Hypomagnesaemia
Serum magnesium below 0.7 mmol/L. Develops from gastrointestinal or renal losses and from diuretic or proton pump inhibitor use. Presents with arrhythmias, tetany, and seizures.
ICD-10 E83.42 drugs
Also known as: Magnesium deficiency, Low serum magnesium
Drugs used for this condition
- AMagnesium (oral salts: citrate, glycinate, oxide, sulfate)First line · Mineral supplements. MacromineralsOral magnesium salts (citrate, lactate, glycinate) are first-line for documented hypomagnesaemia without severe clinical features. When serum magnesium falls below 0.5 mmol/L or patients have arrhythmias or seizures, intravenous magnesium sulphate is used. The underlying cause is identified and addressed in parallel: diuretics, proton pump inhibitors, chronic diarrhoea, alcoholism.
- AMagnesium sulfateFirst line · Magnesium salt: intravenous solution and oral saline laxativeMagnesium repletion during electrolyte correction appears in the AEMPS Sulfato de Magnesio Altan label: hypomagnesaemia and the acute hypokalaemia that goes with it. The link runs both ways – while magnesium stays low, potassium is not retained and a potassium drip achieves nothing. The same label limits the intravenous route: mild to moderate deficiency (1.2–1.7 mg/dL) is covered by diet and oral salts, and the vein is kept for emergencies. Oral magnesium sulfate is rarely used for repletion, because at that dose diarrhoea comes first – citrate, lactate or glycinate serve for longer courses. Common causes of deficiency: loop and thiazide diuretics, months of proton pump inhibitors, alcohol, diarrhoea, refeeding syndrome.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit