International Journal of Clinical Pharmacy

, Volume 39, Issue 4, pp 657–661 | Cite as

Continuous magnesium infusions in the management of systemic anti-cancer therapy-related hypomagnesaemia

  • Hector Mateo-CarrascoEmail author
  • Oluwakemi Kostrzynski
  • Onyinye Ndefo
  • Simon Stapley
  • Elaine Davies
  • Roshan Agarwal
Short Research Report


Background Hypomagnesaemia is a relatively-common side effect of some systemic anti-cancer therapies (SACT). Oral and intravenous magnesium (given as injections or short infusions) have problems arising from their poor tolerability, and need for frequent administrations, respectively. Objective Assessing the effectiveness and safety of weekly continuous magnesium infusions (CMI) in the management of SACT-related hypomagnesaemia. Methods CMIs (initiated at 10 mmol/day and up-titrated subject to response) were prescribed to patients with ≥3 magnesium readings <0.5 mmol/L despite intravenous replacement with bolus-or-short-infusions (BSI). Efficacy (compared to BSI): (a) reduction in the number of moderate/severe hypomagnesaemia episodes, and (b) increase in mean magnesium serum levels. Safety: non-occurrence of grade ≥3 toxicities (according to the common terminology criteria for adverse events v4). Results Three patients were treated (mean age: 62-years), pre-SACT levels were 0.629 ± 0.121 mmol/L. Efficacy: (a) 1 versus 18 episodes; (b) 0.639 ± 0.093 mmol/L versus 0.533 ± 0.191 mmol/L. All comparisons were statistically significant in favour of CMI (p < 0.001). No magnesium-related grade ≥2 side effects were observed. Conclusion CMIs resulted in a marked reduction in the number of episodes of hypomagnesaemia and higher magnesium levels, with no significant side effects. CMIs represent a potential option for the management of SACT-related hypomagnesaemia, although further research in an expanded cohort is required.


Hypomagnesaemia Infusion pump Intravenous injection Magnesium Systemic anti-cancer therapy 



The authors would like to thank its participation to the staff of the Aseptic Services Unit the Pharmacy Department, and the Chemotherapy Suite at Northampton General Hospital. Special thanks to Dr. Eva M Muñoz-Aguilera and Dr. Ehsan Ur Rahman for their help and support.


This study had no funding.

Conflicts of interest

Authors declare no conflict of interest.

Supplementary material

11096_2016_416_MOESM1_ESM.pdf (115 kb)
Supplementary material 1 (PDF 116 kb)


  1. 1.
    Saif MW. Management of hypomagnesemia in cancer patients receiving chemotherapy. J Support Oncol. 2008;6(5):243–8.PubMedGoogle Scholar
  2. 2.
    Schrag D, Chung KY, Flombaum C, Saltz L. Cetuximab therapy and symptomatic hypomagnesemia. J Natl Cancer Inst. 2005;97(16):1221–4.CrossRefPubMedGoogle Scholar
  3. 3.
    de Baaij JH. The art of magnesium transport. Magnes Res. 2015;28(3):85–91.PubMedGoogle Scholar
  4. 4.
    Nijenhuis T, Vallon V, van der Kemp AW, Loffing J, Hoenderop JG, Bindels RJ. Enhanced passive Ca2+ reabsorption and reduced Mg2+ channel abundance explains thiazide-induced hypocalciuria and hypomagnesemia. J Clin Invest. 2005;115:1651.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Gröber U, Schmidt J, Kisters K. Magnesium in prevention and therapy. Nutrients. 2015;7(9):8199–226.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    How is acute hypomagnesaemia treated in adults? Q&A 350.4. Medicines Q&As. UKMI 2010. Accessed 14 Oct 2016.
  7. 7.
    Magnesium sulphate injection 50% w/v Martindale pharmaceuticals. Summary of product characteristics. Accessed 14 Oct 2016.
  8. 8.
    Yu ASL, Yarlagadda SG, Clinical manifestations of magnesium depletion. Up-to-Date Inc. Accessed 14 Oct 2016.
  9. 9.
    Magnesium sulphate. Stabilis 4.0. Accessed 14 Oct 2016.
  10. 10.
    Magnesium sulphate. Handbook on injectable medicines. ISBN: 9781585283781. Accessed 14 Oct 2016.

Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Hector Mateo-Carrasco
    • 1
    Email author
  • Oluwakemi Kostrzynski
    • 1
  • Onyinye Ndefo
    • 1
  • Simon Stapley
    • 1
  • Elaine Davies
    • 1
  • Roshan Agarwal
    • 2
    • 3
  1. 1.Aseptic Services Unit, Pharmacy DepartmentNorthampton General Hospital NHS TrustCliftonville, NorthamptonUK
  2. 2.Northampton Centre for OncologyNorthampton General Hospital NHS TrustNorthamptonUK
  3. 3.Department of Surgery and Cancer, Faculty of MedicineImperial CollegeLondonUK

Personalised recommendations