Magnesium Carbonate; Uses, Dosage, Effects, Interactions

Magnesium Carbonate; Uses, Dosage, Effects, Interactions

Magnesium carbonate also is known as magnesite, is a common over the counter remedy for heartburn and upset stomach caused by overproduction of acid in the stomach.
MAGNESITE is a white, yellowish, grayish-white or brown crystalline solid or crystalline powder. Density: 3-3.1 g cm-3. An important ore for magnesium. Used in the manufacture of materials capable of withstanding very high temperatures. Sometimes used to produce carbon dioxide.
Magnesium carbonate is a magnesium salt with formula CMgO3. Its hydrated forms, particularly the di-, tri-, and tetrahydrates occur as minerals. It has a role as an antacid and a fertilizer. It is a magnesium salt, a carbonate salt, and a one-carbon compound.
Magnesium citrate is a low volume and osmotic cathartic agent. The cathartic action works primarily through the high osmolarity of the solution which draws large amounts of fluid into space where is used.[5] Magnesium citrate is considered by the FDA as an approved inactive ingredient for approved drug products under the specifications of oral administration of a maximum concentration of 237 mg.[7] It is also considered an active ingredient in over-the-counter products.[6]

Mechanism of Action of Magnesium Carbonate

Magnesium carbonate reacts with hydrochloric acid in the stomach to form carbon dioxide and magnesium chloride thus neutralizing excess acid in the stomach
or
It mainly works through its property of high osmolality which will draw large amounts of fluid into the colonic lumen. There is also a possible stimulation of fluid excretion by cholecystokinin release and activation of muscle peristalsis.

Indications of Magnesium Carbonate

  • Used as an over the counter antacid
  •  Magnesium citrate has been used in bowel preparations prior to a colonoscopy as a cathartic agent.[5]
  • It is also used in over-the-counter products to relieve occasional constipation.[8]
  • Magnesium citrate can be one of the forms used for the administration of dietary supplements.[9]
  • Heartburn
  • Acid indigestion
  • Sour stomach
  • Upset stomach due to these symptoms
  • Pressure and bloating commonly referred to as gas
  • Acid reflux, which can include regurgitation, bitter taste, persistent dry cough, pain when you lie down, and trouble swallowing
  • Heartburn which is a burning sensation in your chest or throat caused by acid reflux
  • Indigestion, which is a pain in your upper gut that can feel like gas or bloating
  • Antacids are available over the counter and are taken by mouth to quickly relieve occasional heartburn,
  • The major symptom of gastroesophageal reflux disease and also indigestion.
  • Treatment with antacids alone is symptomatic and only justified for minor symptoms.

Therapeutic Uses of Magnesium Carbonate

  • Exptl Ther Aluminium-containing phosphate binders were replaced by a calcium and magnesium carbonate-containing antacid in 20 patients on long-term hemodialysis, over a three-month period in all of them, for 12 months in ten. After two months the serum aluminium level fell (mean +/- SD) from 3.0 +/- 1.6 to 1.4 +/- 0.5 mmol/l (P less than 0.001). After three months the serum phosphate level had fallen from 1.8 +/- 0.4 to 1.5 +/- 0.4 mmol/l (P<0.05), while during the same period parathormone (PTH-NH2) fell from 1.4 +/- 1.4 to 0.8 +/- 0.7 ng/ml (P<0.05).
  • Serum total calcium concentration rose after two months from 2.2 +/- 0.2 to 2.4 +/- 0.2 mmol/l (P<0.001). In a third of patients, the uraemic acidosis was corrected, standard bicarbonate rising from 18 +/- 2 to 21 +/- 3 mmol/l (P<0.05). Serum pH, potassiumsodiummagnesium and alkaline phosphatase did not change significantly. Hypercalcemia was an expected disadvantage: repeated symptom-free episodes of hypercalcemia occurred in six of 20 patients during the first three months and in a further two up to 12 months. These episodes were successfully controlled by a reduction of CaCO3/MgCO3 dosage and administration of Al(OH)3. Extraosseous calcifications were not observed.
  • Recovery from Mg deficiency was studied in adult Wistar rats fed a semisynthetic diet containing 0.04% Mg in the form of magnesium carbonate.
  • Daily administration of a diet containing recommended levels of calcium carbonate to Mg-deficient rats led to the recovery, within the first seven days of treatment, of normal values in most of the parameters studied: gain in weight/day and Mg retention and content in the Longissimus dorsi muscle and femur.
  • Mg levels in whole blood, however, did not fully recover until the second week of treatment. Net Ca absorption (ADC) and the balance was significantly higher in Mg-deficient rats than in controls and remained elevated although to a lesser extent in the femur. Longissimus dorsi muscle, blood, and plasma were unchanged by Mg deficiency.
  • To avoid the use of aluminum as a phosphate binder, patients on CAPD who were stable were dialyzed against a peritoneal dialysis fluid which was magnesium free. A mixture of calcium and magnesium carbonate was used as a phosphate binder over a period in excess of 1 yr.
  • Vitamin D analogs were used in the majority. Results show satisfactory control of hyperparathyroidism with mean parathyroid hormone concentration for the group of 121 pg/ml (normal <100 pg/ml), calcium concentration of 2.41 mmol/l, magnesium 0.97 mmol/l, phosphate 1.36 mmol/l and aluminium 0.35 mmol/l (normal <0.2 mmol/l). These results were as good as and better in some respects than a minority using calcium carbonate alone or remaining on aluminum hydroxide, the latter remaining on Mg-containing CAPD fluid.
  • The present study deals with the protective effect of a pretreatment period with antacids (preparation A = gastropub it 50; 1 bag with suspension corresponding to 12.5 g contains: 1 g attapulgite, 1.8 g aluminum hydroxide-magnesium carbonate gel and 0.7 g sorbitol. Reference preparation B = commercial product; 1 bag with suspension corresponding to 10 ml contains 600 mg magnesium hydroxide and 9 g aluminum hydroxide gel) on the acute acetylsalicylic acid(ASA)-induced lesions of gastric mucosa in man. 8 healthy volunteers received in a double-blind crossover design 1 or 2 bags of the antacids or placebo 15 min prior to 1500 mg …ASA /orally/. Endoscopy was performed 2 hr later.
  • In the placebo experiments ASA caused severe lesions in all volunteers (placebo values, study with preparation A: 2.9 +/- 0.1; study with preparation B: 2.8 +/- 0.2). Pretreatment with either one bag reduced the ASA-injuries to 2.2 +/- 0.3 (preparation A) and 2.1 +/- 0.3 (preparation B) (not significant compared with placebo). By contrast, a significant protection of human gastric mucosa against ASA could be achieved with 2 bags of preparation A, but not with 2 bags of preparation B (1.5 +/- 0.3, p<0.05; 1.9 +/- 0.3, p<0.05).The majority of the volunteers reported less discomfort evoked by ASA under the higher antacid doses.
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Contra-Indications of Magnesium Carbonate

