Magnesium sulfate 25. Magnesium sulfate: instructions for use. Appointment of the tablet form of magnesia

Magnesium sulfate is a drug that contains magnesium ions and sulfate ions. Magnesium sulfate has been used in medical practice for quite a long time, which makes it possible to judge its high efficiency in the treatment of a large number of pathologies.

Magnesium sulfate is used as an antiarrhythmic, anticonvulsant, vasodilator, it is prescribed to lower blood pressure. The drug can act as an antispasmodic, as a sedative, laxative and choleretic agent. It is often prescribed by obstetricians and gynecologists to reduce the contractility of the uterus, to prevent premature birth. Due to such a wide spectrum of action of the drug, Magnesium sulfate is a symptomatic remedy, which is used to alleviate the condition in a variety of diseases.

Since the drug has been used for quite a long time, it is not surprising that it has received many other names that are often used in colloquial speech by people who do not have a medical education. For example, such names include: bitter or Epsom salt, magnesia, magnesium sulfate. Magnesium sulfate is also called magnesium sulfate heptahydrate. However, the most common name for this drug is magnesia.

When a doctor prescribes Magnesium Sulfate to a patient, the following entry will be on the prescription form:

Rp.: Sol. Magnesil sulfate 25% 10.0 ml

D.t. d. No. 10 in amp.

S. inject 1 time per day, 2 ml.

The concentration of the drug solution may be different, in this recipe it is indicated as a percentage after the phrase Magnesil sulfatis. Next comes the volume of the drug (here it is 10 ml).

D.t. d. No. 10 in amp. - this entry means how many ampoules the patient should receive. In this case, the patient will be given 10 ampoules. The last line contains information on how to use the drug and how much drug should be administered to the patient.

Since the drug has a large number of therapeutic effects, it is simultaneously referred to as a vasodilator and sedative. In addition, magnesium sulfate is a trace mineral.

You can find two forms of release of the drug, among which: powder and ready-made solution in ampoules.

The volume of powder sachets can be equal to 50 g, 25 g, 20 g, 10 g. Before use, the powder is diluted in water in order to obtain a suspension. It can be taken orally.

The volume of ampoules is 30 ml, 20 ml, 10 ml and 5 ml. The concentration of the drug is also different and can be 20 or 25%. That is, in 100 ml of the solution there will be 20 or 25 g of the drug.

There are no other components in the ampoules or powder sachets. It contains only magnesium sulfate, which is the main active ingredient.

Pharmacological properties and therapeutic effect

Magnesium sulfate has a wide range of therapeutic effects, which will vary depending on whether it is taken orally or injected.

List of properties that the drug has:

Vasodilation.

Elimination of seizures.

Decreased blood pressure.

Antiarrhythmic effect.

Removal of spasms.

Calming action.

Relaxation of the uterine muscles (tocolytic effect).

Laxative action.

Choleretic effect.

If the patient takes the drug orally in the form of a suspension, then he receives a laxative and choleretic effect. After entering the gastrointestinal tract, magnesium sulfate irritates the nerve endings of the duodenum, resulting in a choleretic effect.

Magnesium sulfate is not absorbed into the systemic circulation, but contributes to an increased filling of the intestines with water. The result is a laxative effect. Feces liquefy, increase in volume, and bowel movements are much easier and faster.

That small part of the drug, which still enters the bloodstream, is excreted from the body by the kidneys. Therefore, we can say that magnesium sulfate has a weak diuretic effect.

Experts recommend taking magnesium sulfate for intoxication with salts of heavy metals. In this case, chemical reactions will be launched in the body, in which magnesium sulfate acts as an antidote. It not only binds salts of heavy metals, but also contributes to their rapid removal from the body.

After oral administration of the drug, the effect will occur in at least half an hour, and a maximum of 3 hours. The duration of action of the drug is up to 6 hours.

As for the magnesia solution, it is used either in the form of injections or used topically. To provide a local effect, dressings and bandages are impregnated with a solution, which are applied to wounds.

It is possible to use a solution for electrophoresis, for example, in the treatment of diseases of the nervous system or the cardiovascular system. Very often, electrophoresis with magnesium sulfate is used to remove warts.

Separately, it should be said about the intravenous and intramuscular use of the drug. It is used to lower blood pressure, to provide a sedative effect, to relieve convulsions, to dilate blood vessels, to stop arrhythmia. However, if the dosage is exceeded, serious harm to health will be caused. Intravenously administered Magnesium Sulphate is able to have a hypnotic effect, depresses the activity of the central nervous system and, in general, works as a drug-like substance. This effect is based on the fact that magnesium competes with the calcium ion. As a result, calcium is displaced from molecular bonds, which leads to a decrease in the level of acetylcholine, which is responsible for muscle and vascular tone, and also participates in the conduction of nerve impulses.

The elimination of convulsions with magnesium sulfate is achieved due to the fact that magnesium ions displace acetylcholine from the neuromuscular ligaments and take its place. They block the transmission of nerve impulses to the muscles and the spasms stop. By adjusting the dosage, you can achieve a sedative, analgesic or hypnotic effect.

It is possible to eliminate cardiac arrhythmia with the introduction of magnesium sulfate due to its ability to reduce the overall excitation of muscle fibers, including the heart muscle. In addition, the drug contributes to the normalization of the structure and performance of the membranes of the muscle cells of the heart. Magnesium sulfate, in addition to everything, has a protective effect on the heart, promotes vasodilation, and prevents the formation of blood clots.

Magnesium sulfate is often used in obstetric practice when there is a threat of premature birth, due to the tocolytic effect of the drug. The smooth muscles of the uterus relax under the influence of magnesium ions, the expansion of blood vessels occurs, and contractile activity is inhibited. As a result, the threat of premature birth and miscarriage is reduced.

The effect is achieved almost instantly with intravenous administration of the drug. It lasts at least 30 minutes. If the drug is administered intramuscularly, the effect will come after 60 minutes. However, it will last at least 3 hours.

Indications for the use of magnesium sulfate

Indications for the use of magnesium sulfate are quite extensive. In some cases, it is prescribed in the form of injections (in the form of a solution), and in other cases it is taken orally (in the form of a suspension).

Since there are two forms of release of magnesium sulfate, the instructions for use for the powder and for the solution will differ.

Applications of Magnesium Sulphate Powder

In its pure form, powdered magnesium sulfate is not used orally. It must be dissolved in water to obtain a suspension. Boiled water must be used. There is no relationship between taking the drug and eating.

To obtain a choleretic effect, it is necessary to dissolve 20-25 mg of powder in 100 ml of water. Take a solution 3 times a day for a tablespoon. To enhance the effect, you should take the drug before meals.

