For the use of a Registered Medical Practitioner, Hospital or Laboratory only.
1. Description
Magmaxx contains light magnesium oxide, equivalent to 241.2 mg of elemental magnesium per tablet. Magnesium oxide has an empirical formula of MgO and consists of a lattice of Mg2+ ions and O2− ions held together by ionic bonding. Magnesium (Mg) is the fourth most abundant cation in the body and the second most important intracellular cation.
In recent years, Mg has gained much importance with the growing awareness that Mg is required as a cofactor in multiple enzymatic reactions and that it plays an important role in neuromuscular processes. Mg also has a role in mineral bone metabolism, adenosine triphosphate metabolism, neurotransmitter release and in the regulation of vascular tone, heart rhythm and platelet-activated thrombosis.
In patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD), changes in Mg homeostasis may occur. An understanding of the physiology in Mg handling is therefore of relevance for those taking care of patients with CKD and ESRD.
2. Composition
Each film coated tablet contains light Magnesium Oxide 400 mg which is equivalent to elemental magnesium 241.2 mg or 19.6 mEq.
3. Dosage Form
Tablet
4. Pharmacology
Pharmacodynamics
Magnesium is the second most abundant intracellular cation and is an essential cofactor for more than 300 enzymatic reactions involved in energy production, nucleic acid synthesis, protein synthesis, and neuromuscular function.
After oral administration, magnesium oxide dissociates in the gastrointestinal tract to release magnesium ions (Mg²⁺), which are absorbed and incorporated into the body’s magnesium pool.
Magnesium exerts the following pharmacological actions:
Serves as a cofactor in ATP-dependent enzymatic reactions involved in carbohydrate, protein, and nucleic acid metabolism.
Maintains normal neuromuscular transmission by regulating calcium entry into nerve and muscle cells.
Helps maintain normal cardiac rhythm by stabilising myocardial cell membranes and regulating potassium and calcium transport.
Supports bone mineralisation by influencing calcium homeostasis and parathyroid hormone activity.
Regulates vascular smooth muscle tone, contributing to normal blood pressure and endothelial function.
In CKD and post-transplant patients, correction of magnesium deficiency may reduce neuromuscular symptoms and support cardiovascular and metabolic health.
Pharmacokinetics
Absorption
Magnesium oxide is administered orally.
In the acidic environment of the stomach, it is converted to soluble magnesium salts, releasing Mg²⁺ ions for absorption.
Magnesium is absorbed primarily in the small intestine through both passive diffusion and active transport.
The extent of absorption varies with the body’s magnesium status absorption increases when body stores are depleted.
Distribution
Approximately 50–60% of total body magnesium is stored in bone.
About 39–49% is distributed within intracellular compartments of soft tissues.
Less than 1% is present in extracellular fluid, where it is tightly regulated.
Circulating magnesium exists as:
~55% ionised (physiologically active)
~30% protein-bound (mainly to albumin)
~15% complexed with anions.
Metabolism
Magnesium is a mineral and does not undergo metabolism.
After absorption, magnesium is incorporated into physiological processes, acting as an enzyme cofactor and participating in cellular biochemical reactions without being chemically transformed.
Elimination
Magnesium homeostasis is regulated primarily by the kidneys.
Excess absorbed magnesium is excreted in the urine through glomerular filtration and regulated tubular reabsorption.
A small proportion of unabsorbed magnesium is eliminated in the faeces.
In patients with renal impairment, magnesium excretion is reduced, increasing the risk of hypermagnesaemia; therefore, serum magnesium levels should be monitored during therapy.
5. Indications
Magmaxx is indicated in the management of Hypomagnesaemia associated with Acute kidney injury, NODAT/PTDM, Post Renal Transplant & Tacrolimus use.
Hypomagnesaemia is usually defined as serum Magnesium <0.7 mmol/L, <1.4 mEq/L, or <1.7 mg/dL.
Treatment with magnesium salts is indicated when magnesium deficiency is symptomatic or the magnesium concentration is persistently < 1.25 mg/dL (< 0.50 mmol/L).
6. Contraindications
Patients with renal impairment (creatinine clearance of less than 30 mL per minute [0.5 mL per second]) may be at risk of heart block or hypermagnesaemia
7. Precautions
Warnings: This medication contains magnesium oxide. Do not take Magmaxx if allergic to magnesium oxide or any ingredients contained in this drug. Keep out of reach of children. In case of overdose, get medical help immediately.
Pregnancy and Lactation: Use of Magnesium oxide during pregnancy is generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. 350-400 mg/ day elemental magnesium is recommended during pregnancy.
Magnesium oxide is distributed in breast milk; 310-360 mg/day elemental magnesium is recommended during breastfeeding.
8. Drug Interactions
- Magnesium oxide reduces the absorption of tetracyclines, fluoroquinolones, bisphosphonates, levothyroxine, iron salts, digoxin, penicillamine and integrase inhibitors (e.g., dolutegravir) — separate doses by at least 2 hours (4 hours for fluoroquinolones).
- Other magnesium-containing products increase the risk of hypermagnesaemia, especially in renal impairment.
- Calcineurin inhibitors (tacrolimus, ciclosporin), loop and thiazide diuretics and proton-pump inhibitors increase magnesium loss and may increase the dose requirement.
9. Adverse Effects
Oral supplementation generally is safe and well-tolerated; some reports of nausea, vomiting, diarrhoea; overdose may lead to hypotension & muscle weakness.
10. Dosage & Administration
Oral 1 to 2 tabs daily of Magmaxx can be taken until serum magnesium concentration reaches 2.5-3.0 mg/dL.
Treatment is indicated when Magnesium concentration is <1.25 mg/dL (<0.50 mmol/L).
11. Overdosage
No data available.
12. Storage
Keep in a dry place at a temperature not exceeding 30°C. Protected from light.
13. Presentation
10 tablets in a strip, 5 strips in a Box.