Magnesium sulfate solution for injection 25%, 5 ml No. 10 Solofarm

For parenteral administration:

• arterial hypertension (including hypertensive crisis with symptoms of cerebral edema),

• hypomagnesemia (including increased need for magnesium and acute hypomagnesemia - tetany, myocardial dysfunction),

• polymorphic ventricular tachycardia (pirouette type),

• retention of urine,

• encephalopathy,

• epileptic syndrome,

• the threat of premature birth,

• convulsions with preeclampsia,

• eclampsia.

Intravenous .
Doses are specified taking into account the therapeutic effect and the concentration of magnesium ions in the blood serum.
Preeclampsia and eclampsia. The dose is set individually, depending on the clinical situation. Saturation dose - 2-4 g after 5-20 minutes (infusion). The maintenance dose is 1-2 g and hour.
Tetania of the uterus. Saturation dose - 4 g after 20 minutes (infusion). Maintenance dose - first - 1-2 g per hour, later - 1 g per hour (can be administered drip for 24-72 hours).

Hypomagnesemia.
In newborns. The daily dose is 0.2-0.8 mg / kg IV slowly.
In adults. Lightweight. Magnesium sulfate solution is used parenterally if the oral route of administration of magnesium preparations is impossible or impractical (due to nausea, vomiting, impaired resorption in the stomach, etc.).
Heavy. The initial dose is 5 g. The dose is poured into 1 liter of infusion solution and slowly injected intravenously. Dose depending on the concentration of the drug in the blood serum.

Prevention of hypomagnesemia in patients receiving only parenteral nutrition. If there is no magnesium in nutrient solutions, it is added additionally. The daily dose is 1.5-4 g. Usually, 1 g of magnesium sulfate is added to 1 liter of parenteral nutrition solution.
The maximum daily dose of magnesium sulfate for adults is 40 g.
In hypertensive crises, 5-20 ml of a 25% solution of magnesium sulfate is injected intravenously (slowly !!).
To stop arrhythmias, 1Ц2 g is injected intravenously for about 5 minutes, repeated administration is possible.
Doses of magnesium sulfate are indicated in grams.

They correspond to the amount of a 25% solution:
A solution of magnesium sulfate in ampoules is diluted with injection solutions: 0.9% sodium chloride or 5% dextrose (glucose).

Solution for intravenous administration

magnesium sulfate

For parenteral administration: arterial hypotension, depression of the respiratory center, severe bradycardia, AV block, prenatal period (2 hours before delivery).

pharmachologic effect

When administered parenterally, it has a hypotensive, sedative and anticonvulsant effect, as well as a diuretic, arteriodilatory, antiarrhythmic, vasodilatory (on arteries) effect, in high doses - curariform (depressing effect on neuromuscular transmission), tocolytic, hypnotic and narcotic effect, suppresses Centre. Magnesium is a physiological blocker of slow calcium channels and is able to displace it from binding sites. Regulates metabolic processes, interneuronal transmission and muscle excitability, prevents the flow of calcium through the presynaptic membrane, reduces the amount of acetylcholine in the peripheral nervous system and central nervous system. Relaxes smooth muscles, lowers blood pressure (mainly increased), increases urine output.

The mechanism of anticonvulsant action is associated with a decrease in the release of acetylcholine from neuromuscular synapses, while magnesium suppresses neuromuscular transmission, has a direct inhibitory effect on the central nervous system.

The antiarrhythmic effect of magnesium is due to a decrease in the excitability of cardiomyocytes, restoration of ionic equilibrium, stabilization of cell membranes, disruption of sodium current, slow incoming calcium current and unilateral potassium current. The cardioprotective effect is due to the expansion of the coronary arteries, a decrease in systemic vascular resistance and platelet aggregation.

The tocolytic effect develops as a result of inhibition of the contractility of the myometrium (a decrease in the absorption, binding and distribution of calcium in smooth muscle cells) under the influence of magnesium ion, increased blood flow in the uterus as a result of the expansion of its vessels. Magnesium is an antidote for poisoning with salts of heavy metals.

Systemic effects develop almost instantly after i / v and 1 hour after i / m administration. The duration of action with intravenous administration is 30 minutes, with intramuscular injection - 3-4 hours.

Side effect

Early signs and symptoms of hypermagnesemia: bradycardia, diplopia, sudden flushing of the face, headache, decreased blood pressure, nausea, shortness of breath, blurred speech, vomiting, weakness.

Signs of hypermagnesemia (in order of increasing serum magnesium concentration): decreased deep tendon reflexes (2-3.5 mmol / L), lengthening of the PQ interval and expansion of the QRS complex on the ECG (2.5-5 mmol / L), loss of deep tendon reflexes (4 -5 mmol / l), depression of the respiratory center (5-6.5 mmol / l), impaired cardiac conduction (7.5 mmol / l), cardiac arrest (12.5 mmol / l); in addition - hyperhidrosis, anxiety, pronounced sedation, polyuria, uterine atony.

Contraindications for use

• Chronic renal failure, severe, hypersensitivity to magnesium sulfate.

For oral administration:

• appendicitis,

• rectal bleeding (including undiagnosed),

• intestinal obstruction,

• dehydration.

For parenteral administration:

• arterial hypotension,

• oppression of the respiratory center,

• severe bradycardia,

• AV blockade,

• prenatal period (2 hours before delivery).

Application during pregnancy and lactation

During pregnancy, magnesium sulfate is used with caution, only in cases where the expected therapeutic effect outweighs the potential risk to the fetus.

If necessary, use during lactation, breastfeeding should be discontinued.

Application for impaired renal function

Contraindicated in severe chronic renal failure. Take with caution orally or parenterally in chronic renal failure.

special instructions

With caution, take orally or parenterally in case of heart block, myocardial damage, chronic renal failure, respiratory diseases, acute inflammatory diseases of the gastrointestinal tract, pregnancy.

Magnesium sulfate can be used to relieve status epilepticus (as part of complex treatment).

In case of an overdose, it causes depression of the central nervous system. As an antidote for an overdose of magnesium sulfate, calcium preparations are used - calcium chloride or calcium gluconate.

Drug interactions

With parenteral administration of magnesium sulfate and the simultaneous use of peripheral muscle relaxants, the effects of peripheral muscle relaxants are enhanced.

With the simultaneous ingestion of antibiotics from the tetracyclines group, the effect of tetracyclines may decrease due to a decrease in their absorption from the gastrointestinal tract.

A case of respiratory arrest with the use of gentamicin in an infant with an increased concentration of magnesium in the blood plasma against the background of magnesium sulfate therapy is described.

With simultaneous use with nifedipine, severe muscle weakness is possible.

Reduces the effectiveness of oral anticoagulants (including coumarin derivatives or derivatives of indandione), cardiac glycosides, phenothiazines (especially chlorpromazine). Reduces the absorption of ciprofloxacin, etidronic acid, weakens the action of streptomycin and tobramycin.

As an antidote for an overdose of magnesium sulfate, calcium preparations are used - calcium chloride or calcium gluconate.

Pharmaceutically incompatible (precipitate is formed) with calcium preparations, ethanol (in high concentrations), carbonates, hydrocarbonates and phosphates of alkali metals, salts of arsenic acid, barium, strontium, clindamycin phosphate, sodium hydrocortisone succinate, polymyxin B sulfate, procaine hydrochloride and salicylates ...