Magnesium interactions

Magnesium-containing preparations (e.g., antacids) and calcitriol should not be used concomitantly in patients on chronic renal dialysis because such use may lead to the development of hypermagnesemia. (Calcitriol label, Warnings)

Intervention: Concomitant use of diclofenac sodium/misoprostol and magnesium-containing antacids is not recommended. (Diclofenac and misoprostol label, Drug interactions)

Examples Magnesium-containing products such as antacids Intervention Avoid use of magnesium-containing products and doxercalciferol in patients on chronic renal dialysis. (Doxercalciferol label, Drug interactions)

Intervention: Concomitant administration of antacids such as magnesium oxide or aluminum hydroxide, and sucralfate with Naproxen Suspension is not recommended. (Naproxen label, Drug interactions)

If coadministration of nitrofurantoin with antacids containing magnesium trisilicate cannot be avoided, monitor for lack of efficacy [see Clinical Pharmacology (12.3) ]. (Nitrofurantoin label, Drug interactions)

Calcium carbonate, aluminum hydroxide, magnesium hydroxide Prevention or Management: Phenytoin and antacids should not be taken at the same time of day Antineoplastic agents (usually in combination) Bleomycin, carboplatin, cisplatin, doxorubicin, methotrexate Antiviral agents Fosamprenavir, nelfinavir, ritonavir Antiepileptic drugs Carbamazepine, vigabatrin Other… (Phenytoin label, Drug interactions)

Table 8: Selected Drug Interactions in Adults Concomitant Drug Class: Drug Name Effect on Concentration of Raltegravir Clinical Comment Metal-Containing Antacids aluminum and/or magnesium-containing antacids ↓ Coadministration or staggered administration of aluminum and/or magnesium hydroxide-containing antacids and ISENTRESS is not recommended. (Raltegravir label, Drug interactions)

Antacids: Antacids such as aluminum hydroxide/magnesium hydroxide decrease riociguat absorption and should not be taken within 1 hour of taking Adempas [see Clinical Pharmacology (12.3) ]. (Riociguat label, Drug interactions)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Drug Interactions Drugs which may enhance the neuromuscular blocking action of atracurium include: enflurane; isoflurane; halothane; certain antibiotics, especially the aminoglycosides and polymyxins; lithium; magnesium salts; procainamide; and quinidine. (Atracurium label, Drug interactions)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Drug Interactions: Antacids (Aluminum- or Magnesium-Containing): Concomitant administration of 300 mg cefdinir capsules with 30 mL Maalox ® TC suspension reduces the rate (C max ) and extent (AUC) of absorption by approximately 40%. (Cefdinir label, Drug interactions)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Potentiation of Neuromuscular Blockade Certain drugs may enhance the neuromuscular blocking action of Cisatracurium Besylate Injection including inhalational anesthetics, antibiotics, magnesium salts, lithium, local anesthetics, procainamide and quinidine [see Drug Interactions ( 7.1 )] . (Cisatracurium label, Warnings and precautions)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Drug Interactions Concomitant Drug Class: Drug Name Effect on Concentration Increase = ↑; Decrease = ↓; No Effect = ↔ Clinical Comment Antacids: antacids (e.g., aluminum, magnesium hydroxide, or calcium carbonate) ↔ RPV (antacids taken at least 2 hours before or at least 4 hours after RPV) ↓ RPV (concomitant intake) Administer antacids at least 2 hours before… (Emtricitabine, rilpivirine, and tenofovir label, Drug interactions)

Antacids In a clinical pharmacology study, coadministration of an antacid (aluminum hydroxide, magnesium hydroxide, and simethicone) with fosinopril reduced serum levels and urinary excretion of fosinoprilat as compared with fosinopril administrated alone, suggesting that antacids may impair absorption of fosinopril. (Fosinopril label, Drug interactions)

Antacids In a clinical pharmacology study, serum levels and urinary excretion of fosinoprilat were reduced when fosinopril was coadministered with an antacid (aluminum hydroxide, magnesium hydroxide, and simethicone) suggesting that antacids may impair absorption of fosinopril. (Fosinopril and hydrochlorothiazide label, Drug interactions)

Maalox ® (aluminum hydroxide, magnesium hydroxide) The mean bioavailability of gabapentin was reduced by about 20% with concomitant use of an antacid (Maalox ® ) containing magnesium and aluminum hydroxides. (Gabapentin label, Drug interactions)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Antacids (e.g., aluminum and magnesium hydroxide) It is recommended to separate antacid and ledipasvir and sofosbuvir administration by 4 hours. (Ledipasvir and sofosbuvir label, Drug interactions)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Antacid Clinical Impact: Concomitant ingestion of antacids containing magnesium hydroxide has been shown to significantly increase the rate and extent of mefenamic acid absorption [See Clinical Pharmacology ( 12.3 )] Intervention: Concomitant use of mefenamic acid and antacids is not generally recommended because of possible increased adverse events. (Mefenamic acid label, Drug interactions)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

