【藥品性質提示】 ★必確認低血鎂：血清鎂濃度過高產生昏睡、嘔吐、面紅、言語含糊、低血壓及肌肉衰弱，心電圖異常，呼吸抑制等副作用。超過12 mg/dl，可能造成呼吸衰竭或死亡。

Hypomagnesemia
Seizures in severe preeclampsia or eclampsia
Cardiac arrhythmias (ventricular tachycardia/ventricular fibrillation) caused by hypomagnesemia

Decreases acetylcholine in motor nerve terminals and acts on myocardium by slowing rate of S-A node impulse formation and prolonging conduction time.

Onset of action:
Antiseizure medication: IM : 1 hour; IV : Immediate
Duration of antiseizure activity:
IM : 3 to 4 hours; IV : 30 minutes
Distribution:
Bone (50% to 60%); extracellular fluid (1% to 2%)
Protein binding:
30%, to albumin
Excretion:
Urine (as magnesium); feces (as unabsorbed drug)

Hypersensitivity to any component of the formulation
Heart block
Myocardial damage
IV use for preeclampsia/eclampsia during the 2 hours prior to delivery

D

Caution be used if administered to breastfeeding females.
Magnesium sulfate when used for the prevention of seizures is considered compatible with breastfeeding.

Cardiovascular:
Flushing (IV; dose related), hypotension (IV; rate related), vasodilation (IV; rate related)
Endocrine & metabolic:
Hypermagnesemia
Neuromuscular function:
Adverse effects may occur at lower concentrations in patients with neuromuscular disease (eg, myasthenia gravis).

Eclampsia/preeclampsia, seizure prophylaxis and treatment:
IV: Initial 4 to 6 g loading dose over 15 to 30 minutes at onset of labor or induction/cesarean delivery,
followed by 1 to 2 g/hour continuous infusion for at least 24 hours after delivery.
Maximum infusion rate: 3 g/hour.
If seizure occurs while receiving magnesium, an additional bolus of 2 to 4 g may be administered over ≥5 minutes with frequent monitoring for toxicity.
Hypomagnesemia, treatment:
Asymptomatic patients:
Mild deficiency (eg, serum magnesium >1.5 to 1.9 mg/dL):IV: 1 to 2 g over 1 to 2 hours.
Moderate deficiency (eg, serum magnesium 1 to 1.5 mg/dL):IV: 2 to 4 g over 2 to 12 hours.
Severe deficiency (eg, serum magnesium <1 mg/dL):IV: 4 to 8 g over 4 to 24 hours.
Symptomatic patients:
Hemodynamically unstable: Initial: IV: 1 to 2 g administered as a bolus over 2 to 15 minutes; may repeat as needed if patient remains unstable; once patient is stable, administer an additional 4 to 8 g over 12 to 24 hours.
Hemodynamically stable: Initial: 1 to 2 g over 5 to 60 minutes, followed by an additional 4 to 8 g over 12 to 24 hours.

Hypomagnesemia, treatment:
Infants, Children, and Adolescents:
IV, Intraosseous: 25 to 50 mg /kg/dose every 6 hours for 2 to 3 doses, then recheck serum concentration.
Maximum dose: 2,000 mg/dose.

Eclampsia/preeclampsia, seizure prophylaxis and treatment:
Severe renal impairment: IV: Initial: 4 to 6 g loading dose over 15 to 30 minutes, followed by 1 g/hour continuous infusion for at least 24 hours after delivery.Do not exceed 20 g during a 48-hour period.
Hypomagnesemia, treatment:
Renal dysfunction: Reduce dose by 50%. Use with caution; monitor for hypermagnesemia; close monitoring is required.