Milk Of Magnesia Suspension 355ml
It is used to treat constipation.It is used to treat heartburn and upset stomach.
Drug Class
Laxative; Antacid
Pharmacologic Class
Osmotic Laxative; Antacid (Neutralizing 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, or to relieve heartburn and indigestion by neutralizing stomach acid. It works by drawing water into your intestines to soften stool or by reducing stomach acid.
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.
When taking this medication, swallow it with a full glass of water. It's essential to note that this medication may interfere with the absorption of other oral medications. If you take other medications by mouth, you may need to take them at a different time than this medication. Consult with your doctor to determine the best schedule for your medications.
Before using the liquid form of this medication, shake the bottle well. Measure the liquid dose carefully using the measuring device provided with the medication. If a measuring device is not included, ask your pharmacist for one to ensure accurate dosing.
Storing and Disposing of Your Medication
Store this 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 any questions or concerns about taking your medication, consult with your doctor or pharmacist for guidance.
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.
When taking this medication, swallow it with a full glass of water. It's essential to note that this medication may interfere with the absorption of other oral medications. If you take other medications by mouth, you may need to take them at a different time than this medication. Consult with your doctor to determine the best schedule for your medications.
Before using the liquid form of this medication, shake the bottle well. Measure the liquid dose carefully using the measuring device provided with the medication. If a measuring device is not included, ask your pharmacist for one to ensure accurate dosing.
Storing and Disposing of Your Medication
Store this 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 any questions or concerns about taking your medication, consult with your doctor or pharmacist for guidance.
Lifestyle & Tips
- For constipation, increase fluid intake, eat a high-fiber diet, and engage in regular physical activity.
- For heartburn, avoid trigger foods (e.g., spicy, fatty, acidic foods, caffeine, alcohol), eat smaller meals, and avoid lying down immediately after eating.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Laxative: 30-60 mL (2400-4800 mg) orally once daily; Antacid: 5-15 mL (400-1200 mg) orally as needed, up to 4 times daily
Dose Range:
5 - 60 mg
Condition-Specific Dosing:
constipation:
30-60 mL orally once daily
heartburn_indigestion:
5-15 mL orally as needed, up to 4 times daily
Pediatric Dosing
Neonatal:
Not established
Infant:
Laxative (1-2 years): 5-10 mL orally once daily
Child:
Laxative (2-5 years): 10-15 mL orally once daily; (6-11 years): 15-30 mL orally once daily
Adolescent:
Laxative (12+ years): 30-60 mL orally once daily; Antacid (12+ years): 5-15 mL orally as needed, up to 4 times daily
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor for hypermagnesemia
Moderate:
Avoid or use with extreme caution; significant risk of hypermagnesemia
Severe:
Contraindicated due to high risk of hypermagnesemia
Dialysis:
Contraindicated due to high risk of hypermagnesemia
Hepatic Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed
Pharmacology
Mechanism of Action
As a laxative, magnesium hydroxide exerts an osmotic effect, drawing water into the intestinal lumen, which causes distention and promotes peristalsis. As an antacid, it neutralizes gastric acid by reacting with hydrochloric acid in the stomach to form magnesium chloride and water, thereby increasing gastric pH.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 15-30% of magnesium ions are absorbed from the GI tract; absorption increases with higher doses or impaired renal function.
Tmax:
Not well-defined for laxative effect (variable); Antacid effect is immediate.
FoodEffect:
Food may delay gastric emptying, potentially prolonging antacid effect.
Distribution:
Vd:
Not specifically quantified for magnesium hydroxide; absorbed magnesium is widely distributed in bone, muscle, and soft tissues.
ProteinBinding:
Approximately 30% of absorbed magnesium is protein-bound.
CnssPenetration:
Limited under normal conditions; increased with hypermagnesemia.
Elimination:
HalfLife:
Not applicable for unabsorbed drug; absorbed magnesium has a half-life of approximately 2-6 hours in individuals with normal renal function.
Clearance:
Primarily renal clearance for absorbed magnesium.
ExcretionRoute:
Unabsorbed drug excreted in feces; absorbed magnesium excreted renally.
Unchanged:
Nearly 100% of unabsorbed drug is excreted unchanged in feces.
Pharmacodynamics
OnsetOfAction:
Laxative: 30 minutes to 6 hours; Antacid: Immediate
PeakEffect:
Laxative: 2-8 hours; Antacid: Within minutes
DurationOfAction:
Laxative: Variable; Antacid: 30 minutes to 3 hours (depending on gastric emptying)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
If you experience any of the following symptoms, call your doctor or seek medical help immediately, as they may be signs of a severe and potentially life-threatening reaction:
- 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. Contact your doctor or seek medical help if you experience:
- Diarrhea
- Any other side effects that bother you or do not go away
Reporting Side Effects
This list is not exhaustive, and you may have questions about side effects. If so, 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.
If you experience any of the following symptoms, call your doctor or seek medical help immediately, as they may be signs of a severe and potentially life-threatening reaction:
- 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. Contact your doctor or seek medical help if you experience:
- Diarrhea
- Any other side effects that bother you or do not go away
Reporting Side Effects
This list is not exhaustive, and you may have questions about side effects. If so, 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
- Rectal bleeding
- No bowel movement after using for constipation (within 6 hours)
- Symptoms of hypermagnesemia (dizziness, unusual tiredness or weakness, slow heartbeat, muscle weakness, nausea, vomiting)
- Symptoms of appendicitis or bowel obstruction (e.g., severe abdominal pain, nausea, vomiting, fever)
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.
