Magnesium sulfate (as heptahydrate).
Each mL contains Magnesium Sulfate (as Heptahydrate) 500 mg.
Magnesium Sulfate injection is a sterile, non-pyrogenic solution of Magnesium Sulfate in Water for injection. The solution contains no bacteriostatic agent or other preservatives.
Pharmacology: Magnesium is the second most plentiful cation of the intracellular fluids. It is essential for the activity of many enzyme systems and plays an important role with regard to neuro-chemical transmission and muscular excitability. Deficits are accompanied by a variety of structural and functional disturbances. Some of the effects of magnesium in the extracellular fluid cause depression of the central nervous system. Magnesium has a direct depressant effect on skeletal muscle. Abnormally low concentrations of magnesium in the extracellular fluid result in increase acetylcholine release and increase muscle excitability that can produce tetany.
Magnesium slows the rate of S-A nodal impulse formation. Higher concentration of magnesium (greater than 15 mEq/L) produces cardiac arrest in diastole.
Excess magnesium causes vasodilation by both a direct action on blood and ganglionic blockade.
Magnesium is exerted principally by glomerular filtration.
Magnesium Sulfate Injection maybe of the therapeutic value in the following conditions: As CNS depressant, primarily in pre-eclampsia and eclampsia of pregnancy.
As an electrolyte replenisher for hypomagnesemia and magnesium deficiency to maintain normal neuromuscular irritability.
Magnesium Sulfate maybe administered by Intramuscular or direct Intravenous Injection, IV infusion, or addition to and auxiliary medication infusion unit. For Intravenous Injection, a concentration of 20% or less should be used; the rate of injection should not exceed 1.5 mL of a 10% w/v solution or equivalent per minute. For Intramuscular Injection a 25% concentration is satisfactory for adults but dilution to 20% is recommended for children.
The dosage of Magnesium Sulfate should be individualized based on patient's needs and response.
In the management of eclampsia or severe pre-eclampsia, and initial dose of 4 g by I.V. Infusion along with 4 or 5 grams intramuscular into each buttock has been recommended. This dose if forward by intramuscular doses of 4 to 5 g in alternate buttocks at 4 hours interval as needed. Total dosage should not exceed 30 to 40 g daily.
For mild magnesium, the usual adult dose is 1 g Intramuscular every 6 hours for 4 doses.
As anticonvulsant, the usual adult dose is 1 g administered intravenously or muscularly.
In adult with severe renal impairment, the dosage should not exceed 20 g in 48 hours.
Hypermagnesemia is manifested by muscle weakness, hypotension, ECG changes, sedation and confusion. As plasma concentrations of magnesium begin to exceed 4 mEq/L the deep tendon reflexes are decreased and may be absent at levels approaching 10 mEq/L. A 12 to 15 mEq/L respiratory paralysis is a potential hazard; the respiratory effects can be antagonized to some extent by the intravenous administration of Calcium salts. In cases of severe renal impairment, symptomatic hypermagnesemia maybe an indication of dialysis. Although many usually tolerate high concentration of magnesium in plasma, there are occasional instances when cardiac consequences may be seen in the form of complete heart block at concentration below 10 mEq/L.
Magnesium Sulfate Injection should not be administered parenterally in patients with heart block or myocardial damage.
The principal hazard in parenteral magnesium therapy is the production of abnormally high levels of magnesium in the plasma. The most immediate danger to life is respiratory depression. A preparation of Calcium, such as the gluconate or gluceptate, should be at hand for intravenous administration as an antidote.
Magnesium Sulfate Injection can cause fetal harm when administered intravenously by a continuous infusion for longer than 24 hours before delivery, the possibility of the baby's showing signs of neuromuscular or respiratory depression of the newborn should be considered, since fetal toxicity can occur. A baby with hypermagnesemia may require resuscitation and assisted ventilation. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug the patient should be appraised of the potential hazard to the fetus.
Principal adverse reactions are related to the high plasma levels of magnesium and include flushing, sweating, hypotension, circulatory collapse, and cardiac and central nervous system depression. Respiratory depression of the most life-threatening effect.
When barbiturates, narcotics, hypnotics, (or systemic anesthetics), or other central nervous system depressants are to be given in conjunction with magnesium, their dosage should be adjusted caution because of the additive central nervous system depressant effects of magnesium.
Central nervous system depression and peripheral transmission defects produced by magnesium may be antagonized by calcium.
Store at temperature not exceeding 30°C.
A06AD04 - magnesium sulfate ; Belongs to the class of osmotically acting laxatives.
Soln for inj (amp) 500 mg/mL (50% w/v) x 2 mL x 50's.