Magnesium and medicines: what you should know
The headline “never use magnesium with these medications” is too absolute. Magnesium supplements can interfere with the absorption of certain medicines, while some medicines can change your magnesium levels.
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Pay particular attention if you take:
Doxycycline and other tetracycline antibiotics — magnesium can reduce their absorption.
Ciprofloxacin, levofloxacin and other quinolone antibiotics — magnesium can also interfere with absorption.
Oral bisphosphonates, such as alendronate — magnesium can reduce absorption.
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Diuretics, such as furosemide or hydrochlorothiazide — some increase magnesium loss, while others can decrease it.
Proton-pump inhibitors (PPIs) such as omeprazole or pantoprazole — long-term use can contribute to low magnesium levels.
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Timing can make a difference
For doxycycline/tetracycline antibiotics and quinolone antibiotics, NIH guidance recommends taking the antibiotic at least 2 hours before or 4–6 hours after a magnesium-containing supplement. Oral bisphosphonates should generally be separated from magnesium by at least 2 hours.
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Also, high doses of supplemental magnesium can cause diarrhea, nausea and abdominal cramps; extremely high levels can be dangerous, particularly in people with impaired kidney function.
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Don’t stop a prescribed medicine or magnesium supplement without checking with your doctor or pharmacist. If you give me the names and doses of the medicines you take, I can check the specific interactions and tell you how to space them safely.
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