10 Medicines You Should Avoid Mixing with Magnesium

Magnesium is an essential mineral that helps maintain proper function of nerves, muscles, and the immune system. You can find it in foods such as leafy green vegetables, nuts and seeds. Magnesium is also found in various dietary supplements and medications, such as antacids and laxatives.

Despite its benefits, magnesium may interfere with the action of some medications. These interactions may affect how well your body absorbs or processes the medications, resulting in reduced effectiveness or possible side effects.

1. Some antibiotics

Antibiotics are used to treat bacterial infections. But when taken with magnesium, they can bind in the stomach, making it difficult for the body to properly absorb the antibiotic.

This may mean that your antibiotic will not help treat the infection. This interaction does not occur with all antibiotics, but some may need to be taken several hours apart from taking magnesium to prevent problems.

Common antibiotics that interact with magnesium include tetracyclines, such as vibramycin (doxycycline) and minocin (minocycline), and fluoroquinolones, such as Cipro (ciprofloxacin) and levaquin (levofloxacin).

To prevent an interaction, take these antibiotics either two hours before or four to six hours after taking any magnesium supplement or medication.

These antibiotics may also interact with other minerals and certain foods. Check with your doctor or pharmacist if you are not sure what to avoid or how to adjust the timing.

In addition, some aminoglycoside antibiotics, such as gentamicin and tobramycin, can cause the body to lose magnesium through urine. If you take one of these, your doctor may want to monitor your magnesium levels.

2. Bisphosphonates

Bisphosphonate drugs help strengthen bones and reduce the risk of fractures in people with osteoporosis. However, magnesium supplements or medications may affect how well your body absorbs these medications, making them less effective.

Common bisphosphonates include Fosamax (alendronate) and Actonel (risedronate).

To prevent any problems, take magnesium at least two hours before or after taking your bisphosphonate.

3. Blood pressure medications

Blood pressure medications such as Norvasc (amlodipine), Kalan or Verelan (verapamil), and Cardizem (diltiazem) belong to a group of drugs called calcium channel blockers. These medications are prescribed to treat high blood pressure (hypertension) and heart disease. They work by relaxing blood vessels.

Magnesium may act as a natural calcium channel blocker and potentially affect blood pressure. This may be seen as a benefit in some cases, but for some people, taking magnesium supplements along with these medications may cause their blood pressure to drop too low.

Your healthcare provider may tell you to closely monitor your blood pressure if you take magnesium supplements or medications. Alternatively, they may adjust your medications to prevent your blood pressure from dropping too much.

4. Some diabetes medications

Sulfonylureas are a class of diabetes medications that help control blood sugar levels. Magnesium may increase the absorption of sulfonylureas, potentially enhancing their effect. This may cause your blood sugar levels to drop (hypoglycemia).

Common sulfonylureas include:

• Amaryl (glimepiride)
• Diabetes (glyburide
• Glucotrol (glipizide)

In addition, insulin and other diabetes medications that mimic insulin (including sulfonylureas) may interfere with how the body processes magnesium. Insulin can cause magnesium to leak out of your cells, which may contribute to low magnesium levels in people with diabetes.

Over time, this loss of magnesium can worsen health problems associated with diabetes, such as heart problems. That’s why it’s important to maintain healthy magnesium levels, especially if you use insulin or sulfonylureas.

Your healthcare provider may suggest you monitor your blood sugar and magnesium levels or adjust your medications to prevent problems.

5. Digoxin

Digoxin is a medicine used to treat heart failure, but it can cause the body to lose magnesium. Low magnesium levels can make heart problems worse, especially if it also results in low potassium levels.

Because digoxin can affect your magnesium levels, your healthcare provider will likely monitor them closely with regular blood tests. If necessary, they may also suggest taking magnesium supplements to help prevent complications.

6. Diuretics

Diuretics, sometimes called “water pills,” are used to help the body get rid of excess fluid, which helps treat conditions such as high blood pressure, heart failure and kidney problems.

