magnesium hydroxide/mineral oil (OTC)

Brand and Other Names:Phillips' M-O
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

magnesium hydroxide/mineral oil

oral solution

  • (300 mg/1.25mL)/5mL

Laxative

45-60 mL/day PO qDay HS or divided doses

Antacid

Liquid: 5-15 mL PO PRN up to q6hr

Dosage Forms & Strengths

magnesium hydroxide/mineral oil

oral solution

  • (300 mg/1.25mL)/5mL

Laxative

<6 years

  • Not recommended

6-12 years

  • 20-30 mL/day PO qHS or divided doses

>12 years

  • 45-60 mL/day PO qDay HS or divided doses

Antacid

Liquid

  • <12 years old: Not recommended
  • ≥12 years old: 5-15 mL PO PRN up to q6hr
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Interactions

Interaction Checker

and magnesium hydroxide/mineral oil

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (13)

              • baloxavir marboxil

                magnesium hydroxide will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. Avoid or Use Alternate Drug. Baloxavir may bind to polyvalent cations resulting in decreased absorption. Studies in monkeys showed concurrent use with calcium, aluminum, or iron caused significantly decreased plasma levels. Human studies not conducted.

              • demeclocycline

                magnesium hydroxide decreases levels of demeclocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • doxycycline

                magnesium hydroxide decreases levels of doxycycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • eltrombopag

                magnesium hydroxide decreases levels of eltrombopag by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Separate by at least 4 hours.

              • infigratinib

                magnesium hydroxide will decrease the level or effect of infigratinib by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. If use with an acid-reducing agent cannot be avoided, administer infigratinib 2 hr before and after administration of a locally-acting antacid.

              • minocycline

                magnesium hydroxide decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • oxytetracycline

                magnesium hydroxide decreases levels of oxytetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • pazopanib

                magnesium hydroxide will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

              • ponatinib

                magnesium hydroxide decreases levels of ponatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • potassium phosphates, IV

                magnesium hydroxide decreases effects of potassium phosphates, IV by cation binding in GI tract. Avoid or Use Alternate Drug. Magnesium decreases serum phosphate concentration by binding dietary phosphate. Use alternatives if available.

              • raltegravir

                magnesium hydroxide will decrease the level or effect of raltegravir by cation binding in GI tract. Avoid or Use Alternate Drug. Magnesium containing antacids reduce raltegravir plasma levels when taken within 6 hr of raltegravir dose

              • sotorasib

                magnesium hydroxide will decrease the level or effect of sotorasib by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. If use with an acid-reducing agent cannot be avoided, administer sotorasib 4 hr before or 10 hr after administration of a locally-acting antacid.

              • tetracycline

                magnesium hydroxide decreases levels of tetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              Monitor Closely (26)

              • beta carotene

                mineral oil decreases levels of beta carotene by drug binding in GI tract. Use Caution/Monitor.

              • bictegravir

                magnesium hydroxide will decrease the level or effect of bictegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Bictegravir can be taken under fasting conditions 2 hr before antacids containing Al, Mg, or Ca. Routine administration of bictegravir simultaneously with, or 2 hr after, antacids containing Al, Mg, or Ca is not recommended.

              • cabotegravir

                magnesium hydroxide will decrease the level or effect of cabotegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer antacid products at least 2 hr before or 4 hr after taking oral cabotegravir.

              • chloroquine

                magnesium hydroxide will decrease the level or effect of chloroquine by Mechanism: inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Separate doses by at least 4 hr

              • ciprofloxacin

                magnesium hydroxide decreases levels of ciprofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Coadministration of ciprofloxacin with multivalent cation-containing products may reduce the bioavailability of ciprofloxacin by 90%. Administer ciprofloxacin at least 2 hours before or 6 hours after using these products. Use alternatives if available.

              • crizotinib

                magnesium hydroxide decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .

              • deferiprone

                magnesium hydroxide decreases levels of deferiprone by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Deferiprone may bind polyvalent cations (eg, iron, aluminum, and zinc), separate administration by at least 4 hr between deferiprone and other medications (eg, antacids), or supplements containing these polyvalent cations.

