Magnesium interactions

Magnesium supplements and antacids bind to some antibiotics and bone drugs, and several common medicines change magnesium levels.

Magnesium has 44 documented interactions across the FDA labels and fact sheets we index: 5 major, 16 moderate, 20 minor, and 3 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This vitamin and mineral page is a starting point, not a verdict for your situation.

Major interactions (5)

  • Calcitriolvitamin D analogMajor

    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)

  • NaproxenNSAIDMajor

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

  • NitrofurantoinantibioticMajor

    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)

  • PhenytoinanticonvulsantMajor

    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)

  • RiociguatvasodilatorMajor

    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)

Moderate interactions (16)

  • AlendronatebisphosphonateModerate

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

  • CefdinircephalosporinModerate

    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)

  • CiprofloxacinfluoroquinoloneModerate

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

  • Doxycyclinetetracycline antibioticModerate

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

  • FosinoprilACE inhibitorModerate

    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)

  • GabapentinanticonvulsantModerate

    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)

  • IbandronatebisphosphonateModerate

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

  • LevofloxacinfluoroquinoloneModerate

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

  • Minocyclinetetracycline antibioticModerate

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

  • MoxifloxacinfluoroquinoloneModerate

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

  • OfloxacinfluoroquinoloneModerate

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

  • RisedronatebisphosphonateModerate

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

  • RosuvastatinstatinModerate

    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)

  • Sofosbuvir and velpatasvirantiviralModerate

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

  • TadalafilPDE5 inhibitorModerate

    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)

  • Tetracyclinetetracycline antibioticModerate

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

Minor mentions (20)

  • Bisoprolol and hydrochlorothiazidebeta blockerMinor

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

  • Bumetanideloop diureticMinor

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

  • Chlorthalidonethiazide diureticMinor

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

  • Dexlansoprazoleproton pump inhibitorMinor

    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)

  • Esomeprazoleproton pump inhibitorMinor

    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)

  • Ethacrynic acidloop diureticMinor

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

  • Furosemideloop diureticMinor

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

  • Hydrochlorothiazidethiazide diureticMinor

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

  • Indapamidethiazide diureticMinor

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

  • Lansoprazoleproton pump inhibitorMinor

    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)

  • Lisinopril and hydrochlorothiazideACE inhibitorMinor

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

  • Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Minor

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

  • Metolazonethiazide diureticMinor

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

  • Omeprazoleproton pump inhibitorMinor

    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)

  • Pantoprazoleproton pump inhibitorMinor

    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)

  • Rabeprazoleproton pump inhibitorMinor

    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)

  • Spironolactone and hydrochlorothiazidealdosterone antagonistMinor

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

  • Torsemideloop diureticMinor

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

  • Triamterene and hydrochlorothiazidepotassium-sparing diureticMinor

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

  • Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Minor

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

No significant interaction reported (3)

  • DofetilideantiarrhythmicNo interaction

    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)

  • DuloxetineSNRINo interaction

    However, co-administration of CYMBALTA with aluminum- and magnesium-containing antacids (51 mEq) or CYMBALTA with famotidine, had no significant effect on the rate or extent of duloxetine absorption after administration of a 40 mg oral dose. (Duloxetine label, Drug interactions)

  • OlanzapineantipsychoticNo interaction

    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)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.