In case of intoxication of the body with barium salts, gastric lavage is performed with a solution of magnesium sulfate in a 1% concentration. In order to prepare such a composition, 100 ml of water and 1 g of powder are required. After the washing procedure is completed, the patient is offered a 10-12% solution of magnesium sulfate orally. To obtain this concentration, dilute 20-25 g of the drug in 200 ml of water.

With intoxication of the body with mercury, lead or arsenic, intravenous administration of the drug is indicated. To prepare the solution, you need 100 ml of water and 5-10 mg of powder. One-time injection of up to 10 ml of solution.

To perform duodenal sounding, you can use a solution of 10% and 25% concentration. To obtain a 10% solution, take 10 g of powder and 100 ml of water, and to obtain a 25% solution, take 12.5 g of powder and 50 ml of water. The warm solution is then injected into the probe, which is used to perform probing of the gallbladder. If a 10% solution is used, then 100 ml of liquid will be required, and if a 25% solution is used, then 50 ml of liquid will be required.

Use of magnesium sulfate as a laxative

To achieve a laxative effect, magnesium sulfate is used in powder form. It is necessary to take it in the evening, or in the morning, immediately after waking up and before eating. First, a suspension must be prepared from the powder. The dosage for children over 15 years of age and for adults is 10-30 g of the drug, diluted in half a glass of water.

If magnesium sulfate is prescribed to a child under 15 years old, then the dose is calculated based on his age (1 g - 1 year, 6 g - 6 years).

To speed up bowel movements, you need to take a large amount of warm water. Then the effect can be felt already after 60 minutes (maximum after 3 hours). The drug is forbidden to be taken for several days without a break, as it will contribute to inflammation of the intestinal mucosa.

Most often, magnesium sulfate is prescribed once to eliminate acute constipation, or if you need to quickly empty the intestines. You can take the drug after anthelmintic therapy.

It is possible to use enemas with a solution of powder. To prepare it, you need 20-30 g of the drug, which is diluted in 100 ml of water.

If the drug is in ampoules, then it is ready for use. The concentration of magnesium sulfate can be 20 and 25%. Depending on how quickly you need to get the desired effect, the drug is administered intravenously or intramuscularly.

A sharp drop in blood pressure to extremely low values.

No knee jerk.

CNS and respiratory depression.

To stop such life-threatening conditions, intravenous administration of calcium chloride or calcium gluconate in a 10% concentration is necessary. The volume of the injected solution, which acts as an antidote, can be from 5 to 10 ml. Additionally, the patient is given oxygen therapy, if necessary, the patient is connected to an artificial respiration apparatus. Hemodialysis (peritoneal dialysis) helps to speed up the withdrawal of an excess dose of the drug from the body. If required, doctors regulate the work of the central nervous system, heart and blood vessels.

If an overdose of magnesium sulfate occurs when taken orally, then the patient develops severe diarrhea. To stop it, a person is prescribed antidiarrheal drugs, for example, Loperamide and rehydration agents (Rehydron). This will stop the diarrhea and replenish lost fluids and electrolytes.

For women bearing a child, Magnesium sulfate is prescribed to eliminate the increased tone of the uterus, which avoids the onset of premature birth. The drug quickly and effectively stops contractions of the uterine muscles and the threat of miscarriage or early onset of labor is eliminated.

However, self-treatment is not acceptable. The drug is administered exclusively under medical supervision in a hospital setting.

With regard to the safety of the fetus and the administration of magnesium sulfate, the necessary studies have not been conducted on this subject. Nevertheless, the drug has been used to treat pregnant women for quite a long time, and thanks to it a huge number of children were born. Therefore, magnesium sulfate is considered safe for the fetus if used correctly.

Uncontrolled administration of the drug is strictly prohibited. It is used only when it is not possible to use another remedy to relieve hypertonicity from the muscles of the uterus. The point is that the doctor should have no doubts about the benefits of magnesium sulfate for a pregnant woman and fetus.

During intravenous administration of the drug, it easily crosses the placental barrier and enters the blood of the child. As a result, the same concentration of the active substance is created in his body as in the mother's body. Accordingly, all therapeutic effects are transferred to the fetus. A child may have a drop in blood pressure, respiratory depression if the drug was administered before his birth.

Therefore, doctors refuse to administer the drug to women 2 hours before the start of the expected birth. The exception is convulsions that occur against the background of eclampsia.

If there is such a need, then the drug is administered intravenously continuously. The rate of its supply should not exceed 8 ml per hour (25% solution). It is important that doctors continuously monitor the woman's condition. In this case, it is necessary to monitor the level of the drug in the blood, the respiratory rate, the level of pressure and the safety of the patient's reflexes.

The use of magnesium sulfate in childhood

In childhood, magnesium sulfate is used as a laxative, which helps to gently cleanse the intestines. To do this, the drug in powder form is dissolved in water and the child is offered to drink the required dose. It is best to do this before a night's rest or in the morning, before breakfast.

Depending on age, the dose of the drug will be as follows:

From 5 to 10 g - 6-12 years.

10 g - 12-15 years.

10-30 g - over 15 years old and adults.

Here is the dose of the powder, which is prescribed for 1 dose. You can also offer the child as many grams of the drug as his age. That is, for every year of life there is 1 g of the drug. This rule may apply to children aged 6 years and older. For children under 6 years of age, magnesium sulfate is usually not prescribed.

Moreover, the use of the drug in children under one year is considered dangerous. Failure to follow this recommendation can lead to serious health problems: cause respiratory and central nervous system depression, provoke a drop in blood pressure and dehydration.

In addition to oral administration, you can use Magnesium sulfate in microclysters. First you need to prepare a solution of the drug. For 100 ml of warm water, 20 to 30 g of powder is needed. 50-100 ml of liquid is injected into the rectum.

Intravenous administration to children is possible only to eliminate seizures. Calculation of the dose for a solution of 20% concentration: 0.1-0.2 ml of the drug per 1 kg of the child's weight. Thus, with its weight of 20 kg, 0.1-0.2 * 20 \u003d 2-4 ml of the drug.

Since the list of effects from the use of the drug is quite extensive, it is used to achieve various goals. Below are the most common options.

Cleansing the body and getting rid of excess weight

Modern nutritionists recommend that their clients cleanse the body using Magnesium sulfate before starting a particular diet. Thus, it will be easier to start the process of losing weight, especially with therapeutic starvation. The drug acts as a mild laxative, which dilutes the feces and promotes their excretion from the body.

It is important to consider that the drug can be used only on the first day of the diet, in the future its use is irrational. Magnesium sulfate should not be taken directly during fasting. With its help, toxins are removed from the body, and the symptoms that are provoked by a sharp refusal of food are easier to bear.

There are two options for using the drug before a diet:

It is necessary to dissolve 30 g of the powder in half a glass of warm water and drink it before going to bed or 30 minutes before eating.

