Meta Information
ID:magnesium-chloride
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/condition/renal-impairment
Target name:
Renal Impairment (Kidney Disease)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Individuals with impaired kidney function cannot effectively clear excess magnesium from the body, leading to a high risk of dangerous accumulation (hypermagnesemia) and toxicity.
Actionable advice:
Magnesium supplements should not be used by those with any degree of kidney disease unless specifically directed and monitored by a physician.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Here we detail her clinical course, including the unique challenges of treating eclampsia and PRES in the setting of magnesium toxicity.
Label source:
PubMed: Posterior Reversible Encephalopathy Syndrome and Eclampsia in the Setting of Magnesium Toxicity: A Case Report. (PMID 37948545)
Action type:
avoid
Target id:
/class/chelating-antibiotics
Target name:
Chelating Antibiotics (Tetracyclines, Quinolones)
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
6
Description:
Magnesium ions bind to tetracycline and fluoroquinolone antibiotics in the gut, forming an insoluble complex that prevents the antibiotic from being absorbed.
Actionable advice:
Magnesium should be taken at least 2 hours before or 6 hours after these types of antibiotics.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Fluoroquinolones (FQs) are a widespread class of broad-spectrum antibiotics prescribed as a first line of defense, and, in some cases, as the only treatment against bacterial infection. However, when administered orally, reduced absorption and bioavailability can occur due to chelation in the gastrointestinal tract (GIT) with multivalent metal cations acquired from diet, coadministered compounds (sucralfate, didanosine), or drug formulation.
Label source:
PubMed: Pharmaceutics (2021)
Source url:
Exact phrase from label:
magnesium, calcium, and zinc can interfere with the gastrointestinal absorption of tetracycline antibiotics
Label source:
PubMed: International journal of molecular sciences (2019)
Source url:
Exact phrase from label:
Tetracycline in solution was mixed with aluminum, magnesium, copper, calcium and cobalt ions and analyzed by ultraviolet spectrophotometry. Diffusion rates were determined at pH 1, 5.5 and 8. Tetracycline chelate formation is pH-dependent. The diffusion rate of tetracycline chelates is concentration-dependent and is reduced even if the chelate is water soluble.
Label source:
PubMed: American journal of hospital pharmacy (1975)
Action type:
separate
Target id:
/intervention/bisphosphonates
Target name:
Bisphosphonates
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Magnesium ions can bind to bisphosphonate medications (for osteoporosis), significantly reducing their absorption from the gastrointestinal tract and lowering their effectiveness.
Actionable advice:
Magnesium doses and bisphosphonate medications should be separated by at least 2 hours.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Instruct patients to take supplemental calcium and vitamin D if their dietary intake is inadequate; and to take calcium supplements, antacids, magnesium-based supplements or laxatives, and iron preparations at a different time of the day
Label source:
FDA label: Risedronate (Actonel)
Action type:
separate
Target id:
/condition/myasthenia-gravis
Target name:
Myasthenia Gravis
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Magnesium can inhibit nerve-muscle communication at the neuromuscular junction, which can worsen muscle weakness in people with myasthenia gravis.
Actionable advice:
Magnesium supplements should not be used by those with myasthenia gravis, except under strict medical supervision.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Magnesium is known to act at the neuromuscular junction by inhibiting the presynaptic release of acetylcholine and desensitizing the postsynaptic membrane. Because of these effects, magnesium has been postulated to potentiate neuromuscular weakness.
Label source:
PubMed: Texas Heart Institute journal (2015)
Source url:
Exact phrase from label:
However, magnesium sulfate is strongly contraindicated in MG as it impairs already slowed nerve-muscle connections.
Label source:
PubMed: Case reports in obstetrics and gynecology (2017)
Source url:
Exact phrase from label:
Although paralysis after magnesium administration has been described in patients with known myasthenia gravis, it has not previously been reported to be the initial or only manifestation of the disease. Patients who are unusually sensitive to the neuromuscular effects of magnesium should be suspected of having an underlying disorder of neuromuscular transmission.
Label source:
PubMed: Muscle & nerve (1990)
Action type:
avoid
Target id:
/intervention/levothyroxine
Target name:
Levothyroxine
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
Magnesium can form complexes with levothyroxine in the gut, impairing its absorption and potentially leading to reduced thyroid hormone levels and efficacy.
Actionable advice:
Magnesium and levothyroxine doses should be separated by at least 4 hours.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Sucralfate, antacids and Antacids proton pump inhibitors may cause hypochlorhydria, affect (e.g., aluminum & magnesium intragastric pH, and reduce levothyroxine absorption.
Label source:
FDA label: Levothyroxine (Synthroid)
Action type:
separate
Target id:
/class/potassium-sparing-diuretics
Target name:
Potassium-Sparing Diuretics
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
These diuretics reduce the amount of magnesium lost in the urine, increasing the risk of high magnesium levels (hypermagnesemia) when taking supplements.
