Milk Of Magnesia Suspension 473ml
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?
Magnesium Hydroxide is an over-the-counter medicine used in two main ways: as an antacid to relieve heartburn, sour stomach, or indigestion, and as a laxative to treat occasional constipation. As an antacid, it works by neutralizing stomach acid. As a laxative, it works by drawing water into your intestines to help soften stool and promote a bowel movement.
How to Use This Medicine
Taking Your Medication Correctly
To use this medication safely and effectively, follow your doctor's instructions and read all accompanying information carefully. Take your medication as directed, and be sure to:
Swallow it with a full glass of water
Note that this medication may interfere with the absorption of other oral medications. If you take other medications by mouth, consult your doctor about the best timing for taking them in relation to this medication
Shake the liquid form well before use
Measure liquid doses accurately using the provided measuring device or ask your pharmacist for a suitable device if one is not included
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication:
Store it at room temperature in a dry location
Avoid storing it in a bathroom
Missing a Dose
Since this medication is taken as needed, do not take it more frequently than prescribed by your doctor. If you have any questions or concerns about your medication schedule, consult your doctor for guidance.
To use this medication safely and effectively, follow your doctor's instructions and read all accompanying information carefully. Take your medication as directed, and be sure to:
Swallow it with a full glass of water
Note that this medication may interfere with the absorption of other oral medications. If you take other medications by mouth, consult your doctor about the best timing for taking them in relation to this medication
Shake the liquid form well before use
Measure liquid doses accurately using the provided measuring device or ask your pharmacist for a suitable device if one is not included
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication:
Store it at room temperature in a dry location
Avoid storing it in a bathroom
Missing a Dose
Since this medication is taken as needed, do not take it more frequently than prescribed by your doctor. If you have any questions or concerns about your medication schedule, consult your doctor for guidance.
Lifestyle & Tips
- Drink plenty of fluids (water, juices) when using as a laxative to prevent dehydration and aid its effect.
- Maintain a balanced diet rich in fiber to help prevent constipation.
- Engage in regular physical activity to promote healthy bowel function.
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 in divided doses.
Dose Range:
5 - 60 mg
Condition-Specific Dosing:
antacid:
5-15 mL
laxative:
30-60 mL
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): 2.5-5 mL; Antacid (6-11 years): 5-15 mL. Laxative (2-5 years): 5-15 mL; Laxative (6-11 years): 15-30 mL. All doses orally, once daily or as directed by physician.
Adolescent:
Antacid (12+ years): 5-15 mL; Laxative (12+ years): 30-60 mL. Orally, once daily or as directed by physician.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor for hypermagnesemia.
Moderate:
Avoid use or use with extreme caution at reduced doses; monitor magnesium levels closely.
Severe:
Contraindicated due to high risk of hypermagnesemia.
Dialysis:
Contraindicated due to high risk of hypermagnesemia.
Hepatic Impairment:
Mild:
No specific adjustment needed.
Moderate:
No specific adjustment needed.
Severe:
No specific adjustment needed, unless co-existing renal impairment is present.
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, which distends the bowel, increases peristalsis, and promotes evacuation of the bowel.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal (approximately 15-30% of magnesium is absorbed from the GI tract, primarily for antacid effect; less for laxative effect as it acts locally).
Tmax:
Antacid: Rapid onset (minutes). Laxative: 0.5-6 hours.
FoodEffect:
May slightly delay onset of antacid action if taken with food, but generally not significant.
Distribution:
Vd:
Not widely distributed as it acts primarily in the GI tract. Absorbed magnesium is distributed 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; increased in hypermagnesemia.
Elimination:
HalfLife:
Not applicable (acts locally). Absorbed magnesium has a half-life of approximately 2-6 hours.
Clearance:
Renal clearance for absorbed magnesium.
ExcretionRoute:
Unabsorbed portion excreted in feces. Absorbed portion excreted renally.
Unchanged:
Nearly 100% (unabsorbed portion).
Pharmacodynamics
OnsetOfAction:
Antacid: Within minutes. Laxative: 0.5-6 hours.
PeakEffect:
Antacid: Within 30 minutes. Laxative: 2-8 hours.
DurationOfAction:
Antacid: 1-3 hours. Laxative: Variable, typically 6-12 hours.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice 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. Although many people may not experience any side effects or only minor ones, it's essential to monitor your body's response. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for guidance:
Diarrhea
Important Note
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, don't hesitate to reach out to your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor is available to provide medical advice about side effects, so don't hesitate to contact them.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice 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. Although many people may not experience any side effects or only minor ones, it's essential to monitor your body's response. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for guidance:
Diarrhea
Important Note
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, don't hesitate to reach out to your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor is available to provide medical advice about side effects, so don't hesitate to contact them.
Seek Immediate Medical Attention If You Experience:
- Severe abdominal pain or cramping
- Rectal bleeding
- Failure to have a bowel movement after using as a laxative
- Signs of dehydration (e.g., extreme thirst, decreased urination, dizziness)
- Symptoms of too much magnesium (e.g., unusual tiredness, muscle weakness, slow heartbeat, lightheadedness)
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 health problems that may affect your ability to take this medication
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication with your existing health conditions and other medications. Never start, stop, or change the dose of any medication without consulting your doctor first.
