Amikacin
Severe
Database
Clinical effect not specified
Source: DDInter
Drug reference
Magnesium Sulfate
Electrolyte / anticonvulsant (magnesium salt) · Antiepileptic
Also known as MgSO4, Magnesium Sulphate, Epsom Salt (oral/topical)
START
Eclampsia: 4–6 g IV load, then 1–2 g/h
TYPICAL MAX
~40 g/24 h (eclampsia, monitored); 2 g per asthma dose
STOP IF
Reflexes lost, RR <12, or urine output <30 mL/h
WATCH
Deep tendon reflexes, RR, urine output, Mg level; have calcium gluconate ready
CDSCO approvedSchedule H (injectable forms)Jan AushadhiATC B05XA05
KDIGO 2024 + manufacturer label
- ONSET
- 1min · immediate IV
- PEAK
- 6min · minutes
- t½
- 4h · t½ (normal renal)
- DURATION
- 30min · bolus
EXCRETION
Renal (glomerular filtration); not metabolised
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Standard of care in eclampsia/pre-eclampsia; avoid >5–7 days (fetal bone).
FDA category + note
Top interactionssee all 12 →
- AmikacinSevereDatabaseDDInter
- AtracuriumSevereDatabaseKimi deep-research + Cla
- BictegravirSevereDatabaseDDInter
- DolutegravirSevereDatabaseDDInter
Available in India
5 branded formulations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
Magnesium acts as a physiological calcium antagonist — membrane stabilisation, NMDA-receptor modulation and smooth-muscle relaxation; raises seizure threshold in eclampsia and is membrane-stabilising in torsades.
Indications
Eclampsia (seizure prevention/treatment)Severe pre-eclampsia (seizure prophylaxis)Torsades de pointesSevere acute asthma (adjunct)Symptomatic hypomagnesaemiaPreterm fetal neuroprotection
Dosing
- Adult
- Eclampsia: 4–6 g IV over 15–20 min, then 1–2 g/h infusion (continue 24 h after last seizure/delivery). Torsades: 1–2 g IV over 5–20 min. Severe asthma: 2 g IV over 20 min.
- Pediatric
- Asthma: 25–50 mg/kg IV (max 2 g) over 20 min.
- Renal adjustment
- Reduce maintenance / monitor levels closely if CrCl <30 (toxicity risk).
- Hepatic adjustment
- No adjustment (renally eliminated).
- Geriatric
- Monitor for toxicity (reduced renal reserve).
- Max dose
- Eclampsia: ~40 g/24 h with monitoring; 2 g per asthma dose
Pharmacokinetics
Onset
Immediate (IV); ~1 h (IM)
Peak effect
Within minutes (IV)
Duration
~30 min (IV bolus); sustained with infusion
Half-life
Depends on renal function (~4 h normal)
Bioavailability
IV 100% (IM well absorbed)
Protein binding
~30% (to albumin)
Metabolism
Not metabolised (inorganic ion)
Excretion
Renal (glomerular filtration)
Contraindications
- Heart block / myocardial damage
- Severe renal failure (relative — risk of toxicity)
- Hypermagnesaemia
- Myasthenia gravis (caution)
Side effects
Common
FlushingWarmthNauseaSweatingHypotension (rapid IV)
Serious
- Respiratory depression/arrest
- Loss of deep tendon reflexes
- Cardiac arrest (hypermagnesaemia)
- Profound hypotension
Pregnancy & lactation
Pregnancy
Standard of care in eclampsia/pre-eclampsia; avoid >5–7 days (fetal bone).
Lactation
Compatible; minimal clinically relevant milk levels.
Drug interactions
Atracurium
Severe
Database
Marked potentiation of block
Reduce dose; close neuromuscular monitoring
Source: Kimi deep-research + Cla
Bictegravir
Severe
Database
Clinical effect not specified
Source: DDInter
Dolutegravir
Severe
Database
Clinical effect not specified
Source: DDInter
Erdafitinib
Severe
Database
Clinical effect not specified
Source: DDInter
Gentamicin
Severe
Database
.
Source: DDInter
Kanamycin
Severe
Database
Clinical effect not specified
Source: DDInter
Neomycin
Severe
Database
Clinical effect not specified
Source: DDInter
Netilmicin
Severe
Database
Clinical effect not specified
Source: DDInter
Neuromuscular Blockers
Severe
Database
Potentiated neuromuscular blockade
Reduce blocker dose; monitor neuromuscular function
Source: Kimi deep-research + Cla
Plazomicin
Severe
Database
Clinical effect not specified
Source: DDInter
Streptomycin
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Ask House about Magnesium Sulfate
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20