Interaction of magnesium oxide with gastric acid secretion inhibitors in clinical pharmacotherapy

Yamasaki, Miho; Funakoshi, Sachiyo; Matsuda, Shohei; Imazu, Tomoko; Takeda, Yoshiaki; Murakami, Teruo; Maeda, Yorinobu

doi:10.1007/s00228-014-1694-x

Cited by 30 publications

(23 citation statements)

References 8 publications

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“…Consistent with the data reported by Yamasaki et al ,. antacids such as PPI and H 2 RB reversed the laxative effect of magnesia at doses of <2000 mg/day.…”

Section: Discussionsupporting

confidence: 93%

“…The water‐soluble MgCl 2 is converted in the duodenum to magnesium bicarbonate by the following formulation: MgCl 2 + 2NaHCO 3 → Mg(HCO 3 ) 2 + 2NaCl. Yamasaki et al . reported that magnesium bicarbonate produced in the duodenum increases the osmotic pressure within the intestines, stimulates water exudation and softens the stool, which leads to laxative effect of magnesia.…”

Section: Discussionmentioning

confidence: 99%

“…Mg (HCO 3 ) 2 + 2NaCl. Yamasaki et al [9] reported that magnesium bicarbonate produced in the duodenum increases the osmotic pressure within the intestines, stimulates water exudation and softens the stool, which leads to laxative effect of magnesia. Magnesia is approved in Japan as an ethical drug, and the dosage is 500-1000 mg/day for antacid use and 2000 mg/day for laxative use (manufacturer's instruction).…”

Section: Discussionmentioning

confidence: 99%

“…It has been demonstrated that magnesia, an osmotic laxative, requires gastric acid to fulfil its action, in which the compound is soluble in gastric juice containing hydrochloride to form magnesium chloride, [8] which is reacted with bicarbonate ion secreted from duodenum to produce the osmotic laxative magnesium bicarbonate. [9] Therefore, it is conceivable that the laxative effect of magnesia is blocked by antacid. [9] A number of patients receive opioid analgesic in combination with non-steroidal anti-inflammatory drugs (NSAIDs), according to the World Health Organization (WHO) analgesic ladder for the relief of cancer pain.…”

Section: Introductionmentioning

confidence: 99%

“…[9] Therefore, it is conceivable that the laxative effect of magnesia is blocked by antacid. [9] A number of patients receive opioid analgesic in combination with non-steroidal anti-inflammatory drugs (NSAIDs), according to the World Health Organization (WHO) analgesic ladder for the relief of cancer pain. [10] Moreover, significant amount of patients take antacids such as proton pump inhibitors (PPI) and histamine H 2 receptor blockers (H 2 RB) for prevention of mucosal toxicity induced by NSAIDs.…”

Section: Introductionmentioning

confidence: 99%

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Antacid attenuates the laxative action of magnesia in cancer patients receiving opioid analgesic

Ibuka

Ishihara

Suzuki

et al. 2016

Journal of Pharmacy and Pharmacology

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ObjectiveThis study was designed to investigate pharmacological interaction between magnesium laxative and antacid in patients receiving opioid analgesic.MethodsData obtained from a total of 441 eligible patients receiving opioid analgesic for the first time were retrospectively analysed. The incidence of constipation, defined as stool‐free interval of 3 days and more within the first week of opioid intake, was compared between patients who took laxative alone and those who received laxative in combination with antacid.Key findingsLaxatives were prescribed in 74% of patients, among them 61% received antacids such as proton pump inhibitor and H2 receptor blocker. Magnesia was the most commonly used laxative (89%). Constipation occurred in 21% and 55% of patients with and without laxatives, respectively. Antacids reversed the laxative action of lower doses (<2000 mg/day) but not higher doses (>2000 mg/day) of magnesia without affecting the effects of other laxatives. Therefore, it is suggested that both acid‐dependent and acid‐independent mechanisms may operate in the laxative action of magnesia, in which the former may be involved in the action of lower doses of magnesia.ConclusionCare should be taken to avoid the unfavourable pharmacological interaction between low doses of magnesia and antacid.

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“…Consistent with the data reported by Yamasaki et al ,. antacids such as PPI and H 2 RB reversed the laxative effect of magnesia at doses of <2000 mg/day.…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%