An overview of diagnosis and management of drug‐induced hypomagnesemia

• Published in: Pharmacology research & perspectives Vol. 9; no. 4; pp. e00829 - n/a
• Main Authors: Liamis, George, Hoorn, Ewout J., Florentin, Matilda, Milionis, Haralampos
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.08.2021; John Wiley and Sons Inc; Wiley
• Subjects: adverse effect; Animals; Antibiotics; Ataxia; Cardiac arrhythmia; Clinical medicine; Diabetes; Drug dosages; drug therapy; Drug-Related Side Effects and Adverse Reactions; Electrolytes; Epidermal growth factor; Homeostasis; Humans; Hypertension; Hypocalcemia; Hypokalemia; hypophosphatemia; Kidneys; magnesium; Magnesium - blood; Magnesium - metabolism; Magnesium Deficiency - blood; Magnesium Deficiency - etiology; Mammals; Metabolism; Muscle pain; Pharmacology; Physiology; Potassium; Psychosis; Review; Sodium; magnesium; hypokalemia; drug therapy; adverse effect; hypocalcemia; hypophosphatemia
• ISSN: 2052-1707; 2052-1707
• DOI: 10.1002/prp2.829

Magnesium (Mg) is commonly addressed as the “forgotten ion” in medicine. Nonetheless, hypomagnesemia should be suspected in clinical practice in patients with relevant symptomatology and also be considered a predisposing factor for the development of other electrolyte disturbances. Furthermore, chronic hypomagnesemia has been associated with diabetes mellitus and cardiovascular disease. Hypomagnesemia as a consequence of drug therapy is relatively common, with the list of drugs inducing low serum Mg levels expanding. Culprit medications linked to hypomagnesemia include antibiotics (e.g. aminoglycosides, amphotericin B), diuretics, antineoplastic drugs (cisplatin and cetuximab), calcineurin inhibitors, and proton pump inhibitors. In recent years, the mechanisms of drug‐induced hypomagnesemia have been unraveled through the discovery of key Mg transporters in the gut and kidney. This narrative review of available literature focuses on the pathogenetic mechanisms underlying drug‐induced hypomagnesemia in order to increase the insight of clinicians toward early diagnosis and effective management.