Magonate 1000mg/5ml Liquid
It is used to treat or prevent low magnesium levels.
Drug Class
Mineral supplement, Antacid, Laxative
Pharmacologic Class
Magnesium salt
Pregnancy Category
Category B (for supplementation at recommended doses; C for higher doses)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Magnesium carbonate is a mineral supplement that can also be used as an antacid to relieve heartburn and indigestion, or as a laxative to treat constipation. It works by neutralizing stomach acid or by drawing water into the intestines to help with bowel movements. As a supplement, it helps your body perform many important functions, like muscle and nerve function, and maintaining strong bones.
How to Use This Medicine
Taking Your Medication Correctly
To ensure you get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions precisely. When taking a liquid dose, measure it accurately using the measuring device that comes with the medication. If one is not provided, ask your pharmacist for a suitable measuring device.
It's recommended to take this medication with food to help your body absorb it properly.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding bathrooms and areas prone to moisture. Keep all medications in a safe and secure location, out of reach of children and pets.
When disposing of unused or expired medication, do not flush it down the toilet or pour it down the drain unless specifically instructed to do so. Instead, consult with your pharmacist for guidance on the best disposal method. You may also want to inquire about drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
To ensure you get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions precisely. When taking a liquid dose, measure it accurately using the measuring device that comes with the medication. If one is not provided, ask your pharmacist for a suitable measuring device.
It's recommended to take this medication with food to help your body absorb it properly.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding bathrooms and areas prone to moisture. Keep all medications in a safe and secure location, out of reach of children and pets.
When disposing of unused or expired medication, do not flush it down the toilet or pour it down the drain unless specifically instructed to do so. Instead, consult with your pharmacist for guidance on the best disposal method. You may also want to inquire about drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
Lifestyle & Tips
- Take with a full glass of water.
- If using as an antacid, take after meals or at bedtime.
- If using as a laxative, ensure adequate fluid intake throughout the day.
- Avoid taking other medications (especially antibiotics like tetracyclines or fluoroquinolones, and thyroid hormones) within 2-4 hours of taking magnesium carbonate, as it can interfere with their absorption.
- Do not exceed recommended doses without consulting a healthcare professional.
- Maintain a balanced diet rich in magnesium (e.g., leafy greens, nuts, seeds, whole grains) if using for supplementation.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
Dosage varies significantly based on indication. For magnesium supplementation: 289 mg elemental magnesium (equivalent to 1000 mg Magnesium Carbonate) once daily, or as directed by a healthcare professional. For antacid: 250-1000 mg (as Magnesium Carbonate) as needed. For laxative: 2-5 g (as Magnesium Carbonate) once daily.
Dose Range:
250 - 5000 mg
Condition-Specific Dosing:
Magnesium Deficiency (mild):
289 mg elemental magnesium (1000 mg MgCO3) daily, adjusted based on serum levels.
Antacid:
250-1000 mg (MgCO3) as needed, not exceeding 4 g/day.
Laxative:
2-5 g (MgCO3) once daily.
Pediatric Dosing
Neonatal:
Not established (use with extreme caution, if at all, under specialist supervision)
Infant:
Not established (use with extreme caution, if at all, under specialist supervision)
Child:
For antacid (6-12 years): 250-500 mg (MgCO3) as needed. For laxative (6-12 years): 1-2.5 g (MgCO3) once daily. For supplementation, consult a physician; doses are based on elemental magnesium and age/weight.
Adolescent:
Similar to adult dosing for antacid/laxative. For supplementation, consult a physician; doses are based on elemental magnesium and age/weight.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor serum magnesium levels.
Moderate:
Significant dose reduction required; avoid if possible. Monitor serum magnesium closely.
Severe:
Contraindicated due to risk of hypermagnesemia.
Dialysis:
Contraindicated due to risk of hypermagnesemia.
Hepatic Impairment:
Mild:
No specific adjustment needed.
Moderate:
No specific adjustment needed.
Severe:
No specific adjustment needed.
Pharmacology
Mechanism of Action
Magnesium Carbonate acts as an antacid by neutralizing gastric acid, forming magnesium chloride and water. As a laxative, it exerts an osmotic effect in the gastrointestinal tract, drawing water into the lumen, which distends the bowel and promotes peristalsis. As a mineral supplement, magnesium is an essential cofactor for over 300 enzymatic reactions, playing roles in protein synthesis, muscle and nerve function, blood glucose control, and blood pressure regulation. It is also required for energy production, oxidative phosphorylation, and glycolysis.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 30-50% of ingested elemental magnesium is absorbed from the small intestine, but this can vary based on dose, dietary factors, and individual magnesium status. For antacid use, absorption is minimal.
Tmax:
Not well-defined for antacid/laxative action. For systemic absorption, peak serum levels are typically reached within 2-8 hours.
FoodEffect:
Food can slightly decrease the rate of absorption but may not significantly impact the total amount absorbed. Taking with food may reduce GI upset.
