Dosing & Uses
Dosage Forms & Strengths
sodium sulfate/magnesium sulfate/potassium chloride
tablet
- 1.479g/0.225g/0.188g
-
Each carton contains
- 2 bottles; each bottle contains 12 tablets.
- 1 container with a 16-ounce fill line
Bowel Preparation
Indicated for cleansing of the colon in preparation for colonoscopy
Administer as a split dose (2-dose) regimen
Split-dose regimen consists of 2 doses: First dose during the evening prior to colonoscopy and second dose the next day, during the morning of the colonoscopy
Dose 1 (evening before colonoscopy)
- A low-residue breakfast (eg, eggs, white bread, cottage cheese, yogurt, coffee, tea) may be consumed
- After breakfast, consume only clear liquids until after the colonoscopy
- Early in the evening prior to colonoscopy, open one bottle of 12 tablets
- Fill provided container with 16 ounces of water (up to the fill line); swallow each tablet with a sip of water and drink entire amount over 15-20 min
- ~1 hr after the last tablet is ingested, drink 16 ounces of water over 30 minutes
- Wait ~30 min after finishing the second container of water; drink another 16 ounces of water over 30 minutes
- If patients experience preparation-related symptoms (eg, nausea, bloating, cramping), pause or slow the rate of drinking the additional water until symptoms diminish
Dose 2 (morning of colonoscopy)
- Continue to consume only clear liquids until after colonoscopy
- Morning of colonoscopy (5-8 hr before colonoscopy and no sooner than 4 hr from starting Dose 1), open second bottle of 12 tablets
- ~1 hr after the last tablet is ingested, drink 16 ounces of water over 30 minutes
- Wait ~30 min after finishing the second container of water; drink another 16 ounces of water over 30 minutes
- If patients experience preparation-related symptoms (eg, nausea, bloating, cramping), pause or slow the rate of drinking the additional water until symptoms diminish
- Complete all tablets and water at least 2 hr prior to colonoscopy
Dosage Modifications
Renal impairment
- Use with caution in patients with renal impairment or patients taking concomitant medications that may affect renal function; these patients may be at risk for renal injury
Safety and efficacy not established
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (13)
- baloxavir marboxil
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of baloxavir marboxil by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- bisacodyl
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of bisacodyl by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.
- bisacodyl rectal
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of bisacodyl rectal by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.
- demeclocycline
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of demeclocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- doxycycline
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of doxycycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- eravacycline
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of eravacycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- minocycline
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- omadacycline
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- polyethylene glycol/electrolytes and bisacodyl
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of polyethylene glycol/electrolytes and bisacodyl by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.
- raltegravir
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of raltegravir by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- sarecycline
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- senna
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of senna by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.
- tetracycline
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of tetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
Monitor Closely (251)
- abobotulinumtoxinA
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of abobotulinumtoxinA by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- alendronate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of alendronate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- aluminum hydroxide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of aluminum hydroxide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- amikacin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of amikacin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- amikacin liposome inhalation
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of amikacin liposome inhalation by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- amiodarone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of amiodarone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias.
- amitriptyline
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of amitriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- amlodipine
amlodipine, sodium sulfate/?magnesium sulfate/potassium chloride. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- amoxapine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of amoxapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- amphotericin B cholesteryl sulfate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of amphotericin B cholesteryl sulfate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- amphotericin B deoxycholate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of amphotericin B deoxycholate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- amphotericin B liposomal
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of amphotericin B liposomal by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- amphotericin B phospholipid complex
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of amphotericin B phospholipid complex by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- anagrelide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of anagrelide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias.
- aripiprazole
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of aripiprazole by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- arsenic trioxide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of arsenic trioxide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias.
- asenapine
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of asenapine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias.
