Magnesium sulfate Magnesium sulfate or magnesium sulphate (in English-speaking countries other than the US) is a chemical compound, a salt with the formula , consisting of magnesium cations (20.19% by mass) and sulfate anions . It is a white crystalline solid, ...

as a medication is used to treat and prevent low blood magnesium and seizures in women with

eclampsia Eclampsia is the onset of seizures (convulsions) in a woman with pre-eclampsia. Pre-eclampsia is one of the hypertensive disorders of pregnancy that presents with three main features: new onset of high blood pressure, large amounts of protein in ...

. It is also used in the treatment of

torsades de pointes ''Torsades de pointes, torsade de pointes'' or ''torsades des pointes'' (TdP) (, , translated as "twisting of peaks") is a specific type of abnormal heart rhythm that can lead to sudden cardiac death. It is a polymorphic ventricular tachycardia ...

, severe

asthma exacerbations Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, cou ...

constipation Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel moveme ...

, and barium poisoning. It is given by

injection into a vein Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutrie ...

muscle Skeletal muscles (commonly referred to as muscles) are Organ (biology), organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other ...

as well as by mouth. As

epsom salts Magnesium sulfate or magnesium sulphate (in English-speaking countries other than the US) is a chemical compound, a salt with the formula , consisting of magnesium cations (20.19% by mass) and sulfate anions . It is a white crystalline solid, ...

, it is also used for

mineral bath Mineral spas are spa resorts developed around naturally occurring mineral springs. Like seaside resorts, they are mainly used recreationally although they also figured prominently in prescientific medicine. Origins Spas were used for mille ...

s. Common side effects include

low blood pressure Hypotension is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure is indicated by two numbers, the systolic blood pressure (the top number) and the dia ...

skin flushing Flushing is to become markedly red in the face and often other areas of the skin, from various physiological conditions. Flushing is generally distinguished, despite a close physiological relation between them, from blushing, which is milder, ge ...

, and

low blood calcium Hypocalcemia is a medical condition characterized by low calcium levels in the blood serum. The normal range of blood calcium is typically between 2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L) while levels less than 2.1 mmol ...

. Other side effects may include vomiting, muscle weakness, and decreased breathing. While there is evidence that use during

pregnancy Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ...

may harm the baby, the benefits in certain conditions are greater than the risks. Its use during

breastfeeding Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that bre ...

is deemed to be safe. The way it works is not fully understood, but is believed to involve depressing the action of

neurons A neuron, neurone, or nerve cell is an electrically excitable cell that communicates with other cells via specialized connections called synapses. The neuron is the main component of nervous tissue in all animals except sponges and placozoa. ...

. Magnesium sulfate came into medical use at least as early as 1618. It is on the

World Health Organization's List of Essential Medicines The WHO Model List of Essential Medicines (aka Essential Medicines List or EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health s ...

Forms

Magnesium sulfate is available as magnesium sulfate dihydrate, magnesium sulfate heptahydrate, and magnesium sulfate monohydrate.

Heptahydrate

The World Health Organization recommends magnesium sulfate heptahydrate for medical injection.

External uses

Bath salts

Magnesium sulfate is used in

bath salts Bath salts are water-soluble, pulverized mineral, minerals that are added to water to be used for bathing. They are said to improve cleaning, enhance the enjoyment of bathing, and serve as a vehicle for cosmetic agents. Bath salts have been dev ...

, especially for foot baths to soothe sore feet. The reason for the inclusion of the salt is partially cosmetic: the increase in ionic strength prevents some of the temporary skin wrinkling (partial maceration) which would occur with plain water baths. Epsom salt baths have been claimed to also soothe and hasten recovery of muscle pain, soreness, or injury. However, these claims have not been scientifically confirmed. The solubility of magnesium sulfate water is inhibited by lipids in lotions resulting in variable absorption rates when applied to the skin. Temperature and concentration are also factors.

Research

Research on

topical A topical medication is a medication that is applied to a particular place on or in the body. Most often topical medication means application to body surfaces such as the skin or mucous membranes to treat ailments via a large range of class ...

magnesium (for example

epsom salt Epsomite, Epsom salt, or magnesium sulfate heptahydrate, is a hydrous magnesium sulfate mineral with formula MgSO4·7H2O. Epsomite crystallizes in the orthorhombic system as rarely found acicular or fibrous crystals, the normal form is as massi ...

baths) is limited.