The same amount of the drug should be drunk in the morning, an hour after eating. The effect should be expected after 4-6 hours.

Sometimes doctors allow you to take the drug on the first day of fasting. However, a person will need to refuse to take any food before the end of this day, but an adequate drinking regimen should be observed. You will need to drink at least 2 liters of water per day.

The main danger of taking the drug during fasting is the development of diarrhea, fainting, vomiting. In addition, a person may become dehydrated.

Magnesium sulfate has been used for many years for physiotherapy. Baths with this drug help to reduce pain, fatigue, relieve nervousness, physical and emotional stress. Take such baths before a night's rest, no more than once a day.

Effects that can be obtained after taking Magnesium sulfate:

Strengthening blood microcirculation.

Elimination of spasm from the capillaries.

Decreased blood pressure.

Reducing the risk of thrombosis.

Fight against cellulite.

Removal of tone from the muscles.

Removal of bronchospasm.

Prevention of seizures with high blood pressure during pregnancy.

Acceleration of recovery processes after various injuries and diseases due to increased metabolic processes.

The course of therapeutic baths can be up to 15 procedures. For the purpose of prevention, you can take such baths up to 2 times in 7 days. For 1 time, you will need 100 g of the drug, 500 g of sea salt and 50 g of ordinary salt. The water temperature must not exceed 39 °C. Immersion should be carried out for half an hour, but no more. After taking such a bath, you need to rest for another half an hour, as the person will experience vasodilation and a decrease.

Carrying out tubage with magnesium sulfate Tubage is a cleansing of the gallbladder and liver. The best time for the procedure is from 6 to 8 pm. Previously, a person will need to take 1 antispasmodic tablet (No-shpa). The procedure will require 0.5-1 l of the finished solution. For 100 ml, take 30 g of powder. In 20 minutes, you need to drink 0.5-1 liter of the drug, then you should lie on your right side and apply a heating pad to it (on the area of ​​\u200b\u200bthe abdomen where the liver is located). In this position, you will need to spend 2 hours. The course of tubage consists of 10-16 procedures. They are carried out 1 time in 7 days. It is possible that after tyubage a bitter taste will appear in a person's mouth. To eliminate it, nothing should be done, it will pass on its own. Restrictions to the procedure: acute stage of cholecystitis, diseases of the gastrointestinal tract (ulcers and erosion of the stomach and intestines).

Magnesium sulfate is used to perform warm compresses, which have an analgesic and absorbable effect. It is possible to apply them to the places of DTP vaccination in a child. For a compress, you will need to take gauze rolled up in 8 layers and moisten it in a solution of Magnesium Sulfate 25% concentration. The resulting compress is applied to the sore spot, covering the top with special paper. The paper is insulated with cotton wool, which is fixed with a bandage. The holding time of the compress is from 6 to 8 hours. After removing it, the skin is rinsed with warm water, dried and a fat cream is applied to the treatment site.

Contraindications to taking magnesium sulfate

Contraindications for injections:

Individual intolerance to magnesium sulfate.

High levels of magnesium in the blood.

Low heart rate.

Respiratory depression.

2 hours before the onset of labor.

Renal failure (CC less than 20 ml / min).

Antrioventricular block.

Contraindications for oral administration:

Bleeding of the intestines and its obstruction.

Inflammation of the appendix.

Dehydration of the body.

Restrictions on the use of the drug:

Respiratory diseases.

Renal failure.

Inflammatory processes in the digestive organs.

Side effects when taking magnesium sulfate

With any method of using magnesium sulfate in the form of injections, the following side effects may occur:

Feeling of heat and increased sweating.

Increased anxiety.

When taken orally, the development of diarrhea, vomiting and nausea, inflammation of the digestive system is possible.

Pharmacodynamics
When administered parenterally, it has an anticonvulsant, antiarrhythmic, antihypertensive, antispasmodic effect, in large doses it inhibits neuromuscular transmission, has a tocolytic effect, and suppresses the respiratory center.
Magnesium is a "physiological" calcium antagonist (by blocking "slow" calcium channels) and is able to displace it from its binding sites. Regulates metabolic processes, interneuronal transmission and muscle excitability, prevents the entry of calcium ions through the presynaptic membrane, reduces the amount of acetylcholine in the peripheral nervous system and central nervous system (CNS), which leads to inhibition of neuromuscular transmission. Relaxes the smooth muscles of the internal organs, uterus and blood vessels, lowers blood pressure (BP) (mainly high), increases diuresis.
Anticonvulsant action. Magnesium reduces the release of acetylcholine from neuromuscular synapses, while suppressing neuromuscular transmission, has a direct inhibitory effect on the central nervous system.
Antiarrhythmic action. Magnesium reduces the excitability of cardiomyocytes, restores ionic balance, stabilizes cell membranes, disrupts sodium flow, slow incoming calcium flow and one-way potassium flow.
tocolytic action. Magnesium inhibits the contractility of the myometrium (by reducing the absorption, binding and distribution of calcium ions in smooth muscle cells), increases blood flow in the uterus as a result of the expansion of its vessels.
It is an antidote for poisoning with salts of heavy metals.
Systemic effects develop almost instantly after intravenous administration.
The duration of action for intravenous administration is 30 minutes.
Pharmacokinetics
With intravenous administration, the anticonvulsant effect develops immediately, and after intramuscular administration, within 1 hour. The duration of the effect is about 30 minutes when injected into a vein and 3–4 hours when administered intramuscularly.
The concentration of magnesium ions in the blood plasma normally averages 0.84 mmol / l, 25–35% of this amount is in a protein-bound state. It penetrates well through the placenta and the blood-brain barrier, in milk it creates concentrations 2 times higher than plasma concentrations.
It is excreted in the urine (while increasing diuresis) by filtration, the rate of renal excretion is proportional to plasma concentration. 93-99% of magnesium undergoes reverse reabsorption in the proximal and distal renal tubules.

Indications for use

Arterial hypertension (including hypertensive crisis with symptoms of cerebral edema);
- hypomagnesemia;
- polymorphic ventricular tachycardia (pirouette type);
- eclampsia (to suppress seizures) and preeclampsia (to prevent seizures in severe preeclampsia);
- tetany of the uterus;
- poisoning with salts of heavy metals (mercury, arsenic, tetraethyl lead).

Contraindications

myasthenia;
- bradycardia;
- severe arterial hypotension;
- hypocalcemia;
- prenatal period (2 hours before childbirth);
- severe renal dysfunction (creatinine clearance less than 20 ml / min);
- hypersensitivity and hypermagnesemia;
- atrioventricular blockade of 1-3 degrees;
- depression of the respiratory center.