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of asenapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant. - asenapine transdermal
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of asenapine transdermal by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- aspirin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of aspirin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- aspirin rectal
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of aspirin rectal by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- aspirin/citric acid/sodium bicarbonate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of aspirin/citric acid/sodium bicarbonate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- atracurium
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of atracurium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- azilsartan
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of azilsartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- benazepril
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of benazepril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- betamethasone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of betamethasone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- bictegravir
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of bictegravir by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Bictegravir sodium/emtricitabine/tenofovir alafenamide fumarate can be takenat least 2 hr before or 6 hr after taking a medication containing magnesium.
- bumetanide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of bumetanide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- buprenorphine
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of buprenorphine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias.
- calcitriol
calcitriol increases levels of sodium sulfate/?magnesium sulfate/potassium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely.
- calcium acetate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of calcium acetate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- calcium carbonate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of calcium carbonate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- calcium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of calcium chloride by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- calcium citrate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of calcium citrate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- calcium gluconate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of calcium gluconate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- calcium/vitamin D
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of calcium/vitamin D by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- candesartan
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of candesartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- captopril
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of captopril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- carbonyl iron
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- carboplatin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of carboplatin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- cariprazine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of cariprazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- celecoxib
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of celecoxib by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- chlorothiazide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of chlorothiazide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- chlorpromazine
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer chlorpromazine at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of chlorpromazine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. . - chlorthalidone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of chlorthalidone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- choline magnesium trisalicylate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of choline magnesium trisalicylate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ciprofloxacin
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ciprofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- cisatracurium
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of cisatracurium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- cisplatin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of cisplatin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- citalopram
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of citalopram by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.
- clevidipine
clevidipine, sodium sulfate/?magnesium sulfate/potassium chloride. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- clofazimine
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of clofazimine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- clomipramine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of clomipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- clozapine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of clozapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- corticotropin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of corticotropin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- cortisone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of cortisone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- cyclophosphamide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of cyclophosphamide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- daxibotulinumtoxinA
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of daxibotulinumtoxinA by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- deferiprone
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of deferiprone by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer deferiprone at least 2 hr before and after each dose to avoid chelation with magnesium. .
- deflazacort
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of deflazacort by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- delafloxacin
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of delafloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- desipramine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of desipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- dexamethasone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of dexamethasone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- diclofenac
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of diclofenac by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- diflunisal
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of diflunisal by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- digoxin
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of digoxin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer digoxin at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- diltiazem
diltiazem, sodium sulfate/?magnesium sulfate/potassium chloride. Either decreases toxicity of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- disopyramide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of disopyramide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- dofetilide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of dofetilide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- dolutegravir
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of dolutegravir by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer dolutegravir at least 2 hr before or 6 hr after each dose to avoid chelation with magnesium. .
- doxepin
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of doxepin by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- doxercalciferol
doxercalciferol increases levels of sodium sulfate/?magnesium sulfate/potassium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Doxercalciferol may enhance the hypermagnesemic effect of magnesium salts. .
- dronedarone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of dronedarone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- droperidol
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of droperidol by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- eliglustat
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of eliglustat by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- enalapril
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of enalapril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- eprosartan
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of eprosartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- escitalopram
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of escitalopram by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.
- ethacrynic acid
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ethacrynic acid by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ethanol
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ethanol by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- etidronate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of etidronate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- etodolac
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of etodolac by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- fenoprofen
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of fenoprofen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ferric carboxymaltose
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferric carboxymaltose by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- ferric citrate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ferric citrate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferric citrate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. . - ferric derisomaltose
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferric derisomaltose by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- ferric gluconate
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferric gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- ferric maltol
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- ferric pyrophosphate DIALYSATE
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferric pyrophosphate DIALYSATE by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- ferric pyrophosphate IV
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferric pyrophosphate IV by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- ferrous fumarate
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferrous fumarate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- ferrous gluconate
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferrous gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- ferrous sulfate
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferrous sulfate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- ferumoxytol
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ferumoxytol by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- fludrocortisone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of fludrocortisone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- fluoxetine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of fluoxetine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.
- fluphenazine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of fluphenazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- flurbiprofen
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of flurbiprofen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- fluvoxamine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of fluvoxamine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.