Isolation tanks

Magnesium sulfate is commonly used in

flotation therapy An isolation tank, sensory deprivation tank, float tank, float pod, float cabin, flotation tank, or sensory attenuation tank is a water filled, pitch-black, light-proof, soundproof environment heated to the same temperature as the skin, developed ...

to prepare the concentrated solutions that fill the

isolation tank An isolation tank, sensory deprivation tank, float tank, float pod, float cabin, flotation tank, or sensory attenuation tank is a water filled, pitch-black, light-proof, soundproof environment heated to the same temperature as the skin, developed ...

s. Its high solubility in water yields baths with high

specific gravity Relative density, or specific gravity, is the ratio of the density (mass of a unit volume) of a substance to the density of a given reference material. Specific gravity for liquids is nearly always measured with respect to water (molecule), wa ...

that make the body more buoyant. Its negligible toxicity is an important asset in that application.

Mineral waters

Magnesium and sulfate ions are naturally present in some

mineral water Mineral water is water from a mineral spring that contains various minerals, such as salts and sulfur compounds. Mineral water may usually be still or sparkling (carbonated/effervescent) according to the presence or absence of added gases. T ...

Drawing paste

In the UK, a medication containing magnesium sulfate, called "drawing paste", is claimed to be useful for small

boil A boil, also called a furuncle, is a deep folliculitis, which is an infection of the hair follicle. It is most commonly caused by infection by the bacterium ''Staphylococcus aureus'', resulting in a painful swollen area on the skin caused by an ...

s or localised

infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable d ...

s, and removing splinters. The standard

British Pharmacopoeia The ''British Pharmacopoeia'' (''BP'') is the national pharmacopoeia of the United Kingdom. It is an annually published collection of quality standards for medicinal substances in the UK, which is used by individuals and organisations invo ...

composition is dried magnesium sulfate 47.76% (by mass),

phenol Phenol (also called carbolic acid) is an aromatic organic compound with the molecular formula . It is a white crystalline solid that is volatile. The molecule consists of a phenyl group () bonded to a hydroxy group (). Mildly acidic, it ...

0.49%, and

glycerol Glycerol (), also called glycerine in British English and glycerin in American English, is a simple triol compound. It is a colorless, odorless, viscous liquid that is sweet-tasting and non-toxic. The glycerol backbone is found in lipids know ...

to balance.

Internal uses

Magnesium sulfate can be administered internally by oral, respiratory, intravenous, or intrathecal routes.

Magnesium deficiency

Injected magnesium sulfate is used as a replacement therapy for

magnesium deficiency Magnesium deficiency is an electrolyte disturbance in which there is a low level of magnesium in the body. It can result in multiple symptoms. Symptoms include tremor, poor coordination, muscle spasms, loss of appetite, personality changes, ...

. Orally administered magnesium sulfate is

laxative Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation. Laxatives vary as to how they work and the side effects they may have. Certain stimulant, lub ...

and thus the magnesium is not well absorbed.

Arrhythmia

Magnesium sulfate may be used as an

antiarrhythmic agent Antiarrhythmic agents, also known as cardiac dysrhythmia medications, are a group of pharmaceuticals that are used to suppress abnormally fast rhythms ( tachycardias), such as atrial fibrillation, supraventricular tachycardia and ventricular t ...

for

cardiac arrest Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possib ...

under the ECC guidelines and for managing

quinidine Quinidine is a class IA antiarrhythmic agent used to treat heart rhythm disturbances. It is the enantiomer of antimalarial agent quinine, originally derived from the bark of the cinchona tree. The drug causes increased action potential duratio ...

-induced arrhythmias.

Asthma

Magnesium sulfate may be used as

bronchodilator A bronchodilator or broncholytic (although the latter occasionally includes secretory inhibition as well) is a substance that dilates the bronchi and bronchioles, decreasing resistance in the respiratory airway and increasing airflow to the l ...

after

beta-agonist Beta adrenergic agonists or beta agonists are medications that relax muscles of the airways, causing widening of the airways and resulting in easier breathing. They are a class of sympathomimetic agents, each acting upon the beta adrenoceptors. I ...

and

anticholinergic Anticholinergics (anticholinergic agents) are substances that block the action of the neurotransmitter called acetylcholine (ACh) at synapses in the central and peripheral nervous system. These agents inhibit the parasympathetic nervous syste ...

agents have been tried, e.g. in severe exacerbations of

asthma Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, c ...

,. The salt can be administered by nebulization or by intravenous injection.

Eclampsia

Magnesium sulfate is effective in decreasing the risk that

pre-eclampsia Pre-eclampsia is a disorder of pregnancy characterized by the onset of high blood pressure and often a significant amount of protein in the urine. When it arises, the condition begins after 20 weeks of pregnancy. In severe cases of the disease ...

progresses to

. Intravenous magnesium sulfate is used to prevent and treat seizures of eclampsia. It reduces the

systolic blood pressure Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" r ...

but does not alter the

diastolic Diastole ( ) is the relaxed phase of the cardiac cycle when the chambers of the heart are re-filling with blood. The contrasting phase is systole when the heart chambers are contracting. Atrial diastole is the relaxing of the atria, and ventricu ...

blood pressure, so the blood perfusion to the fetus is not compromised. It is also commonly used for eclampsia where compared to

diazepam Diazepam, first marketed as Valium, is a medicine of the benzodiazepine family that acts as an anxiolytic. It is commonly used to treat a range of conditions, including anxiety, seizures, alcohol withdrawal syndrome, muscle spasms, insomnia, ...

phenytoin Phenytoin (PHT), sold under the brand name Dilantin among others, is an anti-seizure medication. It is useful for the prevention of tonic-clonic seizures (also known as grand mal seizures) and focal seizures, but not absence seizures. The intr ...

it results in better outcomes.

