Magnesium preparations: properties, when indicated, contraindications, types and uses

The most important macronutrient, without it most of the biochemical reactions occurring in the human body are impossible. Translated from Latin, “magnesium” means great, and this indicates its indispensability for the normal functioning of organs and systems.

In recent years, magnesium preparations have become widely used not only for the treatment of diseases of the heart, nervous system, digestion, and leg cramps, but also for the prevention of a variety of diseases, improving well-being, reducing nervousness and increasing stress resistance.

Almost every biochemical reaction is controlled by magnesium; the synthesis of proteins, lipids and carbohydrates is not possible without it; it is part of enzymes, participates in the conduction of nerve impulses, regulates vascular tone and muscle tone. Magnesium has a calming effect on the nervous system, prevents the occurrence of seizures, reduces the severity of allergic and inflammatory reactions, and promotes the proper functioning of the hemostatic and immune systems.

Figure: foods rich in magnesium (mg/100 g)

The main source of macronutrients is food, and with a balanced diet there is usually enough of it, however, physical activity, stress, overwork, and an overly active lifestyle can cause an increase in the need for it, which is difficult to “cover” with nutrition.

Research by scientists shows that almost half of the world's population experiences varying degrees of magnesium deficiency, which inevitably affects the general state of health, ability to work, resistance to infections, and with severe deficiency of the element, serious diseases occur.

These data prompted the creation of drugs based on magnesium, where the latter is associated with organic or inorganic acids, other minerals or vitamins, in particular group B. It is not so easy to understand the list of drugs offered today for magnesium deficiency, but to choose a suitable, effective one and affordable - even more difficult.

Patients come to the aid of specialists who offer detailed instructions on certain medications, and the Internet is flooded with a variety of information, sometimes from people who do not have special knowledge in the field of medicine and biochemistry. If the issue of taking magnesium has become, as they say, an issue, then it is better to entrust the choice and your health to a competent doctor who can recommend the right drug and the right dosage, taking into account contraindications, which, by the way, also exist.

When and why are magnesium supplements prescribed?

Some situations or diseases can increase the need for vitamins and minerals, and deficiency can occur even when nutrition is more than adequate. These include:

• Surgical interventions;
• Diabetes;
• Pathology of the digestive system, especially with bleeding, spasms;
• Treatment with cytostatics, drugs with antacid properties;
• Abuse of laxatives and diuretics;
• Use of hormonal contraceptives;
• Heavy sweating;
• Alcoholism;
• Frequent or chronic stress.

Reasons for prescribing magnesium supplements may include:

1. Magnesium deficiency proven through a biochemical blood test, even if there are no symptoms as such;
2. Symptoms of magnesium deficiency are nervousness, increased nervous excitability, spasms of the digestive organs, tachycardia, weakness, muscle cramps and tingling in the muscles;
3. Heart pathology (with arrhythmia, myocardial infarction);
4. Arterial hypertension;
5. Convulsive syndrome, epilepsy (for children too);
6. Pregnancy, especially in case of increased uterine tone or threat of miscarriage, with gestosis;
7. As a laxative - orally for constipation;
8. Inflammatory changes in the biliary tract;
9. Poisoning with heavy metals, barium.

As you can see, the indications for the use of Mg preparations are quite varied, which once again shows the importance of the element and its participation in many biochemical processes. It is believed that an overdose practically does not occur when taking magnesium-containing products, because most medications taken orally contain a significantly smaller daily dose of a macronutrient, however, an overdose is still possible and has characteristic symptoms:

• The disappearance of the knee reflex is the most common and earliest manifesting sign of excess magnesium;
• Changes in the ECG - a decrease in heart rate, expansion of the ventricular complex, which indicates a slowdown in the conduction of impulses;
• When the norm of magnesium in the blood is greatly exceeded, nausea and vomiting appear, hypotension develops, deep reflexes from the tendons disappear, double vision begins, and speech is impaired;
• With severe hypermagnesemia, the respiratory center is depressed, conduction in the myocardium sharply slows down, which leads to cardiac arrest and death of the patient.

