Hypermagnesemia. Elderly over-the-counter drug users at risk
M. C. Fung, M. Weintraub and D. L. Bowen
Office of Over-the-Counter Drug Evaluation, Center for Drug Evaluation and Research, Food and Drug Administration, Rockville, Md, USA.
We present a case of magnesium toxic effects that demonstrates the wide
spectrum of associated clinical signs and symptoms. As shown by the case
report, the literature review, and the MEDWATCH database, physicians
frequently neglect to consider hypermagnesemia in the differential
diagnosis of this clinical presentation. Abnormal renal function is a
well-known risk factor for the development of hypermagnesemia. This case
report highlights several associated nonrenal risk factors for
hypermagnesemia, which include age, gastrointestinal tract disease, and
administration of concomitant medications, particularly those with
anticholinergic and narcotic effects. This case report also demonstrates
how consumers may misuse magnesium-containing over-the-counter drug
products. In addition, physicians may not inquire about and patients may
not volunteer over-the-counter medications in a complete drug history.
However, the morbidity associated with hypermagnesemia as well as its
reversibility make it an important diagnostic consideration for elderly
patients with gastrointestinal tract disease, regardless of renal function.
For easy reference for both consumers and health-care personnel, we provide
a list of over-the-counter drug products that contain significant amounts
of magnesium.
