Magnesium sulfate is a drug with anticonvulsant, antiarrhythmic, vasodilating, hypotensive, antispasmodic, sedative, choleretic, laxative and tocolytic action.
Release form and composition
- Powder for preparing a solution for oral administration (10, 20 or 25 g in heat-sealable bags, in a cardboard pack of 1, 2, 3, 4, 6, 8, 10, 12 or 20 bags);
- Solution for intravenous administration (5 or 10 ml in ampoules, in a cardboard bundle 10 ampoules);
- Solution for intramuscular and intravenous administration (5 or 10 ml in ampoules, 10 ampoules in plastic contoured packages, in a cardboard box 1 pack).
The active ingredient of the drug is magnesium sulfate. Its content is:
- 1 packet of powder for oral solution - 10, 20 or 25 g;
- 1 ml solution for intravenous administration - 200 or 250 mg;
- 1 ml solution for intramuscular and intravenous administration - 250 ml.
Indications for use
For oral administration:
- Duodenal intubation (to obtain a cystic portion of bile);
- Dyskinesia of the gallbladder hypotonic type (for tubing);
- Colon cleansing before diagnostic procedures.
For parenteral administration:
- Increased need for magnesium (growth period, pregnancy, excessive sweating, stress, recovery period);
- Hypomagnesaemia as a result of inadequate or unbalanced nutrition, chronic alcoholism, contraceptive pills, muscle relaxants or diuretics);
- Acute hypomagnesemia (myocardial dysfunction, tetany);
- Spasms of preeclampsia;
- The threat of preterm birth;
- Epileptic syndrome;
- Polymorphic ventricular tachycardia of the type of pirouette;
- Ventricular arrhythmias associated with prolongation of the QT interval;
- Arterial hypertension (including hypertensive crisis with symptoms of cerebral edema);
- Arrhythmias due to low plasma concentrations of magnesium and / or potassium;
- Urinary retention;
In addition, magnesium sulfate can be used for poisoning with salts of heavy metals (arsenic, mercury, barium, tetraethyl lead).
Both dosage forms of the drug are contraindicated in the following conditions:
- Severe chronic renal failure;
- Hypersensitivity to magnesium sulfate.
Additional contraindications for oral administration:
- Intestinal obstruction;
- Rectal bleeding.
Additional contraindications for parenteral administration:
- Depression of the respiratory center;
- AV blockade;
- Severe bradycardia;
- Severe renal failure (creatinine clearance less than 20 ml / minute);
- Prenatal period (2 hours before birth).
Relative contraindications to magnesium sulfate are the following diseases (special caution is required when applying):
- For oral administration: myocardial damage, heart block, chronic renal failure;
- For parenteral use: diseases of the respiratory system, myasthenia, acute inflammatory diseases of the gastrointestinal tract, impaired renal function and chronic renal failure.
Dosing and Administration
Magnesium sulfate is taken orally, injected intramuscularly (IM) and intravenously (IV), as well as through a duodenal probe.
Dosage regimen individual: determined depending on the indications and the dosage form of the drug.
Intravenously (slowly) and intramuscularly usually injected in 5-20 ml of 20-25% solution 1-2 times a day. When poisoning with tetraethyl lead, arsenic, mercury - in / in 5-10 ml of 5-10% solution. In order to relieve seizures in children - in / m at 0.1-0.2 ml / kg (20-40 mg / kg) of a 20% solution. The maximum daily dose is 40 g of magnesium sulfate (or 160 mmol).
Inside magnesium sulfate take:
- As a laxative: adults - 10-30 g in 1/2 cup of water, children - at the rate of 1 g for each year of life;
- As a choleretic: 1 tablespoon of a 20-25% solution 3 times a day.
For duodenal intubation, the drug is administered through a probe: 50 ml of a 25% solution or 100 ml of a 10% solution.
In case of poisoning with soluble barium salts with a 1% solution of magnesium sulfate, the stomach is washed or taken inside - 20-25 g per 200 ml of water. For poisoning with mercury, lead and arsenic, intravenous administration of 5-10 ml of 5-10% solution is indicated.
When taking magnesium sulfate inside: nausea, diarrhea, vomiting, thirst, abdominal pain of a spastic nature, flatulence, electrolyte imbalance (confusion, asthenia, arrhythmia, fatigue, convulsions), exacerbation of inflammatory diseases of the gastrointestinal tract, hypermagnesium (especially with renal failure).
When used parenterally: the early symptoms of hypermagneemia - sweating, flushing, diplopia, low blood pressure, bradycardia, depression of the heart and central nervous system; at a concentration of magnesium in the blood of 2-3.5 mmol / l, deep tendon reflexes decrease, at a concentration of 2.5-5 mmol / l - expansion of the QRS complex and prolongation of the PQ interval on the electrocardiogram, 4-5 mmol / l - loss of deep tendon reflexes, 5-6.5 mmol / l - inhibition of the respiratory center; 7.5 mmol / l - violation of the conductivity of the heart; 12.5 mmol / l - cardiac arrest occurs. In addition, such side effects as weakness, headache, hypothermia, anxiety, uterine atony are possible. When relief of eclampsia may develop hypocalcemia with signs of secondary tetany. If the concentration of magnesium in the plasma is too high (for example, due to a very rapid intravenous administration, or in patients with renal insufficiency, paresthesias, nausea and vomiting, and polyuria are possible.
In case of overdose, the drug inhibits the central nervous system. Calcium — calcium gluconate and calcium chloride — are specific antidotes to magnesium sulfate.
With prolonged treatment should monitor the activity of the heart, blood pressure, respiratory rate, kidney function, tendon reflexes.
If necessary, the simultaneous use of calcium salts should be administered drugs in different veins.
Patients with severe renal impairment should not use more than 20 g of magnesium sulfate for 48 hours. Rapid intravenous administration of the drug is contraindicated in the same category of patients and patients with oliguria.
Magnesium sulfate pharmaceutically incompatible (as a precipitate) from arsenic acid salts, strontium and barium carbonates, clindamycin phosphate, hydrocortisone sodium succinate, bicarbonates and phosphates of alkali metals, procaine hydrochloride, polymyxin B sulfate, tartrates, salicylates, ethanol (in high concentrations) and preparations of Ca 2+ .
With simultaneous use of magnesium sulfate enhances the action of peripheral muscle relaxants, reduces the effectiveness of antibiotics from the tetracycline group, cardiac glycosides, oral anticoagulants (including derivatives of indandion and coumarin derivatives), phenothiazines (especially chlorpromazine), tobramycin, streptomycin.
The drug reduces the absorption of etidronic acid and ciprofloxacin.
In the case of simultaneous use of nifedipine, pronounced muscle weakness is possible.
There is a known case of respiratory arrest in an infant, who was given gentamicin during a period of elevated concentration of magnesium in the blood plasma as a result of Magnesium sulfate treatment.
Terms and conditions of storage
Store at temperatures up to 30 ºС out of the reach of children, powder - in a sealed package.
The shelf life of solutions - 3 years, powder - 5 years.