Before you start using any drug containing magnesium, you need to study the list of contraindications, although it is unlikely that you should prescribe treatment yourself without consulting a doctor. Contraindications include:

1. Increased individual sensitivity to any component of the drug;
2. Profound renal failure;
3. Phenylketonuria and some hereditary metabolic syndromes;
4. Children under 6 years of age (relative contraindication);
5. Myasthenia;
6. Dehydration, heavy sweating;
7. Intestinal obstruction, acute inflammatory changes in the intestines, bleeding - with oral administration of magnesium sulfate;
8. Rare pulse, atrioventricular heart block.

Review of magnesium-containing drugs and features of their use

Before starting treatment or prevention of magnesium deficiency, it is important to know the rules for taking these medications:

• Thus, the combination of magnesium with vitamin B6 is considered very successful, since these substances mutually enhance their effectiveness, and the vitamin improves the absorption of the macronutrient, maintains its intracellular concentration and provides a better therapeutic result.
• Given the common routes of absorption in the intestines, magnesium is not recommended to be taken simultaneously with calcium and iron supplements. In this case, there will be an equally low effect from both magnesium and calcium with iron. If such complex treatment is necessary, the doctor will prescribe how best to differentiate between medications and what intervals between doses are best observed.
• Magnesium supplements should not be taken on an empty stomach or between meals, as this can cause abdominal pain and stool upset. They should be washed down with water, not milk.

Products with magnesium are available in tablets, ampoules for intravenous or intramuscular administration, and in powder form for oral administration. The specific dosage form is determined by the indications for treatment. For long-term use, tablets are usually prescribed; in acute cases such as a hypertensive crisis, a solution will be used, and in case of digestive problems, powder will be used before manipulation of the abdominal organs.

Pharmacies offer a fairly wide list of medications with magnesium as the main component, as well as in combination with vitamin B6 or potassium. They differ not only in bioavailability, composition, dosage, but also in price, which is also considered a significant factor in choice. In this case, price often means the quality and effectiveness of the drug, which can be confirmed by patients who have tried medications of different compositions from different manufacturers.

Bioavailability, that is, the level of digestibility and, accordingly, effectiveness, depends on the composition of the drug and the element or substance with which magnesium is associated in it. For example, there are inorganic magnesium salts - sulfate, chloride, as well as oxides and hydroxides. Organic ones include citrate, lactate, magnesium gluconate, compounds with salicylic and ascorbic acids and others.

Information regarding the absorption of organic and inorganic magnesium compounds varies and is even contradictory. Thus, some researchers refute the common point of view according to which organic salts are absorbed better, citing weighty arguments; therefore, when choosing, it is not always necessary to rely on the composition. For example, magnesium sulfate is considered the most poorly absorbed, but it can successfully combat constipation when taken orally and hypertensive crises when injected.

The criteria for choosing the best magnesium preparations often include the manufacturer, the composition and concentration of the macroelement in the tablet, and the price. The manufacturing company is important from the point of view that the quality of raw materials, the safety of the drug and its bioavailability depend on it, so it is still worth listening to recommendations regarding a specific company that are perceived by many patients as an advertising ploy.

Not every one of us thinks about the fact that the dosage indicated on the package does not mean the content of pure magnesium in the tablet. Some manufacturers honestly indicate this figure, others do not, and then the buyer should calculate it himself, remembering the school chemistry course and clarifying the daily requirement for the macronutrient.

Organic magnesium salts are considered quite effective and have additional positive effects on the body. Among them:

1. Magnesium citrate, a derivative of citric acid, has high bioavailability and can improve metabolism in general by activating respiratory processes and producing energy in cells;
2. Magnesium malate - a salt of malic acid - also boasts high availability for cells, a positive effect on cellular respiration and metabolism;
3. Magnesium aspartate - a salt of aspartic acid - bioavailability is good, and aspartic acid takes an active part in nitrogen metabolism;
4. Magnesium orotate is a drug with good bioavailability, orotic acid improves metabolic processes and growth;
5. Magnesium lactate is a lactic acid derivative with good bioavailability.

Inorganic Mg-based substances include sulfate (sulfuric acid salt) and metal oxide. Sulfate is used in powder form as a remedy for constipation and to cleanse the intestines before operations and studies; when administered intravenously or intramuscularly, it has a hypotensive effect. Not used to eliminate macronutrient deficiency. Magnesium oxide is very poorly absorbed, but is quite effective in combating constipation.