- foscarnet
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of foscarnet by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- fosinopril
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of fosinopril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- fosphenytoin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of fosphenytoin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- furosemide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of furosemide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- gabapentin
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of gabapentin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer gabapentin at least 2 hr after each dose to avoid chelation with magnesium. .
- gemifloxacin
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- gentamicin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of gentamicin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- glasdegib
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of glasdegib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- haloperidol
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of haloperidol by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- hydrochlorothiazide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of hydrochlorothiazide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- hydrocortisone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of hydrocortisone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- hydroxychloroquine sulfate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of hydroxychloroquine sulfate by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- ibandronate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ibandronate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ibuprofen
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ibuprofen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ibuprofen IV
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ibuprofen IV by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ibuprofen/famotidine
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ibuprofen/famotidine by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ibutilide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ibutilide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- ifosfamide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ifosfamide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- iloperidone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of iloperidone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of iloperidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant. - imipramine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of imipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- incobotulinumtoxinA
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of incobotulinumtoxinA by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- indomethacin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of indomethacin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin aspart
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin aspart protamine/insulin aspart
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin aspart protamine/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin degludec
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin detemir
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin detemir by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin glargine
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin glargine by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin glulisine
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin glulisine by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin inhaled
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin isophane human/insulin regular human
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin isophane human/insulin regular human by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin lispro
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin lispro by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin lispro protamine/insulin lispro
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin lispro protamine/insulin lispro by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin NPH
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin NPH by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- insulin regular human
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin regular human by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- irbesartan
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of irbesartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- iron dextran complex
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- iron sucrose
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of iron sucrose by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- isoniazid
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of isoniazid by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- isradipine
isradipine, sodium sulfate/?magnesium sulfate/potassium chloride. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- ivosidenib
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ivosidenib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- kanamycin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of kanamycin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ketoconazole
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ketoconazole by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ketoprofen
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ketoprofen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ketorolac
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ketorolac by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ketorolac intranasal
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ketorolac intranasal by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- lanthanum carbonate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of lanthanum carbonate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- lefamulin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of lefamulin by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- lenvatinib
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of lenvatinib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- levamlodipine
levamlodipine, sodium sulfate/?magnesium sulfate/potassium chloride. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- levofloxacin
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of levofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- levoketoconazole
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of levoketoconazole by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- levothyroxine
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer levothyroxine at least 4 hr after each dose to avoid chelation with magnesium.
- lisinopril
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of lisinopril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- lopinavir
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of lopinavir by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- losartan
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of losartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- loxapine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of loxapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- loxapine inhaled
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of loxapine inhaled by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- lurasidone
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of lurasidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- macimorelin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of macimorelin by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- magaldrate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of magaldrate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- magnesium oxide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of magnesium oxide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- mannitol
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of mannitol by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- meclofenamate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of meclofenamate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- mefenamic acid
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of mefenamic acid by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- meloxicam
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of meloxicam by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- methadone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of methadone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- methyclothiazide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of methyclothiazide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- methylprednisolone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of methylprednisolone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- moexipril
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of moexipril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- molindone
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of molindone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- mometasone sinus implant
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of mometasone sinus implant by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- moxifloxacin
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- nabumetone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of nabumetone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- naproxen
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of naproxen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- neomycin PO
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of neomycin PO by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- nicardipine
nicardipine, sodium sulfate/?magnesium sulfate/potassium chloride. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- nifedipine
nifedipine, sodium sulfate/?magnesium sulfate/potassium chloride. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- nilotinib
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of nilotinib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- nimodipine
nimodipine, sodium sulfate/?magnesium sulfate/potassium chloride. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- nisoldipine
nisoldipine, sodium sulfate/?magnesium sulfate/potassium chloride. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- norfloxacin
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of norfloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- nortriptyline
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of nortriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- ofloxacin
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- olanzapine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of olanzapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- olmesartan
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of olmesartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- onabotulinumtoxinA
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of onabotulinumtoxinA by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- oxaprozin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of oxaprozin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- paliperidone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of paliperidone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of paliperidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant. - pancuronium
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of pancuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- panobinostat
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of panobinostat by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- paroxetine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of paroxetine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.
