Drug-induced electrolyte disorder. Part 2. Drug-induced hypomagnesemia

O.D. Ostroumova^1,2, A.I. Kochetkov¹, M.V. Klepikova¹

¹Russian Medical Academy of Continuous Professional Education, Moscow

²Sechenov University, Moscow

Drug-induced hypomagnesemia is caused by a wide range of medications, including those widely used in clinical practice (diuretics, proton pump inhibitors, insulin preparations, aminoglycosides, antineoplastic drugs, drugs used in cardiology (digoxin) and pulmonology (beta-agonists, theophylline, glucocorticosteroids). The prevalence of drug-induced hypomagnesemia is not generally known, but can reach 90% among certain classes of medications. A special feature of magnesium is its small percent in the blood serum composition (only 0.3% of the total amount in the human body), while the largest percent is found in the intracellular compartment. This commonly makes it difficult for early diagnosis of hypomagnesemia, which increases the risk of dangerous clinical signs concerning magnesium deficiency occurrence. Diagnosis of this condition is based on the detection of low magnesium levels in the blood. Methods have also been developed for determining the intracellular and interstitial magnesium content in red blood cells, white blood cells, platelets, macrophages, muscle tissue, hair, nails, and teeth. Due to the frequent combination of hypomagnesemia (including drug-induced) with potassium deficiency, the rational treatment tactics for such patients is to simultaneously fill the lack of these cations. High efficiency and safety profile in hypomagnesemia treatment was  proved by the use of combined preparation of potassium and magnesium asparaginate, which allows for combined correction of electrolyte disorders in magnesium deficiency, and, according to the viewpoint of Russian experts, it is also the first-line drug in this clinical picture.

Keywords: hypomagnesemia, drug-induced hypomagnesemia, hypokalemia, adverse events, potassium and magnesium asparaginate.

For citation: Ostroumova O.D., Kochetkov A.I., Klepikova M.V. Drug-induced electrolyte disorder. Part 2. Drug-induced hypomagnesemia. RMJ. 2020;12:–48.