Preparations containing magnesium and calcium at the same time cannot have the desired effect due to the fact that these metals are not absorbed together, therefore, the appropriateness of their use is questionable. If you need to make up for the deficiency of both, then it is better to use the elements separately and drink them at different times.

The so-called magnesium chelate compounds are considered relatively new. which are produced abroad, in particular in the USA. Such magnesium is highly accessible to the body, but is also characterized by the high cost of drugs, since not every pharmaceutical production can create such a compound.

Many pharmacies visitors try to save on medicines by choosing cheap domestic analogues or generic drugs instead of original imported medicines. When calculating the number of French or American-made tablets to be taken for a course of treatment, an impressive amount emerges that will have to be spent on the drug. The financial side of the issue often becomes decisive when choosing.

At the same time, a high price is not only a consequence of advertising campaigns, decent salaries for pharmaceutical production workers, the world-famous name of the manufacturer, etc. The high price hides clinical trials, high dosing accuracy, and safe raw materials for the production of drugs. And few can deny that the effects, including side effects, are sometimes very different for cheap analogues and original drugs from well-known companies.

Magnesium sulfate (magnesium sulfate)

One of the “oldest” products containing magnesium is considered magnesium sulfate in powder and ampoules. Powders of 10 and 20 grams are used exclusively internally and have a choleretic and laxative effect. In addition, it can be used as an antidote for intoxication with heavy metal salts.

The effect of the drug lasts up to 6 hours, and the onset of the effect occurs already half an hour after administration. The reason for the prescription may be constipation, inflammation of the gallbladder and biliary tract, as well as cases when it is necessary to prepare the digestive organs for probing or other manipulations.

As a laxative, magnesium sulfate is consumed at night or half an hour before meals, dissolved in half a glass of warm water. For chronic constipation, you can do enemas with magnesium. In order to obtain a choleretic effect, use a tablespoon of dissolved magnesia three times a day. When probing the duodenum, the drug is administered through a probe.

Side effects occur rarely and are often associated with abdominal discomfort, exacerbation of inflammatory processes in the digestive organs, and electrolyte imbalances. In severe cases, bradycardia, hypotension, shortness of breath and vomiting cannot be excluded. To exclude side effects, the drug cannot be taken continuously and systematically, as well as to compensate for magnesium deficiency due to ineffectiveness.

Magnesia sulfate is not compatible with calcium-containing drugs, ethyl alcohol in large quantities, some antibiotics and hormones, derivatives of salicylic acid.

Unlike powder, magnesium sulfate in ampoules can be used to eliminate magnesium deficiency or prevent it in patients on parenteral nutrition, as well as those taking contraceptives, some types of diuretics, and severe sweating.

When providing ambulance and emergency care it is used to restore heart rhythm, prevent arrhythmia during a heart attack, treat hypertensive crises, seizures, late gestosis in pregnant women, and heavy metal intoxication.

Intravenous drip courses are prescribed for cases of threatened miscarriage or increased uterine tone, but only in a hospital setting. The introduction is carried out very slowly, using special devices that allow you to set the required number of magnesium drops per minute. Despite the relative safety of this magnesium drug, it is prescribed to pregnant women with caution, and nursing mothers should stop feeding during the period of treatment.

The administration of magnesium sulfate should be carried out slowly to avoid undesirable effects such as feelings of heat, hot flashes, and dizziness. When injected into a muscle, the drug is painful. Intravenous use is carried out with the patient in a supine position, and the drip can “drag on” for hours.

For children, indications for prescribing magnesium sulfate may be convulsive syndrome, including against the background of glomerulonephritis. In this case, treatment begins with 20-40 mg per kilogram of body weight intramuscularly. In the first year of a baby’s life, the drug is prescribed with caution and only under the control of the level of magnesium in the blood and tendon reflexes.

An overdose of magnesium causes depression of the respiratory center and cardiac activity. Calcium chloride injected into a vein acts as an antidote. In case of lung dysfunction, artificial ventilation is established, hemodialysis is performed according to indications, and symptomatic treatment is prescribed.