Distribution:
Vd:
Not typically reported for magnesium as it is widely distributed throughout the body. Approximately 50-60% is found in bone, 20-30% in muscle, and the remainder in soft tissues and extracellular fluid.
ProteinBinding:
Approximately 25-30% of serum magnesium is protein-bound (primarily to albumin).
CnssPenetration:
Limited under normal physiological conditions. High serum concentrations can lead to CNS depression.
Elimination:
HalfLife:
Homeostatically regulated; not a typical pharmacokinetic half-life for a mineral. Renal excretion is the primary route for excess magnesium.
Clearance:
Primarily renal clearance, regulated by the kidneys.
ExcretionRoute:
Mainly renal (urine); a small amount is excreted in feces.
Unchanged:
100% (as elemental magnesium)
Pharmacodynamics
OnsetOfAction:
Antacid effect: within minutes. Laxative effect: 0.5 to 6 hours. Supplementation: Gradual, over days to weeks.
PeakEffect:
Antacid effect: within 30 minutes. Laxative effect: 1-3 hours. Supplementation: Not applicable in the same way as drugs.
DurationOfAction:
Antacid effect: 1-3 hours. Laxative effect: 6-12 hours. Supplementation: Dependent on continuous intake and body stores.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for advice:
Diarrhea
Note: This is not an exhaustive list of all possible side effects. If you have questions or concerns about side effects, consult your doctor. For medical advice about side effects, you can also contact your doctor. Additionally, you can report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for advice:
Diarrhea
Note: This is not an exhaustive list of all possible side effects. If you have questions or concerns about side effects, consult your doctor. For medical advice about side effects, you can also contact your doctor. Additionally, you can report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe diarrhea or persistent loose stools
- Muscle weakness or feeling very tired
- Dizziness or lightheadedness
- Slow heartbeat
- Difficulty breathing
- Signs of an allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
If you have kidney disease, as this may affect your ability to take this medication.
This list is not exhaustive, and it is crucial to discuss all your health conditions and medications with your doctor. Please provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your health problems, including any existing medical conditions
To ensure your safety, do not start, stop, or change the dose of any medication without first consulting your doctor. It is vital to verify that it is safe to take this medication in combination with your other medications and health conditions.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
If you have kidney disease, as this may affect your ability to take this medication.
This list is not exhaustive, and it is crucial to discuss all your health conditions and medications with your doctor. Please provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your health problems, including any existing medical conditions
To ensure your safety, do not start, stop, or change the dose of any medication without first consulting your doctor. It is vital to verify that it is safe to take this medication in combination with your other medications and health conditions.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood work and laboratory tests should be conducted as directed by your doctor to monitor your condition.
This medication can interact with many other drugs, reducing their absorption into the body. If you are taking other medications, consult your doctor or pharmacist to determine if you should take them at a different time than this medication to minimize potential interactions.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. You and your doctor will need to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
This medication can interact with many other drugs, reducing their absorption into the body. If you are taking other medications, consult your doctor or pharmacist to determine if you should take them at a different time than this medication to minimize potential interactions.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. You and your doctor will need to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
Overdose Information
Overdose Symptoms:
- Severe diarrhea
- Nausea
- Vomiting
- Abdominal pain
- Lethargy
- Drowsiness
- Muscle weakness
- Hypotension (low blood pressure)
- Bradycardia (slow heart rate)
- Reduced or absent deep tendon reflexes
- Respiratory depression (slow, shallow breathing)
- Coma
- Cardiac arrest
What to Do:
If you suspect an overdose, seek immediate medical attention or call a poison control center (1-800-222-1222). Management typically involves supportive care, intravenous fluids to promote renal excretion, and in severe cases, intravenous calcium gluconate to antagonize magnesium's effects, or dialysis.
Drug Interactions
Contraindicated Interactions
- Sodium Polystyrene Sulfonate (Kayexalate) - risk of intestinal necrosis (especially with sorbitol-containing magnesium products, though less common with carbonate alone, still a concern)
- Patiromer (Veltassa) - binds magnesium, reducing absorption
Major Interactions
- Tetracyclines (e.g., Doxycycline, Minocycline) - reduced absorption of tetracycline due to chelation
- Fluoroquinolones (e.g., Ciprofloxacin, Levofloxacin) - reduced absorption of fluoroquinolone due to chelation
- Bisphosphonates (e.g., Alendronate, Risedronate) - reduced absorption of bisphosphonate
- Thyroid hormones (e.g., Levothyroxine) - reduced absorption of thyroid hormone
- Digoxin - altered absorption and potential for additive effects on cardiac conduction at high magnesium levels
- Calcium Channel Blockers (e.g., Amlodipine, Verapamil) - additive hypotensive and CNS depressant effects, especially with IV magnesium
Moderate Interactions
- Potassium-sparing diuretics (e.g., Amiloride, Spironolactone) - increased risk of hypermagnesemia
- Loop diuretics (e.g., Furosemide) - can increase magnesium excretion, but chronic use may lead to hypomagnesemia, so supplementation might be needed
- Neuromuscular blockers (e.g., Succinylcholine, Vecuronium) - enhanced neuromuscular blockade
- Other laxatives - increased risk of diarrhea and electrolyte imbalance
- Iron supplements - reduced absorption of iron
- Zinc supplements - reduced absorption of zinc
Minor Interactions
- Antacids containing aluminum - can alter absorption of both
Monitoring
Baseline Monitoring
Renal function (BUN, Creatinine, eGFR)
Rationale: Magnesium is primarily renally excreted; impaired renal function increases the risk of hypermagnesemia.
