison LH, Bulugahapitiya D "Laxative induced magnesium poisoning in a 6 week old infant." BMJ 300 (1990): 125
4. Wilson J, Braunwald E, Isselbacher K, Petersdorf R, Martin J, Fauci A, Root R "Harrison's Principles of Internal Medicine, 12th Edition." McGraw-Hill, Inc., Health Professions Division, New York 1 (1991): 1938
5. Jenny DB, Goris GB, Urwiller RD, Brian BA "Hypermagnesemia following irrigation of renal pelvis. Cause of respiratory depression." JAMA 240 (1978): 1378-9
6. Cumming WA, Thomas VJ "Hypermagnesemia: a cause of abnormal metaphyses in the neonate." AJR Am J Roentgenol 152 (1989): 1071-2
7. Golzarian J, Scott HW, Richards WO "Hypermagnesemia-induced paralytic ileus." Dig Dis Sci 39 (1994): 1138-42
More about magnesium citrate
Related treatment guides
Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.