  • Kidney disease with a reduction in kidney function
  • Diarrhea
  • Low amount of phosphate in the blood
  • Hemorrhoids
  • Impacted Stool
  • Stomach or Intestine Blockage
  • Constipation
  • Aluminum Poisoning
  • Chronic Diarrhea
  • Chronic heart failure
  • Severe renal impairment
  • Visible Water Retention
  • Kidney Problems Causing a Decreased Amount of Urine to be Passed
  • The high amount of sodium in the blood
  • Allergy to following ingredients
  • Sodium Bicarbonate
  • Magnesium
  • Aluminum Containing Products
  • Alginic Acid

The Dosage of Magnesium Carbonate

  • Strengths: 54 mg/5 mL; 5%; 250 mg

Dietary Supplement

  • 250 to 1500 mg/day (equivalent to approximately 70 to 420 mg/day elemental magnesium) orally with meals.

Hypomagnesemia

  • 1000 mg (equivalent to approximately 280 mg elemental magnesium) orally four times a day with meals.
  • Magnesium carbonate is less absorbable than other forms of magnesium, thus it is not often used for the treatment of hypomagnesemia. Generally, magnesium gluconate or magnesium chloride is preferred for oral replacement therapy.

Dyspepsia

  • 10 mL (250 mg/5 mL suspension) orally every 3 to 4 hours as needed, not to exceed 40 mL/day.
  • Magnesium carbonate is indicated for the temporary relief of sour stomach, acid indigestion, and upset stomach associated with these symptoms.
  • Magnesium salts alone are generally not used for peptic ulcer because the higher dosages required to control ulcer pain often produce diarrhea as an adverse effect.

Hyperphosphatemia of Renal Failure

  • 250 mg orally three times a day with meals.

Dietary Supplement

  • 1 to 3 years: 250 mg/day (equivalent to approximately 70 mg/day elemental magnesium) orally with meals.
  • 4 to 8 years: 250 to 500 mg/day (equivalent to approximately 70 to 140 mg/day elemental magnesium) orally with meals.
  • 9 to 13 years: 250 to 750 mg/day (equivalent to approximately 70 to 210 mg/day elemental magnesium) orally with meals.
  • 14 to 18 years: 250 to 1500 mg/day (equivalent to approximately 70 to 420 mg/day elemental magnesium) orally with meals.
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Hypomagnesemia

  • 1 to 12 years: 35 to 70 mg/kg (equivalent to approximately 10 to 20 mg/kg elemental magnesium) orally four times a day with meals, up to 4000 mg/day.
  • >12 years: 1000 mg (equivalent to approximately 280 mg elemental magnesium) orally four times a day with meals.
  • Magnesium carbonate is less absorbable than other forms of magnesium, thus it is not often used for the treatment of hypomagnesemia. Generally, magnesium gluconate or magnesium chloride is preferred for oral replacement therapy.

Pediatric Dyspepsia

  • 6 to 12 years: 5 mL (250 mg/5 mL suspension) orally every 3 to 4 hours as needed, not to exceed 20 mL/day.
  • >12 years: 10 mL (250 mg/5 mL suspension) orally every 3 to 4 hours as needed, not to exceed 40 mL/day.
  • Magnesium carbonate is indicated for the temporary relief of sour stomach, acid indigestion, and upset stomach associated with these symptoms.
  • Magnesium salts alone are generally not used for peptic ulcer because the higher dosages required to control ulcer pain often produce diarrhea as an adverse effect.