Some diuretics, including hydrochlorothiazide and loop diuretics such as Lasix (furosemide) and Bumex (bumetanide), can cause the body to lose magnesium through urine. Over time, this can lead to magnesium depletion, which can cause muscle cramps, fatigue, or even heart rhythm problems.

On the other hand, potassium-sparing diuretics such as aldactone (spironolactone) cause your body to conserve or retain minerals such as potassium and magnesium.

If you take diuretics, your healthcare provider may monitor your magnesium levels and recommend supplements if necessary to help maintain your magnesium balance.

7. Penicillamine

Penicillamine, also known as Cuprimin or Depen, is used to treat conditions such as Wilson’s disease, rheumatoid arthritis, and heavy metal poisoning. However, minerals such as magnesium, zinc, and iron can reduce the body’s ability to absorb penicillamine. This may make the medicine less effective.

If your body doesn’t absorb enough penicillamine, you may notice worsening symptoms such as joint pain or fatigue.

To prevent this interaction, your doctor will likely recommend taking magnesium or zinc supplements at least one hour before or after taking penicillamine. If you are also taking iron supplements, they will likely advise you to take a two-hour break from taking penicillamine.

8. Proton pump inhibitors (PPIs).

Proton pump inhibitors (PPIs) are a group of drugs used to reduce stomach acid and treat conditions such as gastroesophageal reflux disease (GERD) and stomach ulcers. Long-term use of PPIs may cause low magnesium levels. PPIs are available with prescription and over-the-counter.

The following drugs are a few examples of PPIs:

Your body needs stomach acid to properly absorb nutrients like magnesium, but PPIs reduce stomach acid production. Over time, this can cause magnesium deficiency, which can lead to muscle cramps, fatigue, or more serious problems such as an irregular heart rhythm.

Your healthcare provider will likely monitor your magnesium levels if you are taking long-term PPIs. Taking magnesium supplements may help, but it may not be enough for everyone. In such situations, they may suggest stopping PPI treatment.

9. Medicines for the thyroid gland

Thyroid medications such as Synthroid (levothyroxine) and Armor Thyroid are used to treat an underactive thyroid (hypothyroidism).

These medications require an acidic environment to be properly absorbed by the body. However, drugs and supplements containing magnesium can reduce stomach acid, making thyroid medications less effective.

To prevent this interaction, your doctor will likely suggest taking thyroid medications and magnesium-containing products at different times, usually several hours apart.

10. Gabapentin

Gabapentin is commonly prescribed to treat nerve pain and some types of seizures. However, magnesium may interfere with the body’s absorption of gabapentin, making it less effective.

To prevent this interaction, it is generally recommended that you take gabapentin at least two hours after taking any magnesium supplements or antacids. This helps ensure that the medicine works as intended.

Does magnesium interact with other supplements?

Although magnesium is important for your health, it can interact with other supplements. For example, long-term use of high doses of zinc can affect the body’s absorption of magnesium.

Likewise, taking too much magnesium can reduce your body’s ability to absorb iron.

Additionally, although it is generally safe to take magnesium and calcium supplements together, they may compete for absorption in the body. To get the most benefit from each mineral, you can take them at different times of the day or in a balanced ratio. Your healthcare provider can give advice on how to safely take mineral supplements to prevent any problems.

Summary

Magnesium is essential for your health, but it can interact with many medications, potentially reducing their effectiveness or causing side effects.

Magnesium is commonly found in vitamins, mineral supplements, and medications such as antacids and laxatives. Some medications that do not mix well with magnesium include some antibiotics, bisphosphonates, blood pressure medications, diabetes medications, diuretics, PPIs, and thyroid medications.

However, this is not a complete list of all possible interactions. If you are taking magnesium supplements or medications containing magnesium, it is important to discuss this with your doctor or pharmacist.