Dosage and administration

Intravenously(stream slowly or drip). The patient should be in the supine position.
Intramuscular therapy should only be used when intravenous administration of the drug is not possible, for example, when peripheral veins are not available.
There are very limited published data indicating that the concentration of an intramuscular magnesium sulfate solution should not exceed 200 mg/ml (20% solution).
Serum magnesium levels should be monitored before and during treatment. The dose of magnesium sulfate should be adjusted individually depending on the needs of the patient and the response to treatment.
Serum magnesium levels > 2.5 mmol/L should be avoided.
Doses of magnesium sulfate are indicated in grams, which corresponds to the amount of the drug: 1 g - 4 ml of a solution for intravenous and intramuscular injection 250 mg / ml (25% solution), 2 g - 8 ml, 3 g -12 ml, 4 g -16 ml , 5 g - 20 ml, 10 g - 40 ml, 15 g - 60 ml, 20 g - 80 ml, 30 g - 120 ml, 40 g - 160 ml solution for intravenous and intramuscular administration 250 mg / ml (25% solution ) respectively.
1 ml of the drug contains 1 mmol of magnesium.
A solution of magnesium sulfate can be diluted with 0.9% sodium chloride solution or 5% dextrose (glucose) solution.
Hypomagnesemia
Easy. A solution of magnesium sulfate is used parenterally if the oral route of administration of magnesium preparations is impossible or impractical (due to nausea, vomiting, impaired absorption in the stomach, etc.). The daily dose is 1–2 g (4–8 ml of a solution for intravenous and intramuscular administration of 250 mg / ml).
This dose is administered once or in 2-3 divided doses.
Heavy. The initial dose is 5 g (20 ml of a solution for intravenous and intramuscular injection of 250 mg / ml) intravenously slowly in 1 liter of infusion solution (0.9% sodium chloride solution or 5% dextrose (glucose) solution). Dose depending on the content of magnesium ions in the blood serum.
With prolonged use, it is recommended to monitor blood pressure, heart activity, tendon reflexes, kidney activity, and respiratory rate. If necessary, the simultaneous administration of calcium and magnesium salts, the drugs should be administered into different veins.
In the treatment of deficient conditions, care must be taken to avoid excess renal excretion of magnesium and the occurrence of hypermagnesemia.
Prophylactic use in parenteral nutrition
The maintenance dose used in adults ranges from 1 g to 3 g (4-12 ml of a solution for intravenous and intramuscular administration of 250 mg / ml) per day.
For infants and children, the maintenance dose range is 0.25 g to 1.25 g (1-5 mL of 250 mg/mL intravenous and intramuscular solution) per day.
Heart rhythm disorder: 1-2 g (4-8 ml solution for intravenous and intramuscular injection 250 mg / ml) for 5 minutes. Possible re-introduction.
At paroxysmal atrial tachycardia the drug should be used only if the usual measures are not effective and there is no damage to the myocardium. The usual dose is 3-4 g (12-16 ml of a solution for intravenous and intramuscular administration of 250 mg / ml) administered slowly intravenously with extreme caution.
With barium poisoning the usual dose of the drug is 1-2 g (4-8 ml of a solution for intravenous and intramuscular injection of 250 mg / ml) intravenously.
Like an antidote magnesium sulfate is used for poisoning with mercury, arsenic, tetraethyl lead, 5 ml of a solution intravenously in a stream.
Tocolysis: initial dose of 4 g (16 ml solution for intravenous and intramuscular injection 250 mg / ml) intravenously, then 1-2 g / hour.
For relief of seizures, associated with epilepsy, glomerulonephritis, the usual adult dose is 1 g (4 ml solution for intravenous and intramuscular injection 250 mg / ml) intramuscularly or intravenously.
For hypertensive crises administered intravenously (slowly over about 5 minutes!) 1-5 g (5-20 ml solution for intravenous and intramuscular injection of 250 mg / ml).
For relief of arrhythmias intravenously injected 1-2 g (4-8 ml solution for intravenous and intramuscular injection of 250 mg / ml) for about 5 minutes. To do this, 10 ml of the solution is diluted in 200 ml of a 5% glucose solution or a potassium polarizing mixture. Possible re-introduction.
Preeclampsia and eclampsia. The dose is set individually depending on the clinical situation. Saturation dose - 2-4 g (8-16 ml solution for intravenous and intramuscular injection 250 mg / ml) after 5-20 minutes (infusion). Maintenance dose 1-2 g (4-8 ml solution for intravenous and intramuscular injection 250 mg / ml) per hour.


During treatment late toxicosis, preeclampsia and eclampsia use the administration of the drug according to the scheme of Richard: initially 4.0 g (16 ml of a solution for intravenous and intramuscular administration of 250 mg / ml) intravenously slowly over 3-4 minutes, after 4 hours, repeat intravenous administration at the same dose and additionally administer 5, 0 g (20 ml solution for intravenous and intramuscular injection 250 mg / ml). Subsequently, intramuscular administration of magnesium sulfate is repeated every 4 hours at a dose of 4.0-5.0 g (16-20 ml of a solution for intravenous and intramuscular injection of 250 mg / ml). Instead of the Richard scheme, intravenous drip administration of 5.0 g of magnesium sulfate (20 ml of a solution for intravenous and intramuscular administration of 250 mg / ml) is possible in a dilution of 400 ml of 0.9% sodium chloride solution or 5% glucose solution at a rate of 9-25 mg / min (15-40 drops / min). In the treatment of preeclampsia and eclampsia, an effective anticonvulsant effect is achieved at a serum magnesium level of 1.6–3.3 mmol/L. A serum magnesium level of 2.64 mmol/L is considered optimal for seizure control.
The maximum daily dose should not exceed 30-40 g of magnesium sulfate.
In case of impaired renal function - no more than 20 g of magnesium sulfate for 48 hours.
Tetany of the uterus. Saturation dose - 4 g (16 ml solution for intravenous and intramuscular injection of 250 mg / ml) after 20 minutes (infusion). Maintenance dose - first 1-2 g (4-8 ml solution for intravenous and intramuscular injection 250 mg / ml) per hour, later - 1 g (4 ml solution for intravenous and intramuscular injection 250 mg / ml) per hour (can be administered drip 24–72 h).

Use in children

Treatment and prevention of hypomagnesemia
Newborns: daily dose - 50-100 mg / kg (0.2-04 ml / kg) intravenously and intramuscularly.
Children: 25–50 mg/kg magnesium sulfate intramuscularly or intravenously every 4–6 hours. The maximum single dose is 2000 mg.
For intravenous administration in children and infants, it is recommended to use a solution of magnesium sulfate 10 mg / ml. The solution is administered intravenously over 1 hour.
In severe cases, half the dose may be given over the first 15 to 20 minutes.
If necessary, it is permissible for children to use a solution of magnesium sulfate 30 mg / ml for intravenous administration.
For intramuscular injection in children, it is recommended to use a solution diluted to a concentration of 200 mg / ml (20% solution).

