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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 9 - Nutrition and blood 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing

09.05.01.03 Magnesium

Magnesium Aspartate (Magnaspartate®)

First Choice

243mg Sachets (10mmol Magnesium). 

N.B This is the only licensed oral magnesium salt and should be prescribed where possible from 2 years upwards.

Maximum licensed dose: 1 sachet (10mmol) twice daily

Magnesium Glycerophosphate

Restricted Drug Restricted

Tablets containing 4mmol Magnesium
Oral Liquid containing 1mmol/1mL

Restricted to use when magnesium aspartate inappropriate e.g children under 2 years and for enteral tube administration where volume too great.

N.B. tablets can be crushed and mixed with waterfor enteral tube administration.

Magnesium Sulphate

RED