1. Magnesium-Depleting Drugs
Famotidine (pepcid and pepcid complete)
Omeprazole (prilosec otc)
Aluminum and magnesium hydroxide (maalox, mylanta)
Aluminum carbonate gel (basaljel)
Aluminum hydroxide (amphojel, alternagel)
Calcium carbonate (tums, titralac, rolaids)
Magnesium hydroxide (phillips’ milk of magnesia)
Sodium bicarbonate (alka-seltzer, baking soda)
Antibiotics (a few examples)
Sulfamethoxazole and trimethoprim (bactrim, septra)
Zidovudine, azt (retrovir)
Zidovudine and lamivudine (combivir)
Blood pressure drugs
Enalapril and hctz (vaseretic)
Angiotensin ii receptor blockers:
Valsartan and hctz (diovan hct)
Ethacrynic acid (edecrin)
Diuretics, thiazide (and any combination drug that contains hctz or hydrochlorothiazide—dozens of drugs contain this)
Candesartan and hctz (atacand hct)
Hydrochlorothiazide or hctz (hydrodiuril)
Possibly the potassium-sparing diuretics, however this is not conclusive
Digoxin (digitek, lanoxicaps, lanoxin)
Central nervous system (cns) stimulants
Methylphenidate (metadate, ritalin)
Betamethasone (diprolene, luxiq)
Prednisolone (pediapred liquid)
Prednisone (deltasone, liquid pred, sterapred)
Triamcinolone (aristocort cream)
Flunisolide (nasarel, nasalide)
Triamcinolone (azmacort inhaler)
Hormone replacement therapy / oral contraceptives
Estradiol (activella, climara, combipatch, estrace, estraderm, estring, estrogel, femring, menostar, and many others)
Estrogen-containing drugs (hormone replacement therapy and birth control)
Estrogens, conjugated (premphase, prempro)
Estrogens, esterified (estratab)
Ethinyl estradiol (found in many birth control pills)
Levonorgstrel (found in many birth control pills)
Cyclosporine (sandimmune, neoral)
Nonsteroidal aromatase inhibitors for breast cancer
S.E.R.M.S (selective estrogen receptor modulators—used for breast cancer)
Sulfa antibiotics, some diabetic medications
2. Magnesium Drug Interactions
People taking magnesium supplements to resolve constipation and temporary digestive problems should beware of antacids because these drugs can reduce the desired laxative effect of the specific magnesium supplement being used.
Some antacids include: calcium carbonate (tums, others), dihydroxyaluminum sodium carbonate (rolaids, others), magaldrate (riopan), magnesium sulfate (bilagog), aluminum hydroxide (amphojel), and others.
Anticoagulant & antiplatelet medications
These drugs are meant to slow down the body’s blood clotting, and magnesium has similar effects. Caution should be advised and a health provider should be consulted about taking magnesium with these medications.
Some medications that slow blood clotting include aspirin, clopidogrel (plavix), dalteparin (fragmin), enoxaparin (lovenox), heparin, indomethacin (indocin), ticlopidine (ticlid), warfarin (coumadin), and others.
Aminoglycoside antibiotics exert their effects on our muscles, and magnesium plays an essential role in our muscles, hence it is wise to consult a practitioner about how to best combine the two. Some aminoglycoside antibiotics include amikacin (amikin), gentamicin (garamycin), kanamycin (kantrex), streptomycin, tobramycin (nebcin), and others.
Quinone antibiotics are another type of antibiotics whose absorption can be hindered by magnesium. These antibiotics should be taken 2 hours before, or 4-6 hours after magnesium supplementation.Some of these antibiotics that might interact with magnesium include ciprofloxacin (cipro), enoxacin (penetrex), norfloxacin (chibroxin, noroxin), sparfloxacin (zagam), trovafloxacin (trovan), and grepafloxacin (raxar).
Tatracycline antiniotics are vulnerable to magnesium interaction in the stomach, where magnesium can bind them, and prevent their absorption. Taking calcium 2 hours before or 4 hours after these antibiotics can help reduce this effect. Some tetracyclines include demeclocycline (declomycin), minocycline (minocin), and tetracycline (achromycin).
Taking magnesium with bisphosphonates can decrease how much of them the body absorbs, thus decreasing their effectiveness. Taking bisphosphonate at least 2 hours before magnesium helps. Some bisphosphonates include alendronate (fosamax), etidronate (didronel), risedronate (actonel), tiludronate (skelid), and others.
Blood pressure medications: calcium channel blockers
Supplementing with magnesium while taking calcium channel blockers may increase the dizziness, nausea, and fluid retention from these drugs, (particularly nifedipine or procardia) in pregnant women. Other calcium channel blockers include amlodipine (norvasc), diltiazem (cardizem), felodipine (plendil), and verapamil (calan).
Glipizide and glyburide are two medications used to control blood sugar levels. Magnesium hydroxide commonly found in antacids may increase the absorption of these drugs. Caution should be advised when supplementing these drugs with magnesium so as to avoid larger swings in blood sugar. The dosages of these drugs may potentially be lowered if combined with magnesium.
Sulfonylureas are another type of medication for diabetics which lower blood pressure, and whose absorption may be increased with magnesium supplementation. Similar caution should also be taken to avoid drastic swings in blood pressure.
This drug has adverse potential side-effects, which are similar to the side-effects of low magnesium in the blood. Extra caution should be taken when using this drug, to ensure blood magnesium levels stay in a healthy range. A safe magnesium supplement should be used to ensure blood magnesium does not drop to dangerous levels especially while taking digoxin.
Two different kinds of diuretics are known to deplete magnesium to potentially dangerous levels: loop (includes furosemide or lasix) and thiazide (includes hydrochlorothiazide). A safe magnesium supplement should be used to ensure magnesium levels do not drop to dangerous levels especially while taking these diuretics.
Gabapentin (neurontin) absorption may be decreased by simultaneous magnesium supplementation. To reduce this effect, it may help taking gabapentin (neurontin) at least 2 hours before, or 4 to 6 hours after taking magnesium supplements.
Hormone replacement therapy (for menopause)
Magnesium levels often drop during menopause and hormone replacement therapy may help prevent these losses. Postmenopausal women or those taking hormone replacement therapy should consult a health professional about supplementing magnesium along with these medications to prevent and major imbalances.
Although not magnesium specifically, several antacids containing magnesium, have been shown to reduce the effectiveness of this drug which is taken for hypothyroid conditions. Caution should be taken with laxatives and antacids while taking levothyroxine.
Magnesium plays a central biological role in magnesium relaxation and thus can noticeably increase the desired effects and side-effects of muscle relaxants. Caution should be taken with the timing and dosages of these two.
Some muscle relaxants include carisoprodol (soma), pipecuronium (arduan), orphenadrine (banflex, disipal), cyclobenzaprine, gallamine (flaxedil), atracurium (tracrium), pancuronium (pavulon), succinylcholine (anectine), and others.
Tiludronate and alendronate(fosamax) are two of these medications whose absorption may be reduced by magnesium. Avoiding magnesium supplements for at least 1 hour before or 2 hours after these medications may help avoid these reductions in absorption.
Penicillamine – used for the treatment of wilson’s disease and rheumatoid arthritis – can inactivate magnesium, particularly with long-term use of high doses. Magnesium supplementation has however been shown to reduce penicillamine’s side effects. Consulting a health professional is advised when looking to used magnesium to alleviate these side effects.
These potassium-sparing diuretics may have the effect of increasing magnesium in the body. Caution is advised when using these drugs with magnesium supplements in people with kidney problems who lack the ability to regulate blood magnesium levels.