Use in elderly patients

The dosage of magnesium sulfate in elderly patients is determined by the degree of impaired renal function.

Side effect

Bradycardia, conduction disorder;
- sensation of hot flashes, sweating;
- hypotension, weakness, headache;
- deep sedation, inhibition of tendon reflexes;
- shortness of breath;
- nausea, vomiting;
- polyuria.

Interaction with other drugs

When used together, it enhances the effect of other drugs that depress the nervous system (alcohol, psychotropic, hypnotics, antiparkinsonian, anticonvulsants). When used together with barbiturates, narcotic analgesics, antihypertensive drugs, the likelihood of inhibition of the respiratory center increases.
Cardiac glycosides increase the risk of developing conduction disorders and atrioventricular blockade when used together with magnesium sulfate.
Aminoglycoside antibiotics, nifedipine, and muscle relaxants may increase the neuromuscular blockade caused by magnesium salts.
Intravenous administration of calcium salts weakens the effect of magnesium sulfate.
With the simultaneous administration of magnesium sulfate with other vasodilators, their hypotensive effect is enhanced.
Pharmaceutically incompatible (forms a precipitate) with calcium preparations, alcohol (in high concentrations), carbonates, bicarbonates and alkali metal phosphates, salts of arsenic acid, barium, strontium, clindamycin phosphate, hydrocortisone succinate, polymyxin B sulfate, procaine, salicylates and tartrates.

Precautionary measures

Magnesium sulfate should be used carefully so that toxic concentrations of the drug do not occur.
Elderly patients usually a reduced dose should be used as they have reduced kidney function.
Patients with impaired renal function(creatinine clearance greater than 20 ml/min) and oliguria should not receive more than 20 g of magnesium sulfate (81 mmol Mg 2+) within 48 hours, magnesium sulfate should not be administered intravenously too quickly. It is recommended to control the concentration of magnesium ions in the blood serum (should not be higher than 0.8–1.2 mmol / l), diuresis (not less than 100 ml / h), respiratory rate (not less than 16 / min), blood pressure, control is necessary tendon reflexes.
With the introduction of magnesium sulfate, it is necessary to have a solution of calcium prepared for intravenous administration, for example, a 10% solution of calcium gluconate.
When using magnesium sulfate, the results of radiological studies for which technetium is used can be distorted.
With prolonged use monitoring of central hemodynamics, monitoring of blood pressure, heart activity, tendon reflexes, respiratory rate and kidney function is required.
If necessary, the simultaneous administration of calcium and magnesium sulfate preparations, they should be injected into different veins.
With laboratory monitoring of magnesium levels in plasma it should be borne in mind that normal levels of magnesium in plasma do not exclude its deficiency in tissues, because. the concentration of magnesium in plasma and its level in the interstitial fluid are not always interrelated.

Recipe (international)

Rp.: Sol. Magnesii sulfatis 25% 10.0
D.t. d. N 10 in amp.
S. According to the scheme.

Rp.: Pulv. Magnesii sulfatis 20.0

S. 1 powder diluted in half a glass of water

Recipe (Russia)

Prescription form - 107-1 / y

Active substance

pharmachologic effect

When administered parenterally, it has a sedative, diuretic, arteriodilating, anticonvulsant, antiarrhythmic, hypotensive, antispasmodic, in large doses - curare-like (an inhibitory effect on neuromuscular transmission), tocolytic, hypnotic and narcotic effects, suppresses the respiratory center.
Magnesium is a "physiological" slow calcium channel blocker (SCC) and is able to displace calcium from its binding sites. Regulates metabolic processes, interneuronal transmission and muscle excitability, prevents the entry of calcium through the presynaptic membrane, reduces the amount of acetylcholine in the peripheral nervous system and central nervous system (CNS). Relaxes smooth muscles, lowers blood pressure (mainly high), increases diuresis.

Anticonvulsant action - magnesium reduces the release of acetylcholine from neuromuscular synapses, while suppressing neuromuscular transmission, has a direct inhibitory effect on the central nervous system.

Antiarrhythmic action - magnesium reduces the excitability of cardiomyocytes, restores ionic balance, stabilizes cell membranes, disrupts sodium current, slow incoming calcium current and one-way potassium current.

The hypotensive effect is due to the effect of magnesium to dilate peripheral vessels at higher doses, at lower doses it causes sweating as a result of vasodilation.

Tocolytic effect - magnesium inhibits the contractility of the myometrium (reducing the absorption, binding and distribution of calcium in smooth muscle cells), increases blood flow in the uterus as a result of the expansion of its vessels.

It is an antidote for poisoning with salts of heavy metals.

Systemic effects develop almost instantly after intravenous and 1 hour after intramuscular administration. The duration of action with intravenous administration is 30 minutes, with intramuscular injection - 3-4 hours.

Mode of application

For adults: The drug is administered intramuscularly or intravenously slowly (the first 3 ml for 3 minutes). When administered intravenously, the patient should be in the supine position.
More preferred is the intravenous route of administration.

Intramuscular injection is painful and can lead to the formation of infiltrates, it is used only when peripheral venous access is not possible.

The maximum dose of the drug is calculated individually based on the concentration of magnesium in the blood plasma (not more than 4 mmol / l). The duration of treatment is determined by the doctor individually, depending on the clinical situation.

Hypomagnesemia

With moderate hypomagnesemia, 4 ml of a 25% (1 g) solution of magnesium sulfate is administered intramuscularly every 6 hours.

In severe hypomagnesemia, the dose of the drug is 250 mg / kg of body weight intramuscularly every 4 hours or 20 ml of a 25% magnesium sulfate solution is diluted per liter of infusion solution (5% glucose solution or 0.9% sodium chloride solution) is administered intravenously for 3 h.

Preeclampsia, eclampsia

In the treatment of preexlampsia and eclampsia, 5.0 g of magnesium sulfate (20 ml of a 25% solution) is administered intravenously in a dilution of 400 ml of 0.9% sodium chloride solution or 5% glucose at a rate of 9-25 mg / min (15-40 drops /min). As an alternative method, Richard's scheme is used: initially, 4.0 g (16 ml of a 25% solution) intravenously slowly over 3-4 minutes, after 4 hours, repeat intravenous administration at the same dose and additionally administer intramuscularly 5.0 g (20 ml 25 % solution). Subsequently, intramuscular administration of magnesium sulfate is repeated every 4 hours at a dose of 4.0-5.0 g (16-20 ml of a 25% solution).
The continued administration of magnesium sulfate in pregnant women should not be longer than 5-7 days due to the high risk of congenital fetal anomalies.

convulsive syndrome

In convulsive conditions, 5-10-20 ml of a 25% solution is administered intramuscularly (depending on the severity of the convulsive syndrome).

