Milk Of Magnesia Susp 100x30ml
It is used to treat constipation.It is used to treat heartburn and upset stomach.
Drug Class
Antacid; Laxative, Osmotic
Pharmacologic Class
Inorganic salt; Osmotic agent
Pregnancy Category
Category B
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Milk of Magnesia is a liquid medicine used to relieve occasional constipation (by helping you have a bowel movement) and to relieve heartburn or indigestion (by neutralizing stomach acid). It works by drawing water into your intestines to soften stool, or by reducing the acid in your stomach.
How to Use This Medicine
Taking Your Medication Correctly
To use this medication safely and effectively, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely.
Take your medication with a full glass of water.
Note that this medication may interfere with the absorption of other oral medications. If you are taking other medications by mouth, consult your doctor about the best schedule for taking them in relation to this medication.
Before using the liquid form of this medication, shake the bottle well. Measure your dose carefully using the measuring device provided with the medication. If no device is included, ask your pharmacist for a suitable measuring tool.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding storage in a bathroom.
Missing a Dose
Since this medication is taken as needed, do not take it more frequently than directed by your doctor. If you have questions about your dosing schedule, consult your healthcare provider.
To use this medication safely and effectively, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely.
Take your medication with a full glass of water.
Note that this medication may interfere with the absorption of other oral medications. If you are taking other medications by mouth, consult your doctor about the best schedule for taking them in relation to this medication.
Before using the liquid form of this medication, shake the bottle well. Measure your dose carefully using the measuring device provided with the medication. If no device is included, ask your pharmacist for a suitable measuring tool.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding storage in a bathroom.
Missing a Dose
Since this medication is taken as needed, do not take it more frequently than directed by your doctor. If you have questions about your dosing schedule, consult your healthcare provider.
Lifestyle & Tips
- Drink plenty of fluids (water, clear broths) when using as a laxative to help prevent dehydration and improve effectiveness.
- Maintain a balanced diet rich in fiber (fruits, vegetables, whole grains) to help prevent constipation.
- Engage in regular physical activity to promote healthy bowel function.
- Avoid taking other medications within 2 hours before or after taking Milk of Magnesia, especially antibiotics (like tetracyclines or fluoroquinolones), iron supplements, or thyroid hormones, as it can interfere with their absorption.
- Do not use for more than 7 days for constipation or 14 days for antacid use without consulting a doctor.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Antacid: 5-15 mL (400-1200 mg) orally as needed, up to 4 times daily. Laxative: 30-60 mL (2400-4800 mg) orally once daily or as directed.
Dose Range:
5 - 60 mg
Condition-Specific Dosing:
Antacid:
5-15 mL (400-1200 mg) orally as needed, up to 4 times daily.
Laxative:
30-60 mL (2400-4800 mg) orally once daily or as directed.
Pediatric Dosing
Neonatal:
Not established (use with extreme caution, risk of hypermagnesemia)
Infant:
Not established (use with extreme caution, risk of hypermagnesemia)
Child:
Antacid (2-5 years): 5 mL (400 mg) orally as needed, up to 4 times daily. Antacid (6-11 years): 5-15 mL (400-1200 mg) orally as needed, up to 4 times daily. Laxative (6-11 years): 15-30 mL (1200-2400 mg) orally once daily or as directed.
Adolescent:
Antacid (12+ years): 5-15 mL (400-1200 mg) orally as needed, up to 4 times daily. Laxative (12+ years): 30-60 mL (2400-4800 mg) orally once daily or as directed.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor for hypermagnesemia.
Moderate:
Avoid use or use with extreme caution at reduced doses; monitor serum magnesium levels closely.
Severe:
Contraindicated due to high risk of hypermagnesemia.
Dialysis:
Contraindicated.
Hepatic Impairment:
Mild:
No specific adjustment needed.
Moderate:
No specific adjustment needed.
Severe:
No specific adjustment needed.
Pharmacology
Mechanism of Action
As an antacid, magnesium hydroxide neutralizes gastric acid by reacting with hydrochloric acid in the stomach to form magnesium chloride and water, thereby increasing gastric pH. As a laxative, it acts as an osmotic agent, drawing water into the intestinal lumen from surrounding tissues. This increases the fluid content of the stool, distends the bowel, and promotes peristalsis and evacuation.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 15-30% of magnesium ions are absorbed systemically from the GI tract, depending on dose and individual factors. The majority remains unabsorbed.
Tmax:
Antacid effect: immediate. Laxative effect: 0.5-6 hours.
FoodEffect:
Food may slightly delay gastric emptying, but does not significantly alter the overall effect for antacid or laxative use.