Certain health conditions, including:
+ Bowel blockage or obstruction
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that have lasted for more than 2 weeks
Kidney disease or any history of kidney problems
This list is not exhaustive, and it is crucial to discuss all your medications, health conditions, and concerns 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
Natural products and supplements
Vitamins
Your doctor will help you determine whether it is safe to take this medication with your existing medications and health conditions. Do not start, stop, or modify the dosage of any medication without first consulting 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.
Certain health conditions, including:
+ Bowel blockage or obstruction
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that have lasted for more than 2 weeks
Kidney disease or any history of kidney problems
This list is not exhaustive, and it is crucial to discuss all your medications, health conditions, and concerns 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
Natural products and supplements
Vitamins
Your doctor will help you determine whether it is safe to take this medication with your existing medications and health conditions. Do not start, stop, or modify the dosage of any medication without first consulting your doctor.
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:
- Nausea
- Vomiting
- Diarrhea
- Muscle weakness
- Lethargy
- Dizziness
- Hypotension (low blood pressure)
- Bradycardia (slow heart rate)
- Respiratory depression
- Coma
What to Do:
Discontinue use immediately. For severe hypermagnesemia, intravenous calcium gluconate may be administered to antagonize magnesium effects. Support blood pressure and respiration. Forced diuresis with intravenous fluids may be used if renal function is adequate. Hemodialysis may be necessary in severe cases, especially with renal impairment. Call 1-800-222-1222 (Poison Control).
Drug Interactions
Contraindicated Interactions
- Sodium Polystyrene Sulfonate (risk of metabolic alkalosis and colonic necrosis)
Major Interactions
- Digoxin (decreased absorption)
- Mycophenolate (decreased absorption)
Moderate Interactions
- Tetracyclines (e.g., Doxycycline, Minocycline - decreased absorption due to chelation)
- Fluoroquinolones (e.g., Ciprofloxacin, Levofloxacin - decreased absorption due to chelation)
- Bisphosphonates (e.g., Alendronate - decreased absorption)
- Thyroid hormones (e.g., Levothyroxine - decreased absorption)
- Iron salts (decreased absorption)
- Azithromycin (decreased absorption)
- Gabapentin (decreased absorption)
- H2-receptor antagonists (e.g., Famotidine, Ranitidine - altered absorption due to increased gastric pH)
- Proton pump inhibitors (e.g., Omeprazole, Pantoprazole - altered absorption due to increased gastric pH)
- Salicylates (increased excretion due to urine alkalinization)
Minor Interactions
- Enteric-coated medications (premature dissolution)
Monitoring
Baseline Monitoring
Renal function (Creatinine, GFR)
Rationale: To assess risk of hypermagnesemia, especially in elderly or those with pre-existing renal impairment, if prolonged use is anticipated.
Timing: Before initiating prolonged therapy or in at-risk patients.
Routine Monitoring
Bowel movements and consistency
Frequency: Daily during laxative use
Target: Regular, soft stools
Action Threshold: No bowel movement after 6 hours (for laxative use) or persistent diarrhea.
Symptoms of hypermagnesemia (e.g., muscle weakness, lethargy, nausea, vomiting, hypotension, bradycardia)
Frequency: Periodically, especially with prolonged use or renal impairment
Target: Absence of symptoms
Action Threshold: Presence of any symptoms; consider serum magnesium level if severe or persistent.
Symptom Monitoring
- Abdominal pain
- Nausea
- Vomiting
- Diarrhea
- Muscle weakness
- Lethargy
- Dizziness
- Slow heart rate
- Difficulty breathing (in severe hypermagnesemia)
Special Patient Groups
Pregnancy
Generally considered safe for occasional use during pregnancy for constipation or heartburn, but prolonged or high doses should be avoided due to potential for electrolyte imbalance in the mother and fetus. 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; however, prolonged use near term could theoretically affect fetal magnesium levels.
Lactation
Considered safe for use during lactation. Magnesium is a normal component of breast milk, and the amount transferred from typical doses is not expected to harm the infant.
Infant Risk:
Low risk (L1)
Pediatric Use
Use with caution, especially in infants and young children, due to increased risk of electrolyte imbalances (e.g., hypermagnesemia, dehydration) with overdose or prolonged use. Dosing must be age-appropriate and carefully measured. Not recommended for children under 2 years without physician consultation.
Geriatric Use
Use with caution due to age-related decline in renal function, which increases the risk of hypermagnesemia. Start with lower doses and monitor for signs of magnesium toxicity. May also be more susceptible to fluid and electrolyte imbalances.
Clinical Information
Clinical Pearls
- Shake the bottle well before each use to ensure uniform suspension.
- Not intended for long-term daily use; prolonged use can lead to dependence or electrolyte imbalances.
- Ensure adequate fluid intake when using as a laxative to prevent dehydration and aid effectiveness.
- Can cause diarrhea, especially at higher doses. Reduce dose if diarrhea occurs.
- Separate administration from other medications by at least 2-4 hours to minimize drug interactions.
Alternative Therapies
- For constipation: Polyethylene glycol (MiraLAX), Docusate sodium (Colace), Senna, Bisacodyl, Fiber supplements (Psyllium, Methylcellulose).
- For antacid: Calcium Carbonate (Tums), Aluminum Hydroxide (Amphojel), H2-receptor antagonists (Famotidine, Ranitidine), Proton Pump Inhibitors (Omeprazole, Pantoprazole).
Cost & Coverage
Average Cost:
Typically $5-$15 per 355ml bottle
Generic Available:
Yes
Insurance Coverage:
Generally not covered by prescription plans as it is an over-the-counter (OTC) medication; 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 this 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 details about the medication, including the amount taken and the time it happened, to facilitate prompt and effective treatment.