▶Child 12–17 years:Initially 4 – 8 mmol 3 times a day, dose
to be adjusted as necessary, dose expressed as Mg(^2) +
DOSE EQUIVALENCE AND CONVERSION
▶Magnesium glycerophosphate 1 g is approximately
equivalent to Mg^2 + 4 mmolormagnesium 97 mg.
NEOMAG®CHEWABLE TABLETS
Hypomagnesaemia
▶BY MOUTH
▶Child 4–11 years:Initially 1 tablet twice daily, dose to be
adjusted according to the serum total magnesium level
▶Child 12–17 years:Initially 1 tablet 3 times a day, dose to
be adjusted according to the serum total magnesium
level
DOSE EQUIVALENCE AND CONVERSION
▶EachNeomag®chewable tablet contains Mg^2 + 4 mmol
ormagnesium 97 mg.
lUNLICENSED USEPreparations other thanNeomag®are
not licensed for use.
lINTERACTIONS→Appendix 1 : magnesium
lSIDE-EFFECTSDiarrhoea.hypermagnesaemia
lRENAL IMPAIRMENTIncreased risk of toxicity.
Dose adjustmentsAvoid or reduce dose.
NEOMAG®CHEWABLE TABLETSManufacturer advises
avoid in severe impairment.
lMONITORING REQUIREMENTSManufacturer advises to
monitor serum magnesium levels every 3 – 6 months.
lDIRECTIONS FOR ADMINISTRATION
NEOMAG®CHEWABLE TABLETSManufacturer advises that
tablets may be broken into quarters and chewed or
swallowed with water.
lNATIONAL FUNDING/ACCESS DECISIONS
NEOMAG®CHEWABLE TABLETS
Scottish Medicines Consortium (SMC) Decisions
TheScottish Medicines Consortiumhas advised (September
2017 ) that magnesium glycerophosphate (Neomag®)is
accepted for use within NHS Scotland as an oral
magnesium supplement for the treatment of patients with
chronic magnesium loss or hypomagnesaemia.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: tablet, capsule, oral suspension, oral
solution, powder
Oral solution
▶LiquaMag GP(Fontus Health Ltd)
Magnesium (as Magnesium glycerophosphate) 24.25 mg per
1mlLiquaMag GP (magnesium 121. 25 mg/ 5 ml ( 5 mmol/ 5 ml)) oral
solution sugar-free| 200 ml £ 49. 99
▶MagnaPhos(TriOn Pharma Ltd)
Magnesium (as Magnesium glycerophosphate) 19.44 mg per
1mlMagnaPhos 97. 2 mg/ 5 ml ( 4 mmol/ 5 ml) oral solution| 200 ml
£ 37. 87 DT = £ 133. 68
Magnesium (as Magnesium glycerophosphate) 24.25 mg per
1mlMagnaPhos 121. 25 mg/ 5 ml ( 5 mmol/ 5 ml) oral solution| 200 ml
£ 37. 87 DT = £ 37. 87
Chewable tablet
EXCIPIENTS:May contain Aspartame
▶MagnaPhate(Arjun Products Ltd)
Magnesium (as Magnesium glycerophosphate)
97.2 mgMagnaPhate (magnesium 97. 2 mg ( 4 mmol)) chewable tablets
sugar-free| 50 tablet £ 22. 64 DT = £ 22. 77
▶MagnaPhos(TriOn Pharma Ltd)
Magnesium (as Magnesium glycerophosphate)
97.2 mgMagnaPhos 97. 2 mg ( 4 mmol) chewable tablets sugar-free|
50 tablet £ 17. 89 DT = £ 22. 77
▶Neomag(Neoceuticals Ltd)
Magnesium (as Magnesium glycerophosphate) 97.2 mg
Neomag (magnesium 97 mg ( 4 mmol)) chewable tablets sugar-free|
50 tabletP£ 22. 77 DT = £ 22. 77
Capsule
▶MagnaPhos(TriOn Pharma Ltd)
Magnesium (as Magnesium glycerophosphate)
48.6 mgMagnaPhos 48. 6 mg ( 2 mmol) capsules| 50 capsule £ 35. 87
Magnesium (as Magnesium glycerophosphate)
97.2 mgMagnaPhos 97. 2 mg ( 4 mmol) capsules| 50 capsule £ 37. 87
Magnesium sulfate
lINDICATIONS AND DOSE
Severe acute asthma|Continuing respiratory
deterioration in anaphylaxis
▶BY INTRAVENOUS INFUSION
▶Child 2–17 years: 40 mg/kg (max. per dose 2 g), to be
given over 20 minutes
Persistent pulmonary hypertension of the newborn
▶INITIALLY BY INTRAVENOUS INFUSION
▶Neonate:Initially 200 mg/kg, to be given over
20 – 30 minutes, then (by continuous intravenous
infusion) 20 – 75 mg/kg/hour for up to 5 days if response
occurs after initial dose (to maintain plasma magnesium
concentration between 3. 5 – 5. 5 mmol/ litre).
Hypomagnesaemia
▶BY INTRAVENOUS INJECTION
▶Neonate: 100 mg/kg every 6 – 12 hours as required, to be
given over at least 10 minutes.
▶Child 1 month–11 years: 50 mg/kg every 12 hours as
required, to be given over at least 10 minutes
▶Child 12–17 years: 1 g every 12 hours as required, to be
given over at least 10 minutes
Hypomagnesaemia maintenance (e.g. in intravenous
nutrition)
▶BY INTRAVENOUS INFUSION, OR BY INTRAMUSCULAR INJECTION
▶Child: 50 – 100 mg/kg daily; maximum 5 g per day
Neonatal hypocalaemia
▶BY DEEP INTRAMUSCULAR INJECTION, OR BY INTRAVENOUS
INFUSION
▶Neonate: 100 mg/kg every 12 hours for 2 – 3 doses.
Torsade de pointes
▶BY INTRAVENOUS INJECTION
▶Child: 25 – 50 mg/kg (max. per dose 2 g), to be given
over 10 – 15 minutes, dose may be repeated once if
necessary (consult local protocol)
DOSE EQUIVALENCE AND CONVERSION
▶Magnesium sulfate heptahydrate 1 g equivalent to
Mg^2 +approx. 4 mmol.
lUNLICENSED USEUnlicensed indication in severe acute
asthma and continuing respiratory deterioration in
anaphylaxis.
lINTERACTIONS→Appendix 1 : magnesium
lSIDE-EFFECTSElectrolyte imbalance
lPREGNANCYNot known to be harmful for short-term
intravenous administration in eclampsia. Sufficient
amount may cross the placenta in mothers treated with
high doses, causing hypotonia and respiratory depression
in newborns.
lHEPATIC IMPAIRMENTAvoid in hepatic coma if risk of
renal failure.
lRENAL IMPAIRMENTIncreased risk of toxicity.
Dose adjustmentsAvoid or reduce dose.
lMONITORING REQUIREMENTSMonitor blood pressure,
respiratory rate, urinary output and for signs of
overdosage (loss of patellar reflexes, weakness, nausea,
sensation of warmth,flushing, drowsiness, double vision,
and slurred speech).
BNFC 2018 – 2019 Hypomagnesaemia 597
Blood and nutrition
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