Distribution:
Vd:
Not applicable for primary action; absorbed magnesium distributes throughout the body, primarily in bone (50-60%), muscle, and soft tissues.
ProteinBinding:
Approximately 30% of absorbed magnesium is protein-bound.
CnssPenetration:
Limited under normal conditions; can cross blood-brain barrier in hypermagnesemia.
Elimination:
HalfLife:
Not applicable for primary action; absorbed magnesium has a half-life of approximately 2-6 hours in individuals with normal renal function.
Clearance:
Primarily renal for absorbed magnesium.
ExcretionRoute:
Unabsorbed magnesium is excreted in feces. Absorbed magnesium is excreted renally.
Unchanged:
Virtually 100% of the drug itself is excreted unchanged (either unabsorbed in feces or absorbed and excreted renally).
Pharmacodynamics
OnsetOfAction:
Antacid: within minutes. Laxative: 0.5 to 6 hours.
PeakEffect:
Antacid: within 30 minutes. Laxative: 2-8 hours.
DurationOfAction:
Antacid: 1-3 hours. Laxative: variable, depending on individual response and dose.
Safety & Warnings
Side Effects
Serious Side Effects: Seek Medical Attention Immediately
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 medical help right away:
- 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, or 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. Contact your doctor or seek medical help if you experience:
- Diarrhea
or any other side effects that bother you or do not go away.
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, consult your doctor. For medical advice about side effects, contact your doctor. You can also 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 medical help right away:
- 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, or 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. Contact your doctor or seek medical help if you experience:
- Diarrhea
or any other side effects that bother you or do not go away.
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, consult your doctor. For medical advice about side effects, contact your doctor. You can also 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 abdominal pain, cramping, or nausea/vomiting (stop use and consult doctor)
- Rectal bleeding or failure to have a bowel movement after laxative use (stop use and consult doctor)
- Symptoms of too much magnesium (hypermagnesemia): unusual tiredness, muscle weakness, slow heartbeat, dizziness, confusion, or difficulty breathing (seek immediate medical attention)
- Allergic reaction symptoms: rash, itching/swelling (especially of face/tongue/throat), severe dizziness, trouble breathing (seek immediate medical attention)
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 allergic reaction and its symptoms.
Certain health conditions, including:
+ Bowel obstruction or blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
Kidney disease or any other kidney problems
This list is not exhaustive, and it is crucial to discuss all your health conditions and medications with your doctor.
To ensure your safety, tell your doctor and pharmacist about:
All prescription and over-the-counter medications you are taking
Any natural products or vitamins you are using
All your health problems
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to confirm it is safe for you to do so.
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 allergic reaction and its symptoms.
Certain health conditions, including:
+ Bowel obstruction or blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
Kidney disease or any other kidney problems
This list is not exhaustive, and it is crucial to discuss all your health conditions and medications with your doctor.
To ensure your safety, tell your doctor and pharmacist about:
All prescription and over-the-counter medications you are taking
Any natural products or vitamins you are using
All your health problems
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to confirm it is safe for you to do so.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. If you are following a low-magnesium diet, consult with your doctor to discuss any potential interactions. Do not use this medication for more than 7 days unless specifically instructed to do so by your doctor. If you experience rectal bleeding or do not have a bowel movement after using this medication, promptly consult with your doctor. Additionally, if you are pregnant, planning to become pregnant, or are breast-feeding, inform your doctor to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe diarrhea
- Abdominal cramping
- Nausea, vomiting
- Muscle weakness
- Lethargy, drowsiness, confusion
- Hypotension (low blood pressure)
- Bradycardia (slow heart rate)
- Respiratory depression (slow, shallow breathing)
- Coma
- Cardiac arrest
What to Do:
Discontinue use immediately. For severe symptoms, seek emergency medical attention. Treatment may involve intravenous fluids, calcium gluconate (to antagonize magnesium effects), and in severe cases, dialysis. Call 1-800-222-1222 (Poison Control).
Drug Interactions
Contraindicated Interactions
- Sodium Polystyrene Sulfonate (Kayexalate) - risk of intestinal necrosis
- Patiromer - binds to magnesium, reducing its 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 - reduced absorption of digoxin
- Mycophenolate - reduced absorption of mycophenolate
Moderate Interactions
- Iron supplements - reduced absorption of iron
- Azithromycin - reduced absorption of azithromycin
- Gabapentin - reduced absorption of gabapentin
- H2-receptor antagonists (e.g., cimetidine, ranitidine) - may alter absorption of other drugs due to pH changes
- Proton pump inhibitors (e.g., omeprazole, pantoprazole) - may alter absorption of other drugs due to pH changes
- Drugs that prolong QT interval (in patients with renal impairment or hypermagnesemia risk)
Minor Interactions
- Salicylates (e.g., aspirin) - increased excretion of salicylates due to urine alkalinization
- Sulfonylureas - may enhance hypoglycemic effect (rare)
Monitoring
Baseline Monitoring
Renal function (e.g., serum creatinine, eGFR)
Rationale: Magnesium is renally excreted; impaired renal function increases risk of hypermagnesemia.
Timing: Prior to initiation, especially in elderly or those with known renal issues.
Electrolyte levels (serum magnesium)
Rationale: To establish baseline and identify pre-existing imbalances, especially if prolonged use or renal impairment is anticipated.
Timing: Prior to initiation in high-risk patients.
Routine Monitoring
Bowel movements and consistency
Frequency: Daily, during use as a laxative.
Target: Soft, formed stool; 1-3 bowel movements per day.
Action Threshold: Excessive diarrhea (more than 3-4 loose stools/day) or no bowel movement after 6 hours (for laxative use).
Symptoms of hypermagnesemia (e.g., muscle weakness, lethargy, nausea, vomiting, hypotension, bradycardia, respiratory depression)
Frequency: Daily, especially in patients with renal impairment or prolonged use.
Target: Absence of symptoms.
Action Threshold: Presence of any symptoms; serum magnesium > 2.5 mEq/L (3.0 mg/dL).
Serum magnesium levels
Frequency: As clinically indicated, especially with prolonged use, high doses, or impaired renal function.
Target: 1.5-2.5 mEq/L (1.8-3.0 mg/dL).
Action Threshold: Levels > 2.5 mEq/L (3.0 mg/dL) or rising trends.
Symptom Monitoring
- Abdominal pain or cramping
- Diarrhea (excessive or persistent)
- Nausea and vomiting
- Muscle weakness
- Lethargy or drowsiness
- Dizziness
- Irregular heartbeat
- Difficulty breathing
- Decreased urine output
Special Patient Groups
Pregnancy
Generally considered safe for occasional use during pregnancy as an antacid or laxative, as systemic absorption of magnesium is limited. However, prolonged or high-dose use should be avoided due to potential for systemic magnesium accumulation and electrolyte imbalance in the mother and fetus. Always consult a healthcare provider.
Trimester-Specific Risks:
First Trimester:
Low risk with occasional use.
Second Trimester:
Low risk with occasional use.
Third Trimester:
Low risk with occasional use, but caution with prolonged use due to potential for hypermagnesemia in mother and fetus, especially near term.
Lactation
Considered compatible with breastfeeding. Magnesium is a normal component of breast milk, and the amount transferred from occasional maternal use is not expected to cause adverse effects in the infant.
Infant Risk:
Low risk (L1).
Pediatric Use
Use with caution, especially in infants and young children, due to increased risk of dehydration and electrolyte imbalances (hypermagnesemia). Dosing must be age-appropriate and strictly adhered to. Not recommended for children under 2 years without physician consultation.
Geriatric Use
Use with caution due to increased likelihood of impaired renal function, which can lead to magnesium accumulation and hypermagnesemia. Start with lower doses and monitor for adverse effects and electrolyte imbalances. May also be more susceptible to dehydration with laxative use.
Clinical Information
Clinical Pearls
- Shake the suspension well before each use to ensure uniform dosing.
- Measure doses accurately using a dosing cup or spoon, not a household spoon.
- For laxative effect, take with a full glass of water to enhance osmotic action and prevent dehydration.
- Do not use as a laxative for more than 7 days or as an antacid for more than 14 days without consulting a doctor.
- Advise patients to separate administration from other medications by at least 2 hours to minimize drug interactions.
- Educate patients on symptoms of hypermagnesemia, especially those with kidney disease or who are taking other magnesium-containing products.
Alternative Therapies
- For Antacid: Calcium carbonate, Aluminum hydroxide, Sodium bicarbonate, H2-receptor antagonists (e.g., famotidine), Proton pump inhibitors (e.g., omeprazole).
- For Laxative: Bulk-forming laxatives (e.g., psyllium, methylcellulose), Stool softeners (e.g., docusate sodium), Stimulant laxatives (e.g., bisacodyl, senna), Polyethylene glycol (PEG) 3350.
Cost & Coverage
Average Cost:
Varies widely, typically $3-$15 per 355 mL (12 fl oz) bottle
Generic Available:
Yes
Insurance Coverage:
Not typically covered by prescription insurance as it is an OTC product. May be eligible for 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 an additional patient information leaflet, so be sure to check with your pharmacist for more information. 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 emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.