              • deflazacort

                magnesium hydroxide and deflazacort both decrease serum potassium. Use Caution/Monitor.

              • digoxin

                mineral oil decreases levels of digoxin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • dolutegravir

                magnesium hydroxide will decrease the level or effect of dolutegravir by cation binding in GI tract. Use Caution/Monitor. Administer dolutegravir 2 hr before or 6 hr after taking medications containing polyvalent cations; use alternative therapy if available

              • fleroxacin

                magnesium hydroxide decreases levels of fleroxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • gemifloxacin

                magnesium hydroxide decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • lanthanum carbonate

                lanthanum carbonate, magnesium hydroxide. cation binding in GI tract. Use Caution/Monitor. Administer antacid at least 2 hours before or after lanthanum. .

              • levofloxacin

                magnesium hydroxide decreases levels of levofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

                mineral oil decreases levels of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely.

              • moxifloxacin

                magnesium hydroxide decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • ofloxacin

                magnesium hydroxide decreases levels of ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • omadacycline

                magnesium hydroxide will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.

              • pancrelipase

                magnesium hydroxide decreases effects of pancrelipase by pharmacodynamic antagonism. Use Caution/Monitor. Antacids may negate beneficial effects of enzymes.

              • penicillamine

                magnesium hydroxide decreases levels of penicillamine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • pexidartinib

                magnesium hydroxide will decrease the level or effect of pexidartinib by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Separate pexidartinib by 2 hr before or after taking a locally-acting antacid.

              • riociguat

                magnesium hydroxide decreases levels of riociguat by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate administration by at least 1 hour.

              • sarecycline

                magnesium hydroxide will decrease the level or effect of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.

              • sodium phosphates, IV

                magnesium hydroxide decreases effects of sodium phosphates, IV by cation binding in GI tract. Modify Therapy/Monitor Closely. Magnesium decreases serum phosphate concentration by binding dietary phosphate. Use alternatives if available.

              • vismodegib

                magnesium hydroxide will decrease the level or effect of vismodegib by Other (see comment). Use Caution/Monitor. Drugs that increase gastric pH alter vismodegib solubility and therefore reduce bioavailability; effect on efficacy unknown

              • vitamin D

                mineral oil will decrease the level or effect of vitamin D by Other (see comment). Use Caution/Monitor. Avoid concomitant use of mineral oil and vitamin D supplements to avoid risk of decreased absorption of vitamin D. Applies to only oral administration of these agents.

                vitamin D increases levels of magnesium hydroxide by Other (see comment). Use Caution/Monitor. Comment: Vitamin D can increase serum magnesium concentrations, particularly in the presence of renal impairment. The combined use of vitamin D and magnesium-containing products should be avoided, if possible, in patients with chronic renal failure.

              Minor (59)

              • amikacin

                amikacin decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • amiloride

                amiloride increases levels of magnesium hydroxide by decreasing renal clearance. Minor/Significance Unknown.

              • amphotericin B deoxycholate

                amphotericin B deoxycholate decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • antithrombin alfa

                mineral oil decreases levels of antithrombin alfa by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • antithrombin III

                mineral oil decreases levels of antithrombin III by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • argatroban

                mineral oil decreases levels of argatroban by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • bazedoxifene/conjugated estrogens

                bazedoxifene/conjugated estrogens decreases levels of magnesium hydroxide by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.

              • bemiparin

                mineral oil decreases levels of bemiparin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • bendroflumethiazide

                bendroflumethiazide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • bivalirudin

                mineral oil decreases levels of bivalirudin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • bumetanide

                bumetanide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • calcitonin salmon

                calcitonin salmon increases levels of magnesium hydroxide by decreasing renal clearance. Minor/Significance Unknown.

              • chlorothiazide

                chlorothiazide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • chlorthalidone

                chlorthalidone decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • conjugated estrogens

                conjugated estrogens decreases levels of magnesium hydroxide by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.

              • conjugated estrogens, vaginal

                conjugated estrogens, vaginal decreases levels of magnesium hydroxide by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.

