Magnesium hydroxide

Identification

Name
Magnesium hydroxide
Accession Number
DB09104
Type
Small Molecule
Groups
Approved, Investigational
Description

Magnesium hydroxide is an inorganic compound with the chemical formula Mg(OH)2. It is naturally found as the mineral brucite. Magnesium hydroxide can be used as an antacid or a laxative in either an oral liquid suspension or chewable tablet form. Additionally, magnesium hydroxide has smoke suppressing and flame retardant properties and is thus used commercially as a fire retardant. It can also be used topically as a deodorant or for the relief of canker sores (aphthous ulcers).

Structure
Thumb
Synonyms
  • Hidroxido de magnesio
  • Magnesio hidróxido
  • Magnesium dihydroxide
  • Milk of magnesia
External IDs
E-528 / INS NO.528 / INS-528
Active Moieties
NameKindUNIICASInChI Key
Magnesium cationionicT6V3LHY83822537-22-0JLVVSXFLKOJNIY-UHFFFAOYSA-N
MagnesiumunknownI38ZP9992A7439-95-4RSHAOIXHUHAZPM-UHFFFAOYSA-N
Hydroxide ionionic9159UV381P14280-30-9XLYOFNOQVPJJNP-UHFFFAOYSA-M
Over the Counter Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Basic Care Milk Of MagnesiaSuspension1200 mg/15mLOralL. Perrigo Company2018-09-28Not applicableUs
Careone Milk Of MagnesiaSuspension1200 mg/15mLOralAmerican Sales Company2012-08-05Not applicableUs
Careone Milk Of MagnesiaSuspension1200 mg/15mLOralAmerican Sales Company2012-07-272018-10-26Us
Careone Milk Of MagnesiaSuspension1200 mg/15mLOralAmerican Sales Company2012-08-26Not applicableUs
Dermagran II Ointment - 0.25%Ointment.25 %TopicalTrans Canaderm Inc.1996-01-011996-09-10Canada
Dermagran II Ointment 0.25%Ointment.25 %TopicalCanadian Medical Supply Inc.1993-12-311996-09-09Canada
Dermagran II Ointment-ont Top 0.25%Ointment0.25 %TopicalCanderm G.P.1998-05-072008-08-06Canada
Dg Health Milk Of MagnesiaSuspension1200 mg/15mLOralDolgencorp2014-05-07Not applicableUs
Equaline milk of magnesiaSuspension1200 mg/15mLOralSupervalu2004-10-14Not applicableUs
Equaline Milk Of MagnesiaSuspension1200 mg/15mLOralSupervalu2005-11-14Not applicableUs
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
Acid Controller CompleteMagnesium hydroxide (165 mg/1) + Calcium Carbonate (800 mg/1) + Famotidine (10 mg/1)Tablet, chewableOralShopko Stores Operating2013-06-052016-11-16Us
Acid Controller CompleteMagnesium hydroxide (165 mg/1) + Calcium Carbonate (800 mg/1) + Famotidine (10 mg/1)Tablet, chewableOralShopko Stores Operating2013-06-052017-01-15Us
Acid Controller CompleteMagnesium hydroxide (165 mg/1) + Calcium Carbonate (800 mg/1) + Famotidine (10 mg/1)Tablet, chewableOralSafeway2008-08-062017-01-19Us
Acid Controller Complete dual actionMagnesium hydroxide (165 mg/1) + Calcium Carbonate (800 mg/1) + Famotidine (10 mg/1)Tablet, chewableOralWalgreen2008-07-30Not applicableUs
Acid Controller Complete dual actionMagnesium hydroxide (165 mg/1) + Calcium Carbonate (800 mg/1) + Famotidine (10 mg/1)Tablet, chewableOralWalgreen2008-07-302017-07-25Us
Acid Reducer CompleteMagnesium hydroxide (165 mg/1) + Calcium Carbonate (800 mg/1) + Famotidine (10 mg/1)Tablet, chewableOralShopko Stores Operating Co., LLC2016-01-06Not applicableUs
Acid Reducer CompleteMagnesium hydroxide (165 mg/1) + Calcium Carbonate (800 mg/1) + Famotidine (10 mg/1)Tablet, chewableOralRite Aid2009-05-152017-09-08Us
Acid Reducer CompleteMagnesium hydroxide (165 mg/1) + Calcium Carbonate (800 mg/1) + Famotidine (10 mg/1)Tablet, chewableOralWalgreen Company2016-01-29Not applicableUs
Acid Reducer CompleteMagnesium hydroxide (165 mg/1) + Calcium Carbonate (800 mg/1) + Famotidine (10 mg/1)Tablet, chewableOralWalgreen Company2016-01-29Not applicableUs
Acid Reducer CompleteMagnesium hydroxide (165 mg/1) + Calcium Carbonate (800 mg/1) + Famotidine (10 mg/1)Tablet, chewableOralShopko Stores Operating Co., LLC2016-01-12Not applicableUs
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
FIRST Mouthwash BLMMagnesium hydroxide (3.15 g/236mL) + Aluminum hydroxide (3.15 g/236mL) + Dimethicone 410 (0.315 g/236mL) + Diphenhydramine hydrochloride (.2 g/.2g) + Lidocaine hydrochloride (1.6 g/1.6g)KitOralCutisPharma, Inc.2004-11-01Not applicableUs
Categories
UNII
NBZ3QY004S
CAS number
1309-42-8
Weight
Average: 58.32
Monoisotopic: 57.990521206
Chemical Formula
H2MgO2
InChI Key
VTHJTEIRLNZDEV-UHFFFAOYSA-L
InChI
InChI=1S/Mg.2H2O/h;2*1H2/q+2;;/p-2
IUPAC Name
magnesium(2+) dihydroxide
SMILES
[OH-].[OH-].[Mg++]