Timing: Prior to initiation, especially in elderly or those with suspected renal impairment.
Baseline serum magnesium levels
Rationale: To establish a baseline, especially if treating deficiency or using high doses.
Timing: Prior to initiation for supplementation or high-dose therapy.
Routine Monitoring
Serum magnesium levels
Frequency: Periodically (e.g., weekly to monthly) for high-dose supplementation or in patients with renal impairment; as needed for symptoms of hypermagnesemia.
Target: 1.7-2.2 mg/dL (0.7-0.9 mmol/L)
Action Threshold: If >2.5 mg/dL (1.03 mmol/L) or symptoms of hypermagnesemia appear, reduce dose or discontinue. If >4.8 mg/dL (2 mmol/L), consider urgent intervention.
Renal function (BUN, Creatinine, eGFR)
Frequency: Periodically (e.g., every 3-6 months) for long-term use or in patients with risk factors for renal decline.
Target: Normal range for age and sex
Action Threshold: Significant decline in eGFR warrants dose reduction or discontinuation.
Bowel movements (for laxative use)
Frequency: Daily
Target: Regular, soft stools
Action Threshold: Excessive diarrhea or lack of effect warrants dose adjustment.
Symptom Monitoring
- Diarrhea
- Abdominal cramping
- Nausea
- Vomiting
- Muscle weakness
- Lethargy
- Drowsiness
- Hypotension
- Bradycardia
- Reduced deep tendon reflexes
- Difficulty breathing (severe hypermagnesemia)
Special Patient Groups
Pregnancy
Magnesium is an essential nutrient during pregnancy. Magnesium carbonate is generally considered safe for use as an antacid or laxative at recommended doses. However, high doses or prolonged use, especially in the third trimester, should be avoided due to potential for hypermagnesemia in the neonate (e.g., respiratory depression, hypotonia). Consult a healthcare provider before use.
Trimester-Specific Risks:
First Trimester:
Generally considered safe for occasional use at recommended doses.
Second Trimester:
Generally considered safe for occasional use at recommended doses.
Third Trimester:
Use with caution; prolonged or high doses may lead to neonatal hypermagnesemia (hypotonia, respiratory depression). Avoid within 2 hours of delivery.
Lactation
Magnesium is a normal component of breast milk. Magnesium carbonate is considered compatible with breastfeeding at usual doses. Excessive doses may lead to diarrhea in the infant.
Infant Risk:
Low risk at recommended maternal doses. Monitor infant for diarrhea.
Pediatric Use
Use with caution, especially in infants and young children, due to increased risk of electrolyte imbalance and hypermagnesemia. Dosing must be carefully calculated based on age and weight, and for specific indications. Not recommended for routine use in neonates or infants without medical supervision.
Geriatric Use
Elderly patients may have reduced renal function, increasing the risk of hypermagnesemia. Start with lower doses and monitor renal function and serum magnesium levels closely. More susceptible to laxative effects and dehydration.
Clinical Information
Clinical Pearls
- Magnesium carbonate contains approximately 28.9% elemental magnesium. A 1000mg dose provides about 289mg elemental magnesium.
- This product can serve multiple purposes: magnesium supplementation, antacid, or laxative, depending on the dose and frequency.
- Always advise patients to separate administration of magnesium carbonate from other medications (especially antibiotics, bisphosphonates, thyroid hormones) by at least 2-4 hours to prevent absorption interference.
- Educate patients on the signs and symptoms of hypermagnesemia, especially those with impaired renal function or on high doses.
- For laxative use, emphasize the importance of adequate fluid intake to prevent dehydration and enhance efficacy.
Alternative Therapies
- For antacid: Calcium carbonate, Aluminum hydroxide, Sodium bicarbonate, H2-receptor antagonists (e.g., Famotidine), Proton pump inhibitors (e.g., Omeprazole).
- For laxative: Polyethylene glycol (PEG), Docusate sodium, Bisacodyl, Psyllium.
- For magnesium deficiency: Other magnesium salts (e.g., magnesium citrate, magnesium glycinate, magnesium L-threonate for better absorption/specific uses).
Cost & Coverage
Average Cost:
Highly variable, typically low cost per bottle (e.g., 240ml)
Generic Available:
Yes
Insurance Coverage:
Often not covered by prescription plans as it's an OTC product; may be covered by FSA/HSA.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with additional patient information leaflets, so be sure to check with your pharmacist for more details. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide information about the medication taken, the amount, and the time it happened.