Pediatric Dose for Hyperphosphatemia of Renal Failure

  • 250 mg orally three times a day with meals.

Side Effects of Magnesium Carbonate

The most common

 Common

Less common

Drug Interactions of Magnesium Carbonate

Magnesium carbonate may interact with following drugs, supplements, & may change the efficacy of the drug

  • This study investigated the in vitro adsorption of halofantrine (Hf) by some antacids. Magnesium carbonate showed the highest adsorptive effect, the extent of adsorption being up to 83%. Only 4% of Hf adsorbed by the antacid could be eluted with 0.1 M HCl while no detectable elution occurred with water.
  • Other antacids investigated were magnesium trisilicate and aluminum hydroxide and these had Hf-adsorption capacities of 23 and 43%, respectively. The effect of magnesium carbonate on the bioavailability of Hf was evaluated in seven healthy volunteers.
  • The subjects were administered with 500 mg oral dose of Hf-HCl or the same dose of the drug in combination with 1 g of magnesium carbonate, in a crossover fashion. Blood samples were collected at predetermined time intervals and were analyzed for Hf and its major metabolite, desbutylhalofantrine (Hfm), using the high-performance liquid chromatography method.
  • The results showed that magnesium carbonate significantly prolonged (P<0.05) the time to reach maximum plasma concentration (Tmax) of Hf. Also, the maximum plasma concentrations (Cmax) of Hf and Hfm were significantly reduced (P<0.05).
  • Furthermore, there were a reduction in the area under the curve (AUC) values of Hf and this was as high as 56% (range 1-56%). Results of this study suggest that it may not be advisable to concomitantly administer Hf with an antacid like magnesium carbonate.
  • The use of calcium carbonate (CaCO3) to bind phosphorus (P) in chronic hemodialysis patients has been a popular tactic in the past decade. Nonetheless, problems with hypercalcemia decrease its usefulness, particularly in patients treated with calcitriol. AP binder not containing calcium (Ca) would be of value in these circumstances.
  • In short-term studies, magnesium carbonate (MgCO3) was well-tolerated and controlled P and Mg levels when given in conjunction with a dialysate Mg of 0.6 mg/dl ,A prospective, randomized, crossover study /was performed/ to evaluate if the chronic use of MgCO3 would allow a reduction in the dose of CaCO3 and yet achieve acceptable levels of Ca, P, and Mg. We also assessed whether the lower dose of CaCO3 would facilitate the use of larger doses of calcitriol.
  • The two phases were MgCO3 plus half the usual dose of CaCO3 and CaCO3 alone given in the usual dose. It was found that MgCO3 (dose, 465 +/- 52 mg/day elemental Mg) allowed a decrease in the amount of elemental Ca ingested from 2.9 +/- 0.4 to 1.2 +/- 0.2 g/day (P<0.0001). The Ca, P, Mg levels were the same in the two phases. The maximum dose of iv calcitriol without causing hypercalcemia was 1.5 +/- 0.3 ug/treatment during the MgCO3 phase and 0.8 +/- ug/treatment during the Ca phase (P<0.02). If these studies are confirmed, the use of MgCO3 and a dialysate Mg of 0.6 mg/dl may be considered in selected patients who develop hypercalcemia during treatment with iv calcitriol and CaCO3.
  • Effect of magnesium on iron and magnesium metabolism in rats was investigated. 96 male Wistar rats were divided into four groups received 2.5; 5.0 and 10.0 mg magnesium daily per kg of body weight–dissolved in 2%–solution of Arabic gum (tests groups) or clear 2%–solution of Arabic gum (test group) for 4 weeks and the next 4 weeks without supplements. Iron concentrations increased in the brain and kidney of the experimental rats but decreased in the spleen, intestine, and liver (2 and 4 weeks only) also in the heart and femur (only 8 wk).
  • Percentage of iron retention decreased during the whole experiment. Magnesium concentrations increased in the spleen, liver, and intestine of rats. It was shown that at 8 weeksthe of experiment the magnesium level of heart and femur decreased (only groups received 2.5 mg and 5.0 mg Mg/kg bw/24 hr), but in group received 10.0 mg Mg/kg bw/24 hr increased for all experiment. The apparent retention of magnesium increasedthe in start of the experiment. These results show that oral magnesium supplementation disturbs metabolism of these elements, especially the balance of iron.
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Pregnancy & Lactation of Magnesium Carbonate

FDA pregnancy Category – N (not known)

Pregnancy 

Calcium carbonate-magnesium carbonate has not been formally assigned to a pregnancy category by the FDA.  Calcium carbonate has not been formally assigned to a pregnancy category by the FDA. Animal reproductive studies and data from controlled human studies are not available. Calcium carbonate is commonly used safely to provide calcium supplementation during human pregnancy. Calcium carbonate should only be used during pregnancy when benefit outweighs the risk.

References

Magnesium Carbonate

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