- penicillamine
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of penicillamine by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer penicillamine at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- perindopril
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of perindopril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- perphenazine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of perphenazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- phenytoin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of phenytoin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- pimavanserin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of pimavanserin by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of pimavanserin by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant. - pimozide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of pimozide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of pimozide by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant. - piroxicam
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of piroxicam by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- pitolisant
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of pitolisant by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- plazomicin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of plazomicin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- polysaccharide iron
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of polysaccharide iron by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .
- prabotulinumtoxinA
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of prabotulinumtoxinA by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- prednisolone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of prednisolone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- prednisone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of prednisone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- primidone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of primidone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- procainamide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of procainamide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- protriptyline
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of protriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- quetiapine
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of quetiapine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of quetiapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant. - quinapril
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of quinapril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- quinidine
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of quinidine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- quinine
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of quinine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- ramipril
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ramipril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- ribociclib
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ribociclib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- rifampin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of rifampin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- rimabotulinumtoxinB
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of rimabotulinumtoxinB by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- risedronate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of risedronate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- risperidone
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of risperidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- rocuronium
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of rocuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- sacubitril/valsartan
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of sacubitril/valsartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- salsalate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of salsalate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- samidorphan
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of samidorphan by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- sertraline
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of sertraline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.
- sevelamer
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of sevelamer by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium polystyrene sulfonate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of sodium polystyrene sulfonate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sotalol
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of sotalol by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- streptomycin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of streptomycin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- succinylcholine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of succinylcholine by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- sucralfate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of sucralfate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sucroferric oxyhydroxide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of sucroferric oxyhydroxide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sulindac
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of sulindac by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- telmisartan
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of telmisartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- tetrabenazine
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of tetrabenazine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- thioridazine
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of thioridazine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- thiothixene
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of thiothixene by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- tiludronate
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of tiludronate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- tobramycin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of tobramycin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- tobramycin inhaled
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of tobramycin inhaled by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- tolmetin
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of tolmetin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- toremifene
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of toremifene by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- torsemide
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of torsemide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- trandolapril
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of trandolapril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- triamcinolone acetonide extended-release injectable suspension
