Magnesium citrate Side Effects
For the Consumer
Applies to magnesium citrate: oral capsule, oral tablet
Other dosage forms:
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Very upset stomach or throwing up.
- Very loose stools (diarrhea).
What are some other side effects of this drug?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Loose stools (diarrhea).
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.
For Healthcare Professionals
Applies to magnesium citrate: compounding powder, oral capsule, oral liquid, oral tablet
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.
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. 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
4. Jenny DB, Goris GB, Urwiller RD, Brian BA "Hypermagnesemia following irrigation of renal pelvis. Cause of respiratory depression." JAMA 240 (1978): 1378-9
5. Alison LH, Bulugahapitiya D "Laxative induced magnesium poisoning in a 6 week old infant." BMJ 300 (1990): 125
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
Some side effects may not be reported. You may report them to the FDA.
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- Drug class: laxatives