Actionable advice:
Caution is warranted, and magnesium levels should be monitored, when combining with potassium-sparing diuretics.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
K-sparing diuretics are usually administered concomitantly with more potent diuretics to counteract diuretic-induced K depletion. These agents act in the late distal tubule and collecting duct. Evidence has accumulated in recent years indicating that these drugs may also exert some Mg-sparing properties.
Label source:
PubMed: Magnesium (1986)
Source url:
Exact phrase from label:
There is evidence that the potassium-sparing diuretic amiloride may also exert magnesium-sparing properties. In saline-loaded rats, the magnesium-sparing effect of amiloride was demonstrated when the drug was administered either alone or in combination with frusemide.
Label source:
PubMed: Drugs (1984)
Source url:
Exact phrase from label:
Because the kidney has a very large capacity for Mg excretion, hypermagnesemia usually occurs in the setting of renal insufficiency and excessive Mg intake. Body excretion of Mg can be enhanced by use of saline diuresis, furosemide, or dialysis depending on the clinical situation.
Label source:
PubMed: International urology and nephrology (2009)
Action type:
monitor
Target id:
/class/loop-diuretics
Target name:
Loop Diuretics
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Loop diuretics (e.g., furosemide) increase the urinary excretion of magnesium, which can lead to magnesium depletion over time with chronic use.
Actionable advice:
Magnesium levels should be monitored if loop diuretics are taken long-term, as supplementation may be necessary to prevent deficiency.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Reference ID: 5673142
11 DESCRIPTION
Lasix ONYU (furosemide injection) for subcutaneous use is a loop diuretic.
Label source:
Action type:
monitor
Target id:
/class/proton-pump-inhibitors
Target name:
Proton Pump Inhibitors (PPIs)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Long-term use of PPIs can impair the absorption of magnesium from the diet and supplements by reducing stomach acid, potentially leading to deficiency.
Actionable advice:
If using PPIs long-term, periodically monitor magnesium levels.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Absorption
PRILOSEC delayed-release capsules contain an enteric-coated granule formulation of omeprazole (because omeprazole is acid-labile), so that absorption of omeprazole begins only after the granules leave the stomach.
Label source:
Action type:
monitor
Target id:
/intervention/calcium-supplements
Target name:
Calcium Supplements
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
High doses of calcium and magnesium compete for the same absorption pathways in the gut, which can reduce the absorption of both minerals.
Actionable advice:
High-dose calcium and magnesium supplements should be separated by at least 2 hours.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Intestinal interactions between Mg and calcium or phosphate have been demonstrated in both humans and animals. The nature of these interactions cannot be readily explained by data currently available.
Label source:
PubMed: The Journal of nutrition (1991)
Source url:
Exact phrase from label:
OBJECTIVE: In view of the widespread use of magnesium (Mg) as a nutritional supplement, we investigated whether Mg would affect the absorption of calcium (Ca) as the intestinal absorption sites for Mg and Ca differ.
Label source:
PubMed: Journal of the American College of Nutrition (1994)
Source url:
Exact phrase from label:
In the uptake medium (extracellular), magnesium was a noncompetitive inhibitor of saturable calcium transport, consistent with a regulatory role in calcium uptake by binding to the transporter at a locus other than that for calcium.
Label source:
PubMed: The American journal of physiology (1989)
Action type:
separate
Target id:
/intervention/vitamin-d
Target name:
Vitamin D
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Adequate Vitamin D levels are necessary for the efficient absorption of magnesium from the intestines and its utilization within the body.
Actionable advice:
It is a good idea to maintain adequate Vitamin D status for optimal magnesium absorption and function.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Pharmacological doses of vitamin D increase Mg absorption in both vitamin D-deficient and vitamin D-replete animals. A substantial amount of Mg absorption, however, occurs independent of vitamin D.
Label source:
PubMed: The Journal of nutrition (1991)
Source url:
Exact phrase from label:
Magnesium and vitamin D are closely linked-vitamin D aids magnesium absorption, while magnesium is vital for vitamin D synthesis, transport, and activation.
Label source:
PubMed: Nutrients (2025)
Source url:
Exact phrase from label:
Magnesium assists in the activation of vitamin D, which helps regulate calcium and phosphate homeostasis to influence the growth and maintenance of bones. All of the enzymes that metabolize vitamin D seem to require magnesium, which acts as a cofactor in the enzymatic reactions in the liver and kidneys.
Label source:
PubMed: The Journal of the American Osteopathic Association (2018)
Action type:
informational_none
Target id:
/intervention/digoxin
Target name:
Digoxin
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Low magnesium levels (hypomagnesemia) can increase the risk of digoxin toxicity. Conversely, very high magnesium can interfere with its cardiac effects.
Actionable advice:
Normal magnesium levels are best maintained, and it is important to consult a doctor before supplementing if taking digoxin.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
5.6 Use in Patients with Electrolyte Disorders
In patients with hypokalemia or hypomagnesemia, toxicity may occur at concentrations within therapeutic
range because potassium or magnesium depletion sensitizes the myocardium to digoxin.