              • cyclopenthiazide

                cyclopenthiazide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • dabigatran

                mineral oil decreases levels of dabigatran by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • dalteparin

                mineral oil decreases levels of dalteparin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • dextrose

                dextrose decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • dextrose (Antidote)

                dextrose (Antidote) decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • digoxin

                digoxin decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • docusate

                docusate increases levels of mineral oil by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • doxercalciferol

                doxercalciferol increases levels of magnesium hydroxide by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • drospirenone

                drospirenone increases levels of magnesium hydroxide by decreasing renal clearance. Minor/Significance Unknown.

              • enoxaparin

                mineral oil decreases levels of enoxaparin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • estradiol

                estradiol decreases levels of magnesium hydroxide by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.

              • estrogens conjugated synthetic

                estrogens conjugated synthetic decreases levels of magnesium hydroxide by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.

              • estrogens esterified

                estrogens esterified decreases levels of magnesium hydroxide by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.

              • estropipate

                estropipate decreases levels of magnesium hydroxide by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.

              • ethacrynic acid

                ethacrynic acid decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • ethinylestradiol

                mineral oil decreases levels of ethinylestradiol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • fondaparinux

                mineral oil decreases levels of fondaparinux by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • furosemide

                furosemide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • gentamicin

                gentamicin decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • glucagon intranasal

                glucagon intranasal increases levels of magnesium hydroxide by decreasing renal clearance. Minor/Significance Unknown.

              • heparin

                mineral oil decreases levels of heparin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • hydrochlorothiazide

                hydrochlorothiazide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • ibandronate

                magnesium hydroxide decreases levels of ibandronate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • indapamide

                indapamide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • mannitol

                mannitol decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • mestranol

                mineral oil decreases levels of mestranol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                mestranol decreases levels of magnesium hydroxide by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.

              • methyclothiazide

                methyclothiazide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • phenindione

                mineral oil decreases levels of phenindione by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • metolazone

                metolazone decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • neomycin PO

                neomycin PO decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • nitrofurantoin

                magnesium hydroxide decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • paromomycin

                paromomycin decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • protamine

                mineral oil decreases levels of protamine by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • sodium polystyrene sulfonate

                sodium polystyrene sulfonate increases levels of magnesium hydroxide by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis.

              • spironolactone

                spironolactone increases levels of magnesium hydroxide by decreasing renal clearance. Minor/Significance Unknown.

              • streptomycin

                streptomycin decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • sulfadiazine

                mineral oil decreases levels of sulfadiazine by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • sulfamethoxazole

                mineral oil decreases levels of sulfamethoxazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • sulfisoxazole

                mineral oil decreases levels of sulfisoxazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • tobramycin

                tobramycin decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • torsemide

                torsemide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • triamterene

                triamterene increases levels of magnesium hydroxide by decreasing renal clearance. Minor/Significance Unknown.

              • vitamin A

                mineral oil decreases levels of vitamin A by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Hypotension

              Respiratory depression

              Lipid pneumonia if taken when reclined

              Excessive bowel activity

              Abdominal cramping

              Electrolyte imbalance

              Muscle weakness

              Anal pruritus and irritation

              Laxative dependence (Avoid chronic use)

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              Warnings

              Contraindications

              Existing electrolyte imbalance, appendicitis symptoms, acute surgical abdomen, fecal impaction, intestinal obstruction or perforation, dysphagia, bedridden patients

              Co-administration with stool softener

              < 6 years

              Hypersensitivity to drug or formulation components

              Cautions

              Renal insufficiency, Mg-restricted diet

              If taken at bedtime, patient should not be reclining to avoid aspiration of oil droplets

              Do not take within 2 hr of meals; may interfere with food nutrients & vitamins absorption

              Use caution in patients with severe renal impairment

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              Pregnancy & Lactation

              Pregnancy Category: C for mineral oil, B for magnesium hydroxide

              Lactation: Use cautiously in breast feeding as it is unknown whether mineral oil is excreted into breast milk

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Saline cathartic effect from magnesium hydroxide & emollient laxative effect from mineral oil

              Pharmacokinetics

              Onset: 30 min-6 hr

              Bioavailabilty: 15-30% of magnesium hydroxide, 30-60% for emulsified mineral oil

              Excretion: Mg is mainly excreted by kidney

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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.