Poisoning with salts of heavy metals, mercury, arsenic

As an antidote, magnesium sulfate is used for poisoning with mercury, arsenic: intravenous bolus of 5 ml of a 25% solution.

In the complex treatment of chronic alcoholism, magnesium sulfate is administered intramuscularly in 5-20 ml of a 25% solution 1-2 times a day.

As part of complex therapy for hypertensive crisis

In case of a hypertensive crisis, 10-20 ml of a 25% solution of magnesium sulfate is administered intramuscularly or intravenously in a stream (slowly).

Elderly patients

Dose adjustment is not required in elderly patients, however, caution should be exercised in case of impaired renal function.
For kids:

Use in children from the neonatal period, intramuscularly and intravenously.

To eliminate magnesium deficiency in newborns, magnesium sulfate is administered at the rate of 25-50 mg / kg of body weight intravenously every 8-12 hours (2-3 doses).

For the relief of seizures, the drug is prescribed for children at the rate of 20-40 mg / kg (0.08-0.16 ml / kg of a 25% solution) intramuscularly.

With intravenous administration of magnesium sulfate is administered drip for 1 hour in the form of a 1% solution (10 mg / ml).

Indications

- hypomagnesemia when oral administration of magnesium preparations is impossible (with chronic alcoholism, severe diarrhea, malabsorption syndrome, parenteral nutrition);
- preeclampsia and eclampsia as part of complex therapy;
- convulsive syndrome;
- hypertensive crisis (as part of complex therapy);
- poisoning with salts of heavy metals (mercury, arsenic, tetraethyl lead).

Contraindications

- hypersensitivity to the active substance of the drug;
- severe bradycardia, atrioventricular blockade;
- severe renal dysfunction (creatinine clearance less than 20 ml / min);
- severe arterial hypotension;
- depression of the respiratory center;
- prenatal period (2 hours before childbirth);
- lactation period, menstruation.

Side effects

- hypersensitivity reactions;
- sensation of hot flashes, sweating, diplopia;
- arterial hypotension;
- hypermagnesemia characterized by hot flashes, thirst, arterial hypotension, drowsiness, nausea, vomiting, confusion, slurred speech, double vision, loss of tendon reflexes due to neuromuscular blockade, muscle weakness, respiratory depression, impaired electrolyte-water balance (hypophosphatemia , hyperosmolar dehydration), ECG changes (long PR, QRS and QT intervals), bradycardia, cardiac arrhythmia, coma and cardiac arrest;
- depression of the respiratory center, up to paralysis of the respiratory center;
- slowing of the respiratory rate, shortness of breath;
- blockade of peripheral neuromuscular transmission, which leads to a weakening of tendon reflexes;
- flaccid paralysis;
- hypothermia; "mandatory provides for a consultation with a specialist, as well as his recommendations on the method of application and dosage of the medicine you have chosen.

In 1 ml ampoule solution - magnesium sulfate 250 mg.

Release form

• Powder for dissolving in water 10 g, 20 g, 25 g and 50 g.
• Solution in ampoules 5 ml and 10 ml 20% or 25%.

Pharmacological group

Trace elements, vasodilators, sedatives.

pharmachologic effect

Sedative, antispasmodic.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

What is magnesium sulfate? The State Pharmacopoeia defines magnesium sulfate (formula MgSOi) as a drug and indicates the standards for its manufacture and the highest doses of use. The product "magnesium sulfate" was assigned the code OKPD24.42.13.683.

With water, this substance forms hydrates, the most important of which is heptahydrate - bitter, or Epsom salt - this is magnesia , as it is more commonly called, which is used in medicine. It is produced in the form of a powder, from which a solution or suspension is prepared for oral administration and in ampoules for intramuscular and intravenous administration.

Depending on the route of administration, it has a different effect on the body. At - sedative , diuretic , vasodilating , anticonvulsant , hypotensive , antispasmodic , antiarrhythmic , tocolytic , hypnotic .

mechanism of action as anticonvulsant due to the fact that magnesium reduces the release of the mediator acetylcholine from synapses, inhibiting neuromuscular transmission, acts depressant on the central nervous system.

Tocolytic action (relaxation of the muscles of the uterus) is due to the fact that magnesium reduces the contractility of the uterus and increases blood flow in it.

Antiarrhythmic action due to the stabilization of cell membranes and a decrease in the excitability of cardiomyocytes. Effects after intravenous administration develop immediately, after intramuscular injection - after 1 hour.

At oral intake renders choleretic action and serves laxative , which is applied when or for cleansing the intestines, with blind probing, poisoning with salts of heavy metals (it is an antidote). The laxative effect is due to poor absorption in the intestine, in which osmotic pressure increases and water accumulates, which leads to liquefaction of the intestinal contents and increased peristalsis.

The solution for injection can be used for oral administration as a laxative. The onset of the effect when taken orally after 1-3 hours, lasts 4-6 hours.

Magnesium sulfate has also found its use in cosmetology in the manufacture of emulsions, lotions and creams. It is used as a relaxing bath salt that relieves muscle tension.

Pharmacokinetics

At parenteral administration (injections) penetrates through the BBB. In breast milk creates concentrations exceeding 2 times the concentration in the blood. It is excreted by the kidneys, the excretion rate is proportional to the level of glomerular filtration. Enhances upon withdrawal diuresis .

At oral administration poorly absorbed in the intestine. With malabsorption and eating fatty foods, magnesium absorption is reduced. It is deposited in bones, muscles, kidneys, myocardium.

Indications for use

• hypomagnesemia , tetany ;
• ventricular ;
• , crisis state With cerebral edema ;
• urinary retention;
• brain concussion ;
• , ;
• barium chloride poisoning , salts of heavy metals ;
• (as part of complex therapy).

Magnesium sulfate powder is used orally for:

• dyskinesia of the gallbladder , cholangitis and (for carrying out tubages);
• duodenal sounding ;
• poisoning with salts of heavy metals;
• for bowel cleansing.

Contraindications for Magnesium Sulfate

• arterial hypotension ;
• severe chronic renal failure;
• pronounced bradycardia ;
• hypersensitivity;
• AV block;
• the period before childbirth (2 hours before);
• depression of the respiratory center.

Prescribed with caution when . Contraindications for oral administration: , intestinal bleeding ,bowel obstruction , .

Side effects

With intravenous use: headache, polyuria, lowering blood pressure, nausea, severe sedation, uterine atony .

signs hypermagnesemia : bradycardia, double vision, shortness of breath, slurred speech, asthenia, decrease and loss of tendon reflexes, depression of the respiratory center and impaired cardiac conduction.

Ingestion: vomiting, exacerbation of diseases of the gastrointestinal tract, , thirst, pain in the intestines, electrolyte imbalance (fatigue, asthenia, convulsions).

