MetabolicĪ metabolic concern in the case of acute hypermagnesemia is hypocalcemia. Ĭardiovascular side effects have included hypotension, depressed myocardial conductivity, asystole, and bradyarrhythmias. The risk of cardiotoxicity from hypermagnesemia is increased in the presence of hypocalcemia, hyperkalemia, acidosis, digitalis therapy, and renal insufficiency. While some patients are inexplicably able to tolerate extraordinarily high Mg levels, there is a significant risk of asystole when levels rise to 25 mEq/L. Hypotension, depressed myocardial conductivity, and bradyarrhythmias may be associated with levels greater than 10 mEq/L. Hypotension may be observed when serum Mg levels rise to 5 to 10 mEq/L. The cardiovascular consequences of hypermagnesemia are due to peripheral vasodilation. Death is not uncommon when serum Mg levels rise to 15 mEq/L. Mg also has a curare-like effect at the neuromuscular junction at serum levels above 10 mEq/L. At levels of 10 to 15 mEq/L, there is usually profound mental depression, areflexia, coma and respiratory paralysis. At levels of 5 to 10 mEq/L, the respiratory rate slows and blood pressure falls. Clinically, if serum magnesium (Mg) levels increase to 4 to 7 mEq/L, there may be a decrease in tendon reflexes, muscle weakness, and/or mental confusion or sedation. Nervous system side effects from hypermagnesemia result from suppression of neuromuscular transmission in the CNS and at the neuromuscular junction (which can be antagonized by calcium). CNS depression, often presenting as somnolence, may be more likely and more severe in patients with renal dysfunction. Nervous system side effects have included a decrease in tendon reflexes, muscle weakness, mental confusion, sedation, mental depression, areflexia, coma and respiratory paralysis. Moderate or severe hypermagnesemia affects the nervous and cardiovascular systems primarily. Mild hypermagnesemia is generally well-tolerated. For Healthcare ProfessionalsĪpplies to magnesium citrate: compounding powder, oral capsule, oral liquid, oral tablet, oral tablet chewable. Call your doctor for medical advice about side effects. This is not a complete list of side effects and others may occur. Weak or shallow breathing, slow heartbeats or Watery diarrhea, nausea, vomiting, severe stomach pain įlushing (warmth, redness, or tingly feeling) Ī light-headed feeling, like you might pass out Pain with bowel movements, rectal bleeding No bowel movement within 6 hours after taking the medicine Stop using magnesium citrate and call your doctor at once if you have: Get emergency medical help if you have signs of an allergic reaction: hives, difficult breathing, swelling of your face, lips, tongue, or throat. Follow all directions on the label and package.
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