Early delivery

Magnesium sulfate was once used as a

tocolytic Tocolytics (also called anti-contraction medications or labor suppressants) are medications used to suppress premature labor (from Greek τόκος ''tókos'', "childbirth", and λύσις ''lúsis'', "loosening"). Preterm birth accounts for 70% ...

, but meta-analyses have failed to support it as an anti-contraction medication. Usage for prolonged periods (more than five to seven days) may result in health problems for the baby. In those at risk of an early delivery, magnesium sulfate appears to decrease the risk of

cerebral palsy Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. Signs and symptoms vary among people and over time, but include poor coordination, spasticity, stiff muscles, Paresis, weak muscles, and tremors. There may be p ...

. It is unclear if it helps those who are born at term. Guidelines for the use of magnesium sulfate in mothers at risk of preterm labour are not strongly adhered to.

Barium chloride poisoning

Magnesium sulfate is used to treat

barium chloride Barium chloride is an inorganic compound with the formula Ba Cl2. It is one of the most common water-soluble salts of barium. Like most other water-soluble barium salts, it is white, highly toxic, and imparts a yellow-green coloration to a flame. ...

poisoning, where sulfate binds to barium to form insoluble

barium sulfate Barium sulfate (or sulphate) is the inorganic compound with the chemical formula Ba SO4. It is a white crystalline solid that is odorless and insoluble in water. It occurs as the mineral barite, which is the main commercial source of barium ...

Lead poisoning

Magnesium sulfate was historically used as a treatment for

lead poisoning Lead poisoning, also known as plumbism and saturnism, is a type of metal poisoning caused by lead in the body. The brain is the most sensitive. Symptoms may include abdominal pain, constipation, headaches, irritability, memory problems, inferti ...

. Prior to the development of

chelation therapy Chelation therapy is a medical procedure that involves the administration of chelating agents to remove heavy metals from the body. Chelation therapy has a long history of use in clinical toxicology and remains in use for some very specific medi ...

, cases of accidental lead ingestion were often immediately treated with magnesium sulfate, which would cause the lead to be precipitated out and, with a high enough dose, literally purged from the digestive system as insoluble

lead(II) sulfate Lead(II) sulfate (PbSO4) is a white solid, which appears white in microcrystalline form. It is also known as ''fast white'', ''milk white'', ''sulfuric acid lead salt'' or ''anglesite''. It is often seen in the plates/electrodes of car batteries ...

. In this application, magnesium sulfate saw particular use in veterinary medicine of the early-to-mid 20th century; Epsom salt was already available on many farms for agricultural purposes, and it was often prescribed in the treatment of farm animals which inadvertently ingested lead.

Adjuvant to local anesthetics

Magnesium sulfate can be administered intrathecally with opioids to prolong their analgesic duration.

Research

Magnesium sulfate has been used as an experimental treatment of

Irukandji syndrome Irukandji syndrome is a condition that results from envenomation by certain box jellyfish. In rare instances the sting may result in cardiac arrest and death. The most common jellyfish involved is the '' Carukia barnesi'', a species of Irukandj ...

caused by envenomation by certain species of

Irukandji jellyfish The Irukandji jellyfish ( ) are any of several similar, extremely venomous species of rare jellyfish. With a very small adult size of about a cubic centimetre (1 cm3), they are both the smallest and one of the most venomous jellyfish in th ...

, but the efficacy of this treatment remains unproven.

Safety

An abnormally elevated plasma concentration of magnesium is called

hypermagnesemia Hypermagnesemia is an electrolyte disorder in which there is a high level of magnesium in the blood. Symptoms include weakness, confusion, decreased breathing rate, and decreased reflexes. Complications may include low blood pressure and cardia ...

References

External links

* * * {{DEFAULTSORT:Magnesium Sulfate Magnesium World Health Organization essential medicines Wikipedia medicine articles ready to translate

Forms

Heptahydrate

External uses

Bath salts

Research

Isolation tanks

Mineral waters

Drawing paste

Internal uses

Magnesium deficiency

Arrhythmia

Asthma

Eclampsia

Early delivery

Barium chloride poisoning

Lead poisoning

Adjuvant to local anesthetics

Research

Safety

See also

References

External links