Application instruction of Magnesium Sulphate (Way and dosage)

Instructions for use of the solution in ampoules

It is used intravenously or intramuscularly, most often a 25% solution. At Ghypertensive crises ,convulsive syndrome , spastic states prescribe 5-20 ml of the drug.

At eclampsia - 10 - 20 ml of a 25% solution up to 4 times a day.

For injected i / m 0.1-0.2 ml per kg of weight 20% solution.

For acute poisoning - in / in 5-10 ml of a 10% solution.

Powder Magnesium Sulfate, instructions for use

How to take magnesium sulfate as a laxative? Powder in the amount of 20-30 g is dissolved in 100 ml of water (preferably warm) and drunk at night or in the morning half an hour before meals. In chronic constipation, enemas are done - the same amount of powder per 100 ml of water. The drug as a laxative can be used only occasionally.

How to use the powder as a choleretic agent

Prepare a solution of 20 g of powder and 100 ml of water. Take 1 tablespoon 3 times a day before meals. At poisoning with salts of heavy metals take a solution inside - 20-25 g per 200 ml of water. At duodenal sounding 50 ml of a 25% solution is injected through the probe.

Magnesium sulfate is also used as a fertilizer - a separate section is devoted to this.

Application as fertilizer

Magnesium sulfate is a fertilizer that is a source of magnesium and sulfur for agricultural and ornamental crops. This fertilizer is a white crystals, highly soluble in water. Accelerates the growth of new shoots and increases the yield, improves the taste of vegetable crops by increasing the content of sugar, starch and vitamins. To prevent magnesium deficiency, it is recommended to apply 50 to 100 g of bitter salt per m2 every year. During the growing season, carry out root and foliar top dressing.

Application for plants causes growth and promotes violent flowering. For example, for roses, take 1 tablespoon of powder in a bucket of water and water each bush with 2 liters of this solution. Top dressing is carried out in June and until mid-July, as it causes increased growth of shoots. You can also carry out foliar top dressing by spraying. For a working solution, take 20 g of the drug per 10 liters of water.

Overdose

An overdose with intravenous administration is manifested by the disappearance of the knee jerk, a sharp decrease in blood pressure, nausea, vomiting, bradycardia, respiratory depression and central nervous system.

Treatment: solution / chloride IV slowly (antidote), oxygen therapy , artificial respiration, symptomatic therapy.

Overdose by ingestion - . Symptomatic treatment is carried out.

Interaction

Use with cardiac glycosides increases the risk of AV blockade, with muscle relaxants - increased neuromuscular blockade. When used together with vasodilators, the hypotensive effect is enhanced. Increases the likelihood of inhibition of the respiratory center and central nervous system when used with barbiturates and narcotic analgesics .

Calcium salts reduce the effect of the drug. A precipitate forms with phosphate , polymyxin B , ,procaine hydrochloride , salicylates , drugs Ca2+ , ethanol , strontium salts , arsenic acid , barium .

Terms of sale

Without recipe.

Storage conditions

At temperatures up to 25 C.

Best before date

Application during pregnancy

The drug during pregnancy is used with the threat of premature birth. How anticonvulsant , which has an antihypertensive effect, it is the drug of choice for the treatment and prevention convulsions at eclampsia . Therapy is initiated if diastolic blood pressure > 130 mm Hg. Art. Magnesia therapy is carried out for another 24-48 hours after childbirth. The criteria for stopping therapy are the disappearance of seizures, the absence of hyperreflexia and convulsive readiness, a persistent decrease in blood pressure, and normalization of diuresis. The use of this drug during childbirth is contraindicated because it reduces the contractile activity of the myometrium.

Analogues

Magnesium sulfate-Darnitsa , Cormagnesin .

Reviews of Magnesium Sulphate

Often, Magnesium Sulphate powder is used as a laxative, reviews of which are contradictory. The laxative effect manifests itself in everyone in different ways: more or less pronounced. Many note a significant increase in peristalsis and the occurrence of abdominal pain. Not everyone can drink the bitter, unpleasant solution that sometimes causes vomiting.

It must be remembered that the drug is contraindicated in , low blood pressure . This tool gives a good effect when conducting blind probing.

Magnesium sulfate is used for weight loss - reviews are given below.

Magnesium Sulphate for weight loss

Before any diet, it is desirable to cleanse the intestines and this remedy is used once. Why can not often resort to this method of cleansing the intestines? Magnesium sulfate irritates the gastrointestinal mucosa, disrupts the water-salt balance and, with frequent use, leads to . Above it was said about how to take the powder to cleanse the intestines.

In order to lose weight, you can take baths by adding a glass of powder or more to the bath. Bath time is 15-20 minutes. You need to take a bath before going to bed, for a course of 15 procedures carried out 2 times a week. After the procedure, you need to cover yourself with a warm blanket to achieve profuse sweating. The action is that excess fluid is removed, puffiness is eliminated and metabolic processes are accelerated. The effect of losing weight is due to the loss of fluid, but after a while everything comes back. Many consider this method as an emergency tool for losing weight - reviews confirm this.

Price of Magnesium Sulfate, where to buy

You can buy Magnesium Sulfate in all pharmacies in Moscow and other Russian cities. Magnesium sulfate powder, the price of which depends on the number of grams, costs between 38-58 rubles.

• Internet pharmacies in Russia Russia
• Internet pharmacies of Ukraine Ukraine
• Internet pharmacies of Kazakhstan Kazakhstan

ZdravCity

Magnesium sulfate powder 20g pack. Tula factory

Magnesium sulfate powder for pre-solution 25gTula Pharmaceutical Factory LLC

Magnesium sulfate powder 20g pack. Moscow factoryCJSC Moscow Pharmaceutical Factory

Magnesium sulfate solution for intravenous injection. 25% 5ml 10 pcs. LLC "Groteks"

Pharmacy Dialog

Magnesium sulfate (pack. 20g) MFF

Magnesium sulfate (pack. 25g) Tula FF

Magnesium sulfate (amp. 25% 5ml №10) Grotex LLC

Magnesium sulfate 25% ampoules 10ml №10Slavyanskaya Apteka LLC

Magnesium sulfate (magnesium sulfate)
- magnesium sulfate heptahydrate (magnesium sulphate heptahydrate)

Composition and form of release of the drug

Solution for intravenous administration as a clear, colorless liquid.

Excipients: water for injection - up to 1 ml.