Magnesium with Vitamin B6

Perhaps the best drugs available to a wide range of consumers are combinations of Mg with vitamin B6. In particular, it is widely known in the Russian Federation and has proven itself well Magne B6 French company Sanofi. This original, but relatively expensive drug contains organic magnesium salt (lactate) and vitamin B6, the mass of ionized magnesium is 48 mg per tablet. In ampoules the weight of pure magnesium is one hundred milligrams.

Magnesium with B6 is prescribed for emotional instability, irritability, anxiety syndrome, increased fatigue, and sleep disorders. Tachycardia in the absence of organic damage to the organ may also indicate the need for treatment. The drug is used for cramps in the legs and tingling sensation in the muscles, cramps in the abdomen.

The recommended duration of treatment is one month. If there is no improvement during this period, then you should switch from monotherapy to the use of drugs from other groups or begin to search for other possible causes of the pathology.

Experience with the use of Magne B6 in pregnant women has not shown any negative effects on the growing fetus, so it is considered safe at any stage, however, nursing mothers should refrain from using the medicine or stop feeding.

Magnesium with vitamin B6 is prescribed to adults and children over six years of age. You should take 6 to 8 tablets a day with meals and a large glass of water. If diarrhea, abdominal pain, or an allergic reaction occurs, treatment is stopped.

For the prevention and treatment of mild forms of magnesium deficiency, tablets are prescribed, and in severe cases, injection of a solution of Mg lactate with vitamin B6 into a vein is indicated. Magne B6 forte contains a double dose of the macronutrient.

In the list of analogues of the “French” - Magnefar B6,magwit, Magnerot. Magnefar B6 is produced by the Polish company Biopharm and has similar indications and contraindications, however, the proportion of pure magnesium in the tablet is somewhat lower, as is the cost of the medicine. Magvit is a product of the Minskintercaps plant, which limited itself to indicating only the concentration of magnesium citrate in one capsule. The price of Magvit is more than affordable and almost 10 times lower than its French counterpart.

Magnesium and the heart

Magnesium supplements for the heart are considered panangin And asparkam. The first is a mixture of organic potassium and Mg salts that affect metabolic processes in the heart muscle. The reasons for its use are considered to be heart failure, heart attack, rhythm disorders, and poor tolerance of cardiac glycosides. Due to the low magnesium content in one tablet, the drug is unlikely to be indicated for eliminating magnesium deficiency.

Panangin is available in tablets, which can be bought without a prescription, and ampoules, sold only with a doctor's prescription. Tablets are taken three times a day, 1-2 pieces, after meals, the duration of treatment is determined by the doctor. Panangin is injected into a vein slowly, diluted with a glucose solution.

The list of magnesium preparations includes the well-known asparkam, which has been prescribed to cardiac patients for many years. It contains potassium and magnesium salts of aspartic acid. Indications for treatment include deficiency of macroelements in the body, complex therapy of cardiac ischemia, rhythm disturbances, prevention of poisoning with cardiac glycosides.

Asparkam is used 2 tablets three times a day for therapeutic purposes and one tablet for prevention. The duration of treatment is determined by the doctor. In case of overdose, signs of hypermagnesium and hyperkalemia appear - hypotension, facial flushing, bradycardia, etc.

Chelated forms

In Russia, Mg chelate from NSP (USA) is still widely distributed; the manufacturing company is equipped with its own laboratory with high quality standards and has documents confirming this very quality of the drugs. For the production of medicines, plant materials are used, and magnesium is produced in the form of chelated compounds. The drug is sold as a biological food additive.

So, we examined only the most popular drugs containing magnesium. The choice is up to the buyer, but one must remember that a cheap price can result in taking useless drugs, and analogues (generics) of well-known drugs may carry a higher risk of negative consequences and side effects with lower effectiveness.

When purchasing magnesium drugs at a pharmacy, you should not blindly follow advertising or choose a cheaper analogue, but be guided by the doctor’s opinion and official data on the safety and bioavailability of a particular drug. In some cases, laboratory monitoring of electrolyte metabolism may be necessary, which allows timely detection of excess of normal concentrations of both magnesium and potassium in the body.

Particular care must be taken when purchasing dietary supplements containing macroelements, since there may be neither accurate information about the content of magnesium ions, nor a list of side effects and contraindications, which means that their use may be fraught with various disorders.

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