Pediatric Hypermagnesemia Treatment & Management

Updated: Aug 16, 2018
  • Author: Alicia Diaz-Thomas, MD, MPH; Chief Editor: Sasigarn A Bowden, MD  more...
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Treatment

Medical Care

Symptoms and signs of magnesium intoxication respond to intravenous calcium. Calcium chloride (5 mL of a 10% solution) may be administered intravenously over 30 seconds to directly antagonize the cardiac and neuromuscular effects of excess extracellular magnesium. Monitor these patients in an intensive care unit (ICU) setting and give careful attention to ECG parameters.

In order to promote a more sustained decrease in serum magnesium, patients with normal urine output and renal function may be treated with intravenous saline infusions and furosemide diuresis.

Dialysis for hypermagnesemia may be used for patients with the following:

  • Renal insufficiency

  • Severe asymptomatic hypermagnesemia (>8 mEq/L)

  • Serious cardiovascular or neuromuscular symptoms at any serum magnesium level

Cathartics or enemas that do not contain magnesium may be used to enhance GI clearance of excess ingested magnesium.

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Consultations

A nephrology consult may be obtained for refractory cases of hypermagnesemia or for patients with hypermagnesemia who require urgent dialysis.

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Diet

Advise the patient with hypermagnesemia to discontinue oral laxatives, antacids, or other preparations that contain magnesium.

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