5 ml - colorless glass ampoules (10) - cardboard boxes.
5 ml - colorless glass ampoules (5) - blister packs (1) - cardboard packs.
5 ml - colorless glass ampoules (5) - blister packs (2) - cardboard packs.
10 ml - colorless glass ampoules (10) - cardboard boxes.
10 ml - colorless glass ampoules (5) - blister packs (1) - cardboard packs.
10 ml - colorless glass ampoules (5) - blister packs (2) - cardboard packs.

pharmachologic effect

When taken orally, it has a choleretic effect (a reflex effect on the receptors of the duodenal mucosa) and action (due to poor absorption of the drug in the intestine, a high osmotic pressure is created in it, water accumulates in the intestine, the intestinal contents liquefy, peristalsis increases). It is an antidote for poisoning with salts of heavy metals. The onset of the effect is after 0.5-3 hours, the duration is 4-6 hours.

When administered parenterally, it has a hypotensive, sedative and anticonvulsant effect, as well as a diuretic, arteriodilating, antiarrhythmic, vasodilating (on the arteries) effect, in high doses - curare-like (an inhibitory effect on neuromuscular transmission), tocolytic, hypnotic and narcotic effects, suppresses respiratory center. Magnesium is a physiological blocker of slow calcium channels and is able to displace it from its binding sites. Regulates metabolic processes, interneuronal transmission and muscle excitability, prevents the entry of calcium through the presynaptic membrane, reduces the amount of acetylcholine in the peripheral nervous system and central nervous system. Relaxes smooth muscles, lowers blood pressure (mainly high), increases diuresis.

The mechanism of anticonvulsant action is associated with a decrease in the release of acetylcholine from neuromuscular synapses, while magnesium suppresses neuromuscular transmission and has a direct inhibitory effect on the central nervous system.

The antiarrhythmic effect of magnesium is due to a decrease in the excitability of cardiomyocytes, restoration of ionic balance, stabilization of cell membranes, disruption of sodium current, slow incoming calcium current and unilateral potassium current. The cardioprotective effect is due to the expansion of the coronary arteries, a decrease in peripheral vascular resistance and platelet aggregation.

The tocolytic effect develops as a result of inhibition of the contractility of the myometrium (decrease in absorption, binding and distribution of calcium in smooth muscle cells) under the influence of magnesium ion, increased blood flow in the uterus as a result of the expansion of its vessels. Magnesium is an antidote for poisoning with salts of heavy metals.

Systemic effects develop almost instantly after i / v and 1 hour after i / m administration. The duration of action with a / in the introduction - 30 minutes, with a / m - 3-4 hours.

Pharmacokinetics

After oral administration, no more than 20% of the dose taken is absorbed.

C ss , at which an anticonvulsant effect develops, is 2-3.5 mmol / l.

Penetrates through the BBB and the placental barrier, excreted in breast milk with a concentration 2 times higher than the concentration in. Excreted by the kidneys, the rate of renal excretion is proportional to plasma concentration and glomerular filtration rate.

Indications

For oral administration: constipation, cholangitis, cholecystitis, gallbladder dyskinesia of the hypotonic type (for tubing), duodenal sounding (to obtain a gallbladder portion of bile), bowel cleansing before diagnostic manipulations.

For parenteral administration: arterial hypertension (including hypertensive crisis with cerebral edema), hypomagnesemia (including increased need for magnesium and acute hypomagnesemia - tetany, myocardial dysfunction), polymorphic ventricular tachycardia (pirouette type) ), urinary retention, encephalopathy, epileptic syndrome, threat of premature birth, convulsions with preeclampsia, eclampsia.

Poisoning with salts of heavy metals (mercury, arsenic, tetraethyl lead, barium).

Contraindications

Chronic renal failure severe, hypersensitivity to magnesium sulfate.

For oral administration: appendicitis, rectal bleeding (including undiagnosed), intestinal obstruction, dehydration.

For parenteral administration: arterial hypotension, depression of the respiratory center, severe bradycardia, AV blockade, prenatal period (2 hours before delivery).

Dosage

Individual, depending on the indications and the dosage form used. It is intended for oral, intramuscular and intravenous (slow) administration, administration through a duodenal tube.

Side effects

Early signs and symptoms of hypermagnesemia: bradycardia, diplopia, sudden flushing of the face, headache, decreased blood pressure, nausea, shortness of breath, slurred speech, vomiting, weakness.

Signs of hypermagnesemia(in order of increasing serum magnesium concentration): decreased deep tendon reflexes (2-3.5 mmol/l), prolongation of the PQ interval and expansion of the QRS complex on the ECG (2.5-5 mmol/l), loss of deep tendon reflexes (4-5 mmol / l), depression of the respiratory center (5-6.5 mmol / l), impaired conduction of the heart (7.5 mmol / l), cardiac arrest (12.5 mmol / l); in addition - hyperhidrosis, anxiety, severe sedation, polyuria, uterine atony.

When taken orally: nausea, vomiting, diarrhea, exacerbation of inflammatory diseases of the gastrointestinal tract, electrolyte imbalance (fatigue, asthenia, confusion, arrhythmia, convulsions), flatulence, spastic abdominal pain, thirst, signs of hypermagnesemia in the presence of renal failure (dizziness).

drug interaction

With the parenteral use of magnesium sulfate and the simultaneous use of peripheral action, the effects of muscle relaxants of peripheral action are enhanced.

With simultaneous ingestion of antibiotics from the tetracycline group, the effect of tetracyclines may decrease due to a decrease in their absorption from the gastrointestinal tract.

A case of respiratory arrest during the use of gentamicin in an infant with an increased concentration of magnesium in the blood plasma during magnesium sulfate therapy is described.

With simultaneous use with nifedipine, severe muscle weakness is possible.

Reduces the effectiveness of oral anticoagulants (including coumarin derivatives or indandione derivatives), cardiac glycosides, phenothiazines (especially chlorpromazine). Reduces the absorption of ciprofloxacin, etidronic acid, weakens the effect of streptomycin and tobramycin.

As an antidote for an overdose of magnesium sulfate, calcium preparations are used - or calcium gluconate.

Pharmaceutically incompatible (precipitate forms) with calcium preparations, ethanol (in high concentrations), carbonates, bicarbonates and alkali metal phosphates, salts of arsenic acid, barium, strontium, clindamycin phosphate, sodium hydrocortisone succinate, sulfate, procaine hydrochloride, salicylates and tartrates.

special instructions

Take with caution or enter parenterally with heart block, myocardial damage, chronic renal failure, respiratory diseases, acute inflammatory diseases of the gastrointestinal tract, pregnancy.

Magnesium sulfate can be used to relieve status epilepticus (as part of complex treatment).

In case of overdose, it causes CNS depression. As an antidote for an overdose of magnesium sulfate, calcium preparations are used - calcium chloride or.

Pregnancy and lactation

During pregnancy, magnesium sulfate is used with caution, only in cases where the expected therapeutic effect outweighs the potential risk to the fetus.

If necessary, use during lactation, breastfeeding should be discontinued.

For impaired renal function

Contraindicated in severe chronic renal failure. Take with caution orally or parenterally in chronic renal failure.