…Concomitant Drug Class: Drug Name Effect on Concentration of Rilpivirine or Concomitant Drug Clinical Comment ↑=increase, ↓=decrease, ↔=no change Antacids: antacids (e.g., aluminum or magnesium hydroxide, calcium carbonate) ↔ rilpivirine (antacids taken at least 2 hours before or at least 4 hours after rilpivirine) The combination of EDURANT or EDURANT PED and antacids… (Rilpivirine label, Drug interactions)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Certain inhalation anesthetics, particularly enflurane and isoflurane, antibiotics, magnesium salts, lithium, local anesthetics, procainamide, and quinidine have been shown to increase the duration of neuromuscular block and decrease infusion requirements of neuromuscular blocking agents [see Drug Interactions ( 7.3 )] . (Rocuronium label, Warnings and precautions)

Mechanism and Clinical Effect(s) Concomitant aluminum and magnesium hydroxide combination antacid administration decreased the mean exposure of rosuvastatin 50% [ see Clinical Pharmacology ( 12.3 ) ]. (Rosuvastatin label, Drug interactions)

Antacids (e.g., aluminum and magnesium hydroxide) Separate antacid and VOSEVI administration by 4 hours. (Sofosbuvir and velpatasvir label, Drug interactions)

…the Neuromuscular Blocking Action of Succinylcholine : promazine, oxytocin, aprotinin, certain non-penicillin antibiotics, quinidine, β-adrenergic blockers, procainamide, lidocaine, trimethaphan, lithium carbonate, magnesium salts, quinine, chloroquine, isoflurane, desflurane, metoclopramide, terbutaline, and drugs that reduce plasma cholinesterase activity. (Succinylcholine label, Drug interactions)

Antacids — Simultaneous administration of an antacid (magnesium hydroxide/aluminum hydroxide) and tadalafil reduced the apparent rate of absorption of tadalafil without altering exposure (AUC) to tadalafil. (Tadalafil label, Drug interactions)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Magnesium-containing supplements and antacids reduce absorption of these drugs; separate the doses by at least two hours. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Concomitant Drug Class: Drug Name Effect on Concentration Clinical Comment Antacids containing polyvalent cations (e.g., aluminum or magnesium hydroxide, calcium carbonate) ↓Cabotegravir Administer antacid products at least 2 hours before or 4 hours after taking VOCABRIA. (Cabotegravir label, Drug interactions)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Proton pump inhibitors taken for a year or longer can cause low magnesium; supplements may not correct it while the PPI continues. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Proton pump inhibitors taken for a year or longer can cause low magnesium; supplements may not correct it while the PPI continues. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Antacids Concomitant administration of magnesium hydroxide and aluminum hydroxide does not interfere with the rate or extent of the absorption of ketoprofen administered as Keoprofen Capsules, USP. (Ketoprofen label, Warnings and precautions)

Proton pump inhibitors taken for a year or longer can cause low magnesium; supplements may not correct it while the PPI continues. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Proton pump inhibitors taken for a year or longer can cause low magnesium; supplements may not correct it while the PPI continues. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Proton pump inhibitors taken for a year or longer can cause low magnesium; supplements may not correct it while the PPI continues. (NIH Office of Dietary Supplements, Magnesium)

Proton pump inhibitors taken for a year or longer can cause low magnesium; supplements may not correct it while the PPI continues. (NIH Office of Dietary Supplements, Magnesium)

Proton pump inhibitors taken for a year or longer can cause low magnesium; supplements may not correct it while the PPI continues. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Proton pump inhibitors taken for a year or longer can cause low magnesium; supplements may not correct it while the PPI continues. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Magnesium salts, administered for the management of toxemia of (Vecuronium label, Precautions)

If a patient requires dofetilide and anti-ulcer therapy, it is suggested that omeprazole, ranitidine, or antacids (aluminum and magnesium hydroxides) be used as alternatives to cimetidine, as these agents have no effect on the pharmacokinetic profile of dofetilide. (Dofetilide label, Drug interactions)

…clinically significant changes in concentration were observed for doravirine when co-administered with the following agents: dolutegravir, TDF, lamivudine, elbasvir and grazoprevir, ledipasvir and sofosbuvir, ritonavir, ketoconazole, aluminum hydroxide/magnesium hydroxide/simethicone containing antacid, pantoprazole, and methadone [see Clinical Pharmacology (12.3) ]. (Doravirine label, Drug interactions)

Drugs Without Clinically Significant Interactions with Efavirenz No dosage adjustment is recommended when efavirenz is given with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, lorazepam, nelfinavir, nucleoside reverse transcriptase inhibitors (abacavir, emtricitabine, lamivudine, stavudine, tenofovir… (Efavirenz label, Drug interactions)

Drugs without Clinically Significant Interactions No dosage adjustment is recommended when SYMFI is administered with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, and lorazepam. (Efavirenz, lamivudine, and tenofovir label, Drug interactions)

Cimetidine and Antacids — Single doses of cimetidine (800 mg) or aluminum- and magnesium-containing antacids did not affect the oral bioavailability of olanzapine. (Olanzapine label, Drug interactions)