Magneon (Magnesium Sulphate / Magnesium Oxide / Magnesium Hydroxide)
Also sold as: Magneon, Magplex, MagOx, Magsule, Epsom Salt (topical/laxative)
Pregnancy
Cat A
Lactation
Safe
Schedule
H
Forms
Tablet/capsule: Magnesium oxide 250–400 mg, Magnesium glycinate 200 mg +2
Indications
- Hypomagnesaemia (magnesium deficiency) — IV/oral replacement
- Pre-eclampsia/eclampsia seizure prophylaxis and treatment (IV MgSO4 — gold standard)
- Severe acute asthma (IV MgSO4 — adjunct in non-responding acute attack)
- Torsades de pointes / polymorphic VT (IV MgSO4)
- Migraine prophylaxis (oral magnesium citrate/glycinate)
- Constipation (magnesium hydroxide / citrate — osmotic laxative)
- Nocturnal leg cramps / muscle cramps (oral supplement)
Adult Dosing
Eclampsia seizure prophylaxis (IV — Pritchard regimen)
Loading: 4g IV over 15–20 min + 5g IM each buttock (= 14g total loading). Maintenance: 5g IM every 4 hours for 24 hours after last seizure or delivery.
Monitor: respiratory rate > 12/min, urine output > 25 mL/hour, patella reflex present. Antidote: calcium gluconate 10 mL of 10% IV (give if respiratory depression/no reflex).
Acute severe asthma (IV)
2g MgSO4 IV over 20 minutes (single dose)
Adjunct when beta-agonists + steroids insufficient. Paediatric: 0.1–0.2 mmol/kg (max 8 mmol) over 20 min.
Torsades de pointes (IV)
2g MgSO4 IV over 1–2 minutes
Emergency resuscitation setting
Oral magnesium supplementation
300–400 mg elemental magnesium/day PO (divided doses)
Ongoing supplementation for deficiency or migraine prophylaxis
Pediatric Dosing
Oral magnesium for children: 6–11 mg/kg/day elemental in divided doses
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl < 30 mL/min | Use with extreme caution IV — magnesium primarily renally excreted; hypermagnesaemia risk. Halve doses and monitor levels closely. Oral: reduce dose. |
Hepatic Adjustment
No specific adjustment for hepatic disease
Pregnancy & Lactation
Pregnancy: Category A
IV magnesium sulphate is the GOLD STANDARD for eclampsia prevention and treatment (Magpie Trial — 58% reduction in eclampsia). Safe; used IV at above doses under close monitoring. Neonatal hypermagnesaemia (hypotonia, respiratory depression) possible after high maternal doses — monitor neonate. Prolonged exposure (> 5–7 days neonatal) has been associated with bone issues — limit duration if used for preterm neuroprotection.
Lactation: Safe
Magnesium passes into breast milk but at levels not harmful to infant. Considered compatible by WHO.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Calcium channel blockers | IV magnesium enhances CCB effect — profound hypotension and neuromuscular blockade | Major |
| Neuromuscular blocking agents (atracurium, vecuronium) | Magnesium potentiates neuromuscular blockade — prolonged paralysis | Major |
| Aminoglycosides | Additive risk of neuromuscular blockade | Moderate |
| Bisphosphonates, fluoroquinolones, tetracyclines (oral) | Oral magnesium chelates these drugs — reduce absorption; separate by 2 hours | Moderate |
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Side Effects
Common
- Flushing (IV — vasodilation)
- Nausea
- Diarrhoea (oral, dose-dependent — osmotic effect)
- Sweating
- Drowsiness (mild with IV)
- Hypotension (IV — too rapid infusion)
Serious / Discontinue If
- Hypermagnesaemia (IV overdose — deep tendon reflex loss → respiratory paralysis → cardiac arrest; antidote: calcium gluconate 10 mL 10% IV)
- Respiratory depression (loss of patellar reflex is warning sign)
- Complete heart block
- Cardiac arrest (rare, very high levels)
Contraindications
- Heart block (IV MgSO4)
- Myasthenia gravis (neuromuscular blockade risk)
- Renal failure without careful dose reduction
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Magneon IV (MgSO4 50% 10mL) | Neon Labs | Amp ₹18 |
| Magplex Sachet | Sun Pharma | 10 sachets ₹225 |
| Magsule 250mg | Wockhardt | 30 cap ₹165 |
Monitoring Required
- IV use — mandatory monitoring every 30 min: respiratory rate (> 12/min — stop if < 12/min), patellar reflexes (absent → stop), urine output (> 25 mL/hour)
- Serum magnesium levels (if available: therapeutic 2–4 mEq/L for eclampsia; toxic > 5 mEq/L)
- Serum calcium, potassium, phosphate (electrolyte panel)
- Blood glucose (MgSO4 can affect glucose)
Patient Counseling Points
- Oral supplements: take with water and food to reduce stomach upset
- High doses of oral magnesium cause diarrhoea — start with a low dose and increase gradually
- IV magnesium (for eclampsia): you may feel flushed, warm, or drowsy — this is expected
- Inform staff immediately if you cannot breathe well, feel confused, or cannot feel your knee jerk (reflex) — important safety sign
- For constipation: magnesium citrate/hydroxide works within hours — use as directed
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Clinically reviewed by: Dr. Suresh Menon, DM (Endocrinology), Consultant Endocrinologist
Last reviewed: 2026-04-01
References
- Magpie Trial (Lancet 2002)
- WHO Eclampsia Guidelines
- BTS Asthma Guidelines 2023
- ACOG Preeclampsia Guidelines 2020
- BNF — Magnesium Sulphate