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 health problems that may affect your ability to take this medication
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication with your existing health conditions and other medications. Never start, stop, or change the dose of any medication without consulting your doctor first.
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 1 week without explicit instruction from 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, plan 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
- Dehydration
- Abdominal cramping
- Nausea
- Vomiting
- Hypermagnesemia (symptoms include muscle weakness, lethargy, confusion, hypotension, bradycardia, respiratory depression, coma, cardiac arrest)
What to Do:
Discontinue use immediately. For mild symptoms, increase fluid intake. For severe symptoms or suspected hypermagnesemia, seek immediate medical attention. Call 911 or Poison Control (1-800-222-1222).
Drug Interactions
Major Interactions
- Sodium Polystyrene Sulfonate (Kayexalate) - risk of metabolic alkalosis and colonic necrosis.
- Bisphosphonates (e.g., Alendronate) - reduced absorption of bisphosphonate.
Moderate Interactions
- Tetracyclines (e.g., Doxycycline) - reduced absorption of tetracycline.
- Fluoroquinolones (e.g., Ciprofloxacin) - reduced absorption of fluoroquinolone.
- Iron supplements - reduced absorption of iron.
- Thyroid hormones (e.g., Levothyroxine) - reduced absorption of thyroid hormone.
- Mycophenolate - reduced absorption of mycophenolate.
- Digoxin - reduced absorption of digoxin.
- H2-receptor antagonists (e.g., Ranitidine) - altered absorption due to pH change.
- Proton pump inhibitors (e.g., Omeprazole) - altered absorption due to pH change.
Minor Interactions
- Enteric-coated medications - premature dissolution of coating.
Monitoring
Routine Monitoring
Bowel movements (for laxative use)
Frequency: Daily during 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, hypotension, bradycardia, respiratory depression)
Frequency: Daily, especially in patients with renal impairment or prolonged use
Target: Absence of symptoms
Action Threshold: Presence of any symptom of hypermagnesemia.
Electrolyte levels (Magnesium, Calcium, Potassium)
Frequency: Periodically, if used chronically or in patients with renal impairment
Target: Magnesium: 1.7-2.2 mg/dL
Action Threshold: Magnesium > 2.5 mg/dL or significant electrolyte imbalance.
Symptom Monitoring
- Abdominal pain or cramping
- Diarrhea
- Nausea
- Vomiting
- Muscle weakness
- Lethargy
- Dizziness
- Lightheadedness
- Irregular heartbeat
- Difficulty breathing
Special Patient Groups
Pregnancy
Generally considered safe for occasional use during pregnancy as an antacid or laxative. Minimal systemic absorption. Consult a healthcare provider before use.
Trimester-Specific Risks:
First Trimester:
Low risk.
Second Trimester:
Low risk.
Third Trimester:
Low risk, but prolonged or high-dose use should be avoided due to theoretical risk of hypermagnesemia in the fetus/neonate.
Lactation
Considered compatible with breastfeeding. Magnesium is a normal component of breast milk, and systemic absorption by the mother is minimal, leading to negligible transfer to breast milk. Infant exposure is very low.
Infant Risk:
Low risk (L1).
Pediatric Use
Use with caution, especially in infants and young children, due to increased risk of dehydration and electrolyte imbalance (hypermagnesemia). Dosing must be age-appropriate and strictly followed. Not recommended for children under 2 years without physician consultation.
Geriatric Use
Use with caution, especially in patients with impaired renal function, due to increased risk of hypermagnesemia. Start with lower doses and monitor for adverse effects. May be more susceptible to dehydration.
Clinical Information
Clinical Pearls
- Shake the suspension well before each use to ensure uniform dosing.
- For laxative effect, take with a full glass of water to enhance osmotic action and prevent dehydration.
- Avoid taking other medications within 2 hours before or after magnesium hydroxide to prevent absorption interference.
- Not intended for long-term daily use as a laxative; prolonged use can lead to laxative dependence and electrolyte imbalances.
- Patients with kidney disease should avoid magnesium hydroxide unless specifically advised by a doctor due to the risk of magnesium accumulation.
Alternative Therapies
- For antacid: Calcium carbonate, Aluminum hydroxide, H2-receptor antagonists (e.g., Famotidine), Proton pump inhibitors (e.g., Omeprazole).
- For laxative: Psyllium (bulk-forming), Docusate sodium (stool softener), Polyethylene glycol (osmotic), Bisacodyl (stimulant).
Cost & Coverage
Average Cost:
$5 - $15 per 473ml bottle
Generic Available:
Yes
Insurance Coverage:
Generally OTC, not typically covered by insurance unless prescribed.
General Drug Facts
If your symptoms or health issues persist or worsen, it is 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 it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with 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 information about the medication taken, the amount, and the time it happened.