Label source:
Action type:
informational_none
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
null
Description:
Magnesium supports neurotransmitter function, such as GABA, which promotes relaxation and can help improve sleep onset and quality.
Actionable advice:
Magnesium is generally best taken 30-60 minutes before bedtime to support relaxation and sleep.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The natural N-methyl-D-aspartic acid (NMDA) antagonist and GABA agonist, Mg(2+), seems to play a key role in the regulation of sleep.
Label source:
PubMed: Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences (2012)
Source url:
Exact phrase from label:
On the other hand, Mg2+, a natural NMDA antagonist and GABA agonist, has a critical role in sleep regulation.
Label source:
PubMed: Frontiers in nutrition (2022)
Source url:
Exact phrase from label:
Magnesium not only reduces the excitability of the nervous system and alters muscle relaxation but also regulates cellular biological clocks, energy balance, and circadian rhythms, playing a crucial role in sleep regulation.
Label source:
PubMed: Nature and science of sleep (2025)
Action type:
separate
Target id:
/intervention/zinc
Target name:
Zinc
Severity:
minor
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Very high doses of zinc (>142 mg/day) can interfere with magnesium absorption; similarly, high doses of magnesium may slightly reduce zinc absorption.
Actionable advice:
High-dose zinc and magnesium supplements are best separated by at least 2 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
OBJECTIVE: Both zinc (Zn) and magnesium (Mg) are widely used as nutritional supplements and the possibility was considered that Zn may interfere with the absorption of Mg, similar to previously reported results [1,2] obtained with the same dose of supplemental Zn on the absorption of calcium (Ca).
Label source:
PubMed: Inhibitory effects of zinc on magnesium balance and magnesium absorption in man. (PMID 7836627)
Action type:
separate
Target id:
/intervention/iron-supplements
Target name:
Iron Supplements
Severity:
minor
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
High doses of magnesium can slightly reduce the absorption of non-heme iron supplements when taken at the same time due to competition for transporters. However further stuides are needed since this was established based on a single published case report of overuse of magnesium laxative.
Actionable advice:
High-dose iron and magnesium supplements are best separated by at least 2 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Exact phrase from label:
Although in vitro studies show that iron absorption can be inhibited by magnesium laxatives such as magnesium oxide, taking oral iron supplements with magnesium laxatives is not considered a clinical problem.
Label source:
Action type:
separate
Target id:
/dietary/phytate-rich-foods
Target name:
Phytate-Rich Foods (Grains, Legumes, Nuts)
Severity:
minor
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Phytic acid, found in plant-based foods like whole grains and legumes, can bind to magnesium in the gut and inhibit its absorption.
Actionable advice:
For maximum absorption, magnesium supplements are best separated from very high-phytate meals by 2 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
FA is known as a dietary inhibitor that chelates minerals and trace elements, limiting their bioavailability and reducing their absorption.
Label source:
PubMed: [The role of phytates in human nutrition]. (PMID 37801451)
Action type:
separate
Target id:
/class/calcium-channel-blockers
Target name:
Calcium Channel Blockers
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Magnesium has mild calcium channel blocking properties, which can add to the effects of these medications, potentially causing excessive blood pressure lowering or dizziness.
Actionable advice:
It is a good idea to check blood pressure when combining magnesium supplements with calcium channel blockers.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
As with other calcium channel blockers, hemodynamic measurements of cardiac function at rest and during exercise (or
pacing) in patients with normal ventricular function treated with NORVASC have generally demonstrated a small increase in
cardiac index without significant influence on dP/dt or on left ventricular end diastolic pressure or volume.
Label source:
Action type:
monitor
Target id:
/intervention/vitamin-b6
Target name:
Vitamin B6
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin B6 acts as a cofactor that helps transport magnesium into cells, potentially enhancing its effectiveness and cellular uptake.
Actionable advice:
Consider taking Vitamin B6 alongside magnesium to potentially improve its cellular uptake.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The length of treatment needed to inhibit audiogenic seizures was reduced by treatment with a combination of vitamin B-6 (a magnesium fixing agent) and PCMH or MgCl2.
Label source:
PubMed: Audiogenic seizures in magnesium-deficient mice: effects of magnesium pyrrolidone-2-carboxylate, magnesium acetyltaurinate, magnesium chloride and vitamin B-6. (PMID 8369195)
Action type:
informational_none
Target id:
/biomarker/rbc-magnesium
Target name:
RBC Magnesium
Severity:
major
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Supplementation with magnesium chloride is intended to increase cellular magnesium levels, which are best measured by the Red Blood Cell (RBC) magnesium test.
Actionable advice:
RBC magnesium testing is used to monitor status and guide supplementation dosage, aiming for the upper end of the reference range.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Exact phrase from label:
A magnesium RBC test measures the amount of magnesium inside your red blood cells. This test may be better at finding low magnesium levels than a regular magnesium blood test.
Label source:
Action type:
monitor