Drug Interaction Report

MONITOR: The concomitant administration of magnesium salts with other magnesium-containing preparations such as antacids or laxatives may increase the risk of magnesium toxicity, particularly in the presence of renal insufficiency. Magnesium toxicity may result in respiratory depression, neuromuscular depression, and heart block.

MANAGEMENT: Clinical and laboratory monitoring for signs of hypermagnesemia and magnesium toxicity is advisable, especially in high-risk patients (e.g., elderly or renally impaired patients).

ADJUST DOSING INTERVAL: Bowel cleansing products can increase the gastrointestinal transit rate. Oral medications administered within one hour of the start of administration of the bowel cleansing solution may be flushed from the gastrointestinal tract and not properly absorbed.

MANAGEMENT: Patients should be advised that absorption of oral medications may be impaired during bowel cleansing treatment. Oral medications (e.g., anticonvulsants, oral contraceptives, antidiabetic agents, antibiotics) should not be administered during and within one hour of starting bowel cleansing treatment whenever possible. However, if concomitant use cannot be avoided, monitoring for reduced therapeutic effects may be advisable.

The recommended maximum number of medicines in the 'magnesium' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'magnesium' category:

• citric acid/magnesium oxide/sodium picosulfate
• magnesium threonate

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.