Magnesium and Drugs
Abstract
:1. Introduction
2. Magnesium and Drugs
3. Influencing Factors
3.1. Age
3.2. pH Value
3.3. Diet, Lifestyle
3.4. Magnesium Transporters
4. Drug-Induced Magnesium Deficiency
4.1. Proton-Pump Inhibitors (PPIs)
4.1.1. PPIs and Magnesium
4.1.2. Diagnostic of Magnesium Deficiency
4.1.3. Recommendations for Clinical Practice
4.2. Thiazide Diuretics
4.2.1. TD and Magnesium
4.2.2. Recommendation for Clinical Practice
5. Conclusions
Acknowledgments
Conflicts of Interest
References
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Drug Group (Drug, Substance) | Examples | Mechanism/Effect |
---|---|---|
Anti-diabetic medication | Insulin, insulin mimetic drugs | interference with Na+/Mg2+ exchanger SLC41A1, increased renal magnesium loss |
Antimicrobials | Aminoglycoside antibiotics (e.g., gentamicin, tobramycin, amikacin) | reduced paracellular reabsorption of magnesium; increased renal magnesium loss, secondary hyperaldosteronism |
Antimicrobial medication (e.g., Pentamidine) | increased renal magnesium loss | |
Antiviral medication (e.g., foscarnet) | magnesium chelating, nephrotoxicity, increased renal magnesium loss | |
Polyene antifungals(e.g., amphotericin B) | nephrotoxicity, increased renal magnesium loss | |
Beta adrenergic agonists | Fenoterol, salbutamol, theophylline | increased renal magnesium excretion, metabolic abnormalities (magnesium shift into cells) |
Bisphosphonates | Pamidronate | renal impairment, increased magnesium excretion |
Cardiac glycoside | Digoxin | reduced renal tubular reabsorption of magnesium, increased magnesium excretion |
Chemotherapeutic agents | Amsacrine, cisplatin | nephrotoxicity, cisplatin accumulates in renal cortex, increased renal magnesium loss, reduced TRPM6 expression (?) |
Diuretics | Thiazide diuretics (e.g., HCT) | reduced TRPM6 expression (distal), increased renal magnesium loss, secondary hyperaldosteronism |
Loop diuretics (e.g,. furosemide) | reduced paracellular magnesium reabsorption (thick ascending limb), increased renal magnesium loss, secondary hyperaldosteronism | |
EGFR-Inhibitors | Cetuximab | increased renal magnesium loss, reduced TRPM6 activity |
Immunosuppressants | mTOR-Kinase-Inhibitor (e.g., Rapamycin/Sirolimus) | reduced paracellular magnesium reabsorption |
Calcineurin inhibitors (e.g., cyclosporine, tacrolimus) | reduced TRPM6 expression (distal), increased renal magnesium loss | |
Proton-pump inhibitors | Omeprazole, pantoprazole | inhibition of active magnesium absorption by interfering with TRPM6 and TRPM7, increased renal magnesium loss (?) |
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Gröber, U. Magnesium and Drugs. Int. J. Mol. Sci. 2019, 20, 2094. https://doi.org/10.3390/ijms20092094
Gröber U. Magnesium and Drugs. International Journal of Molecular Sciences. 2019; 20(9):2094. https://doi.org/10.3390/ijms20092094
Chicago/Turabian StyleGröber, Uwe. 2019. "Magnesium and Drugs" International Journal of Molecular Sciences 20, no. 9: 2094. https://doi.org/10.3390/ijms20092094