Pharmacology

Indication

Magnesium hydroxide can be used as an antacid or a laxative depending on the administered dose.

As an antacid, it is used for the temporary relief of heartburn, upset stomach, sour stomach or acid indigestion.

As a laxative, it is used for the relief of occasional constipation by promoting bowel movements for 30 minutes and up to 6 hours.

Associated Conditions
Pharmacodynamics

As an antacid, magnesium hydroxide suspension neutralizes gastric acid by reacting with hydrochloric acid in the stomach to form magnesium chloride and water. It is practically insoluble in water and does not have any effect until it reacts with the hydrochloric acid in the stomach. There, it decreases the direct acid irritant effect and increases the pH in the stomach leading to inactivation of pepsin. Magnesium hydroxide enhances the integrity of the mucosal barrier of the stomach as well as improving the tone of both the gastric and esophageal sphincters.

As a laxative, the magnesium hydroxide works by increasing the osmotic effect in the intestinal tract and drawing water in. This creates distension of the colon which results in an increase in peristaltic movement and bowel evacuation.

Mechanism of action

The suspension of magnesium hydroxide is ingested and enters the stomach. According to the amount ingested, the magnesium hydroxide will either act as an antacid or a laxative.

Through the ingestion of 0.5-1.5 grams (in adults) the magnesium hydroxide will act by simple acid neutralization in the stomach. The hydroxide ions from the magnesium hydroxide suspension will combine with the acidic H+ ions of the hydrochloric acid made by the stomachs parietal cells. This neutralization reaction will result in the formation of magnesium chloride and water.

Through the ingestion of 2-5 grams (in adults) the magnesium hydroxide acts as a laxative in the colon. The majority of the suspension is not absorbed in the intestinal tract and will create an osmotic effect to draw water into the gut from surrounding tissues. With this increase of water in the intestines, the feces will soften and the intraluminal volume of the feces will increase. These effects still stimulate intestinal motility and induce the urge to defecate. Magnesium hydroxide will also release cholecystokinin (CKK) in the intestines which will accumulate water and electrolytes in the lumen and furthermore increase intestinal motility.

Absorption

About 15%-50% of magnesium hydroxide is absorbed very slowly through the small intestine.

Volume of distribution

The peak action and distribution of magnesium hydroxide are variable.

Protein binding

Magnesium hydroxide does not have any protein binding properties.

Metabolism

Unless a patient is deficient in magnesium, very little is absorbed by the intestine. Overall, about 15%-50% of the magnesium hydroxide suspension is absorbed systemically. However, it does not undergo any metabolism as it is rapidly excreted in the urine.

Route of elimination

After oral administration, up to 50% of the magnesium hydroxide suspension may be absorbed as magnesium ions through the small intestines and then rapidly excreted in the urine through the kidneys. The unabsorbed drug is mainly excreted in the feces and saliva.

