Subcutaneous magnesium in the advanced cancer setting

Abstract

Hypomagnesaemia can arise from a variety of causes but is particularly prevalent in cancer populations. This case report describes a patient with recurrent symptomatic hypomagnesaemia, on the background of advanced ovarian cancer and a high-output ileostomy, who was successfully managed on a daily continuous subcutaneous infusion of magnesium via a syringe pump. There is limited published information on the subcutaneous administration of magnesium and, to our knowledge, this is the first case to report its routine delivery over 24 hours in a syringe pump. This novel but effective approach for administering magnesium can be delivered in the community and can, therefore, prevent repeated hospital admissions for patients with recurrent symptomatic hypomagnesaemia who would otherwise need intravenous replacement.

Possibility of magnesium supplementation for supportive treatment in patients with COVID-19

“…Recent study suggests that increasing intake of magnesium-containing foods may help reduce the incidence and mortality of primary liver cancer ( Zhong et al, 2020 ). One case report shows that the subcutaneous administration of magnesium in a syringe pump can reduce repeated hospital admissions for patients with recurrent symptomatic hypomagnesaemia like the patients with advanced ovarian cancer ( Fenning et al, 2018 ). Higher magnesium intake in the diet is associated with a lower risk of colorectal tumors ( Wark et al, 2012 ).…”

“… Soliman and Nofal (2019) Egypt Magnesium sulfate infusion A continuous infusion of magnesium sulfate (without a loading dose) at 15 mg/kg/h Magnesium sulfate produces a better-controlled effect on blood sugar level, and decreases the requirement of insulin infusion and minimizes the changes in blood potassium level. Cancer Fenning et al (2018) UK Magnesium sulfate infusion 20 mmol intravenous magnesium sulfate in 500 mL normal saline infused at various rates, ranging from 6 to 12 h in a syringe pump Magnesium sulfate mitigates recurrent symptomatic hypomagnesaemia in advanced ovarian cancer. Zhong et al (2020) USA Magnesium supplementation Magnesium intake at 100 mg/day from diet and supplement is evaluated through a food frequency questionnaire in 1 year A high magnesium intake is associated with decreased risk of primary liver cancer incidence and mortality in a nonlinear dose-response manner.…”

Subcutaneous Magnesium Sulfate to Correct High-Output Ileostomy-Induced Hypomagnesemia

“…Appendix 1; for all online suppl. material, see www.karger.com/doi/10.1159/000501121) to identify original research describing subcutaneous administration of magnesium (sulfate) in adults or children yielded 14 publications meeting our inclusion criteria [10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23] (Fig. 2; Table 1, Table 2, Table 3, Table 4).…”

“…2; Table 1, Table 2, Table 3, Table 4). A total of 5 case reports [10, 11, 12, 13, 17] and 3 publications reporting 2 retrospective case series [14, 15, 16] described experiences of patients with gastrointestinal conditions using subcutaneous magnesium supplementation. Seven case reports were identified in nongastrointestinal conditions [18, 19, 20, 21, 22, 23, 24] but one was excluded as there was no English language abstract and the full text was only available in German [24].…”

“…In two cases, subcutaneous magnesium was administered via a syringe pump [10, 17]. In one, a microinfusion pump was used and 14 mmol (8 mL) of magnesium sulfate was added to 7 mL of sterile water and infused over 10 h overnight [10].…”