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of triamcinolone acetonide extended-release injectable suspension by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- triamcinolone acetonide injectable suspension
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of triamcinolone acetonide injectable suspension by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- trientine
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of trientine by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer trientine at least 1 hr before and after each dose to avoid chelation with magnesium. .
- trifluoperazine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of trifluoperazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- trimipramine
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of trimipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- valsartan
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of valsartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- vandetanib
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of vandetanib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- vardenafil
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of vardenafil by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
- vecuronium
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of vecuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- verapamil
verapamil, sodium sulfate/?magnesium sulfate/potassium chloride. Either decreases toxicity of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- ziprasidone
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ziprasidone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of ziprasidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant. - zoledronic acid
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of zoledronic acid by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
Minor (0)
Adverse Effects
>10%
Mild upper abdominal pain (65-82%)
Mild nausea (71-74%)
Mild abdominal distension (68-73%)
Mild vomiting (48-53%)
Moderate vomiting (47-52%)
Moderate upper abdominal pain (16-35%)
Moderate abdominal distension (27-30%)
Moderate nausea (20-27%)
1-10%
Severe nausea (2-6%)
Severe abdominal pain (2%)
Severe abdominal distension (1%)
Postmarketing Reports
Gastrointestinal: Gastric ulceration, gastritis
Hypersensitivity: Anaphylaxis, angioedema, dyspnea, rash, pruritus, urticaria
Warnings
Contraindications
Hypersensitivity to any ingredient
Gastrointestinal obstruction or ileus
Bowel perforation
Toxic colitis or toxic megacolon
Gastric retention
Cautions
Encourage adequate hydration, assess concurrent medications, and consider laboratory assessments (electrolytes, creatinine, BUN) before and after each use
There have been rare reports of serious arrhythmias associated with the use of ionic osmotic laxative products for bowel preparation; use with caution in patients at increased risk of arrhythmias (eg, patients with a history of prolonged QT, uncontrolled arrhythmias, recent myocardial infarction, unstable angina, congestive heart failure, cardiomyopathy); consider predose and postcolonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias
Use with caution in patients with impaired renal function or patients taking concomitant medications that may affect renal function (eg, diuretics, ACE inhibitors, angiotensin receptor blockers, NSAIDs); advise these patients of the importance of adequate hydration and consider performing baseline and postcolonoscopy laboratory testing
Rare reports of serious arrhythmias associated with ionic osmotic laxative products
Osmotic laxative products may produce colonic mucosal aphthous ulcerations; reports of serious cases of ischemic colitis requiring hospitalization; coadministration with stimulant laxatives may increase risk
If gastrointestinal obstruction or perforation suspected, perform appropriate diagnostic studies to rule out these conditions before administering; caution with severe active ulcerative colitis
Seizures
- Reports of generalized tonic-clonic seizures and/or loss of consciousness have been associated with use of bowel preparation products in patients with no prior history of seizures
- Use caution in patients with a history of seizures and in patients at increased risk of seizure, such as patients taking medications that lower the seizure threshold (eg, tricyclic antidepressants), patients withdrawing from alcohol or benzodiazepines, or patients with known or suspected hyponatremia
Drug interaction overview
- Caution with coadministration of drugs that increase risk of fluid and electrolyte disturbances or that may increase risk of seizure, arrhythmias, or prolonged QT
- Avoid coadministration with stimulant laxatives owing to increased risk of mucosal ulceration or ischemic colitis
- Caution if coadministered with medications that may affect renal function (eg, diuretics, ACE inhibitors, angiotensin receptor blockers, NSAIDs)
-
Potential for reduced drug absorption
- Oral medication administered within 1 hr before bowel preparation may not be absorbed properly
- Administer tetracycline or fluoroquinolone antibiotics, iron, digoxin, chlorpromazine, or penicillamine at least 2 hr before and not less than 6 hr after administration of bowel preparation to avoid chelation
Pregnancy & Lactation
Pregnancy
No data available data on use in pregnant females to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
No reproduction or developmental studies in animals have been conducted with sodium sulfate, magnesium sulfate, and potassium chloride
Lactation
There are no available data on drug presence in human or animal milk, effects on the breastfed child, or effects on milk production
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.Pharmacology
Mechanism of Action
Osmotic action of sodium sulfate and magnesium sulfate induces a laxative effect
The physiological consequence is increased water retention in the lumen of the colon, resulting in loose stools
Absorption
Median serum sulfate concentration increased by about 2.5-fold at 5-8 hr post Dose 2 (0.61 mmol/L) compared with baseline (0.25 mmol/L) and returned to baseline by 24-48 hr after colonoscopy
Elimination
Excretion: Fecal
Administration
Oral Administration
Correct fluid and electrolyte abnormalities before treatment
Administration of 2 doses (each dose is 12 tablets) is required for a complete preparation for colonoscopy
Consume water with each dose and additional water must be consumed after each dose
Consume a low-residue breakfast on the day before colonoscopy, followed by clear liquids up to 2 hr prior to colonoscopy.
Do not drink alcohol or milk, and do not eat or drink anything colored red or purple
Do not take other laxatives during treatment
Do not take oral medications within 1 hour of starting each dose
If taking tetracycline or fluoroquinolone antibiotics, iron, digoxin, chlorpromazine, or penicillamine, take these medications at least 2 hr before and not less than 6 hr after administration of each dose
Stop consumption of all fluids at least 2 hr before the colonoscopy
Storage
Tablets: Store at 20-25ºC (68-77ºF); excursions permitted to 15-30ºC (59-86ºF)
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