Half life

N/A

Clearance

Magnesium hydroxide is mainly excreted in the urine by the kidneys. Since the kidneys play a major role in its clearance, individuals with renal failure are at risk of hypermagnesemia with long term consumption as the appropriate amounts of magnesium may not be excreted.

Toxicity

LD50=8500 mg/kg (rat, oral)

Common side effects include drowsiness or flushing (warmth, redness or tingly feeling).

Daily use of magnesium hydroxide can result in fluid and electrolyte disturbances.

Excessive use of the laxative effects of magnesium hydroxide may result in abdominal cramping, nausea and/or diarrhea.

In overdose, symptoms of gastrointestinal irritation and/or watery diarrhea may occur.

Magnesium hydroxide poisoning can result in hypermagnesemia which includes symptoms of: nausea, vomiting, flushing, thirst, hypotension, drowsiness, confusion, loss of tendon reflexes, muscle weakness, respiratory depression, cardiac arrhythmias, coma and cardiac arrest.

Not to be used in individuals with any form of kidney disease or renal failure, a magnesium restricted diet or with any sudden changes in bowel movement lasting over two weeks. Also not to be used in those individuals with abdominal pain, nausea, vomiting, symptoms of appendicitis or myocardial damage, heart block, fecal impaction, rectal fissures, intestinal obstruction or perforation or renal disease. Not to be used in women who are about to deliver as magnesium crosses the placenta and is excreted in small amounts in breast milk.

Using magnesium hydroxide with aluminum hydroxide can decrease the absorption rate of these drugs.

Magnesium hydroxide can react with digoxin, dicoumerol and cimetidine.

Use of ibuprofen with magnesium hydroxide can increase the absorption of the ibuprofen.

Use of magnesium hydroxide with penicallamine, bisphosphates, ketoconazole, quinolones or tetracycline can decrease the absorption of these drugs.

Enteric-coated tablets can be prematurely released when taken with magnesium hydroxide.

It is important to routinely monitor levels of serum magnesium and potassium in patients using magnesium hydroxide. Serum magnesium levels are necessary to determine how much magnesium is being absorbed and how much is being excreted by the kidneys. Excessive diarrhea can occur from use of magnesium hydroxide and thus it is important to also monitor serum potassium levels to ensure hypokalemia does not occur.

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteraction
1-(3-Mercapto-2-Methyl-Propionyl)-Pyrrolidine-2-Carboxylic AcidMagnesium hydroxide can cause a decrease in the absorption of 1-(3-Mercapto-2-Methyl-Propionyl)-Pyrrolidine-2-Carboxylic Acid resulting in a reduced serum concentration and potentially a decrease in efficacy.
1alpha-Hydroxyvitamin D5The serum concentration of Magnesium hydroxide can be increased when it is combined with 1alpha-Hydroxyvitamin D5.
2,5-Dimethoxy-4-ethylamphetamineMagnesium hydroxide may decrease the excretion rate of 2,5-Dimethoxy-4-ethylamphetamine which could result in a higher serum level.
2,5-Dimethoxy-4-ethylthioamphetamineMagnesium hydroxide may decrease the excretion rate of 2,5-Dimethoxy-4-ethylthioamphetamine which could result in a higher serum level.
3-Aza-2,3-Dihydrogeranyl DiphosphateMagnesium hydroxide can cause a decrease in the absorption of 3-Aza-2,3-Dihydrogeranyl Diphosphate resulting in a reduced serum concentration and potentially a decrease in efficacy.
3,4-MethylenedioxyamphetamineMagnesium hydroxide may decrease the excretion rate of 3,4-Methylenedioxyamphetamine which could result in a higher serum level.
4-Bromo-2,5-dimethoxyamphetamineMagnesium hydroxide may decrease the excretion rate of 4-Bromo-2,5-dimethoxyamphetamine which could result in a higher serum level.
AbacavirAbacavir may decrease the excretion rate of Magnesium hydroxide which could result in a higher serum level.
AbafunginMagnesium hydroxide can cause a decrease in the absorption of Abafungin resulting in a reduced serum concentration and potentially a decrease in efficacy.
AcarboseAcarbose may decrease the excretion rate of Magnesium hydroxide which could result in a higher serum level.
Food Interactions
Not Available

