PMID- 24820768
OWN - NLM
STAT- MEDLINE
DCOM- 20150219
LR  - 20220331
IS  - 1432-1041 (Electronic)
IS  - 0031-6970 (Linking)
VI  - 70
IP  - 8
DP  - 2014 Aug
TI  - Interaction of magnesium oxide with gastric acid secretion inhibitors in clinical 
      pharmacotherapy.
PG  - 921-4
LID - 10.1007/s00228-014-1694-x [doi]
AB  - PURPOSE: Magnesium oxide (MgO), a short-term osmotic laxative, is converted into 
      MgCl2 under acidic condition in the stomach and then Mg(HCO3)2 in the intestinal 
      tract, where Mg(HCO3)2 induces the water exudation into the intestine. This 
      indicates that the laxative effect of MgO could be attenuated under the 
      suppressed gastric acid secretion. In this study, the possible interaction of MgO 
      with gastric acid secretion inhibitors was evaluated by using electronic patient 
      records of MgO dosage levels. METHODS: Defecation was controlled with MgO alone 
      in some patients after colon surgery (n = 67) and after total gastric resection 
      (n = 4). Some other patients were treated with a combination use of MgO and H2 
      receptor antagonist (H2RA) (n = 14) or proton pump inhibitor (PPI) (n = 27). The 
      possible drug interaction of MgO with H2RA or PPI was evaluated by comparing 
      dosage levels of MgO used in controlling defecation. RESULTS: In controlling 
      defecation, the daily dosage levels of MgO in patients taking H2RA or PPI and 
      patients with total gastric resection were significantly higher than those 
      patients taking MgO alone after colon surgery. The ratios of good constipation 
      control (controlled well at the dosing level of 1,000 mg MgO) in patients taking 
      H2RA or PPI were significantly lower than that in patients treated with MgO 
      alone. In an in vitro study, the solubility of MgO at pH 4.5 was quite low, as 
      compared with that at pH 1.2. CONCLUSIONS: When patients received H2RA or PPI, 
      the laxative effect of MgO is decreased possibly due to the low solubility of MgO 
      at the higher gastric pH and less generation of MgCl2 and Mg(HCO3)2. Higher 
      dosing level of MgO or another laxative should be used in patients taking H2RA or 
      PPI, as well as the case of patients with total gastric resection.
FAU - Yamasaki, Miho
AU  - Yamasaki M
AD  - Department of Pharmacy, Chugoku Rosai Hospital, 1-5-1 Hiro-Tagaya, Kure, 
      Hiroshima, 737-0193, Japan, yakuzai@chugokuh.rofuku.go.jp.
FAU - Funakoshi, Sachiyo
AU  - Funakoshi S
FAU - Matsuda, Shohei
AU  - Matsuda S
FAU - Imazu, Tomoko
AU  - Imazu T
FAU - Takeda, Yoshiaki
AU  - Takeda Y
FAU - Murakami, Teruo
AU  - Murakami T
FAU - Maeda, Yorinobu
AU  - Maeda Y
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
DEP - 20140513
PL  - Germany
TA  - Eur J Clin Pharmacol
JT  - European journal of clinical pharmacology
JID - 1256165
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Laxatives)
RN  - 0 (Proton Pump Inhibitors)
RN  - 3A3U0GI71G (Magnesium Oxide)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Drug Interactions
MH  - Drug Therapy, Combination
MH  - Female
MH  - Gastric Acid/*metabolism
MH  - Histamine H2 Antagonists/*administration & dosage
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Laxatives/*administration & dosage
MH  - Magnesium Oxide/*administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Proton Pump Inhibitors/*administration & dosage
EDAT- 2014/05/14 06:00
MHDA- 2015/02/20 06:00
CRDT- 2014/05/14 06:00
PHST- 2014/02/25 00:00 [received]
PHST- 2014/05/01 00:00 [accepted]
PHST- 2014/05/14 06:00 [entrez]
PHST- 2014/05/14 06:00 [pubmed]
PHST- 2015/02/20 06:00 [medline]
AID - 10.1007/s00228-014-1694-x [doi]
PST - ppublish
SO  - Eur J Clin Pharmacol. 2014 Aug;70(8):921-4. doi: 10.1007/s00228-014-1694-x. Epub 
      2014 May 13.