“Never Use Magnesium If You Take These Medications” — The Safer Truth
The word “never” is misleading. Magnesium supplements can interact with certain medicines, but the problem is often solved by separating doses or monitoring magnesium levels, rather than avoiding magnesium altogether.
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Office of Dietary Supplements
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Pay particular attention if you take:
Doxycycline and other tetracycline antibiotics — magnesium can bind the medicine and reduce absorption.
Ciprofloxacin, levofloxacin, and other quinolone antibiotics — magnesium can also reduce absorption. These antibiotics generally need to be taken at least 2 hours before or 4–6 hours after a magnesium supplement.
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Office of Dietary Supplements
Alendronate and other oral bisphosphonates — magnesium can reduce absorption; separating the doses by at least 2 hours is recommended.
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Office of Dietary Supplements
Diuretics (“water pills”) — furosemide and hydrochlorothiazide can increase magnesium losses, while medicines such as spironolactone can reduce magnesium excretion. Your clinician may need to monitor your levels.
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Office of Dietary Supplements
Proton-pump inhibitors (PPIs) — long-term use of medicines such as omeprazole can sometimes cause low magnesium levels. In some cases supplementation is used; occasionally the PPI itself needs to be reconsidered.
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Office of Dietary Supplements
Levothyroxine — magnesium-containing antacids or supplements may interfere with absorption. Medication timing should be discussed with your pharmacist or doctor.
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DailyMed
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Be especially careful with kidney disease
Healthy kidneys remove excess magnesium. If kidney function is impaired, magnesium from supplements, antacids, or laxatives can accumulate and, at very high levels, cause serious problems including low blood pressure, breathing difficulties, abnormal heart rhythm, and cardiac arrest.
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Office of Dietary Supplements
For adults, the NIH upper limit for magnesium from supplements and medications is generally 350 mg per day, unless a healthcare professional recommends otherwise. Magnesium naturally present in food isn’t included in this limit.
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Office of Dietary Supplements
Bottom line: Don’t automatically stop magnesium—or a prescription medicine—because of an internet warning. Have a pharmacist review your complete list of prescriptions, over-the-counter medicines, antacids, laxatives, and supplements and advise you on appropriate timing.
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fda.gov
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