References

General References
  1. Wikipedia [Link]
  2. Drugs.com [Link]
  3. Glow [Link]
  4. Medicines [Link]
  5. Drugs.com [Link]
External Links
KEGG Compound
C07876
PubChem Compound
73981
PubChem Substance
310265028
ChemSpider
14107
ChEBI
6637
ChEMBL
CHEMBL1200718
Wikipedia
Magnesium_hydroxide
ATC Codes
A02AA04 — Magnesium hydroxideG04BX01 — Magnesium hydroxide
AHFS Codes
  • 56:04.00 — Antacids and Adsorbents
  • 84:24.12 — Basic Ointments and Protectants
  • 56:12.00 — Cathartics and Laxatives
  • 84:24.00 — Emollients Demulcents and Protectants

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedBasic ScienceHealthy Volunteers3
1CompletedBasic ScienceHuman Immunodeficiency Virus (HIV) Infections1
1CompletedOtherHealthy Volunteers1
1CompletedTreatmentAdvanced Solid Tumors1
1CompletedTreatmentHuman Immunodeficiency Virus (HIV) Infections1
1, 2CompletedTreatmentChronic Kidney Disease (CKD) / Hypomagnesaemia1
2CompletedNot AvailableAcid Reflux Disease / Gastro-esophageal Reflux Disease (GERD) / Heartburn / Regurgitation1
3TerminatedTreatmentRadiation-induced Oesophagitis1
4CompletedTreatmentEmergency / Indigestion / Pain NOS1
Not AvailableCompletedPreventionPost Procedural Constipation1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage forms
FormRouteStrength
SuspensionOral
OintmentTopical.25 %
OintmentTopical0.25 %
KitOral
GelOral
LiquidOral
TabletOral
SolutionOral
TabletOral385 mg
LiquidOral400 mg/5mL
EmulsionOral
ConcentrateOral2400 mg/10mL
LiquidOral400 mg
SuspensionOral1200 mg/15mL
SuspensionOral2400 mg/30mL
SuspensionOral2400 mg/10mL
SuspensionOral400 mg/5mL
SuspensionOral80 mg/1mL
SuspensionOral7.75 %
LiquidOral1200 mg/15mL
LiquidOral8 g
TabletOral300 mg
SuspensionOral400 mg
SuspensionOral80 mg
SuspensionOral440 mg
Tablet, coatedOral
Tablet, chewableOral400 mg/1
Tablet, chewableOral
LiquidOral80 mg
Tablet, chewableOral311 mg/1
LiquidOral2400 mg/15mL
CreamOral
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US6489346No2002-12-032016-07-16Us
US6699885No2004-03-022016-07-16Us
US6645988No2003-11-112016-07-16Us
US7399772No2008-07-152016-07-16Us
US6814978Yes2004-11-092022-02-26Us
US5989588Yes1999-11-232018-03-30Us

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
logP-0.57ChemAxon
pKa (Strongest Acidic)3.09ChemAxon
Physiological Charge2ChemAxon
Hydrogen Acceptor Count0ChemAxon
Hydrogen Donor Count0ChemAxon
Polar Surface Area0 Å2ChemAxon
Rotatable Bond Count0ChemAxon
Refractivity0 m3·mol-1ChemAxon
Polarizability1.78 Å3ChemAxon
Number of Rings0ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterNoChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
Not Available

Taxonomy

Description
This compound belongs to the class of inorganic compounds known as alkaline earth metal hydroxides. These are inorganic compounds in which the largest oxoanion is hydroxide, and in which the heaviest atom not in an oxoanion is an alkaline earth metal.
Kingdom
Inorganic compounds
Super Class
Mixed metal/non-metal compounds
Class
Alkaline earth metal oxoanionic compounds
Sub Class
Alkaline earth metal hydroxides
Direct Parent
Alkaline earth metal hydroxides
Alternative Parents
Inorganic salts / Inorganic oxides / Inorganic hydrides
Substituents
Alkaline earth metal hydroxide / Inorganic hydride / Inorganic oxide / Inorganic salt
Molecular Framework
Not Available
External Descriptors
magnesium hydroxide (CHEBI:6637)

Drug created on September 16, 2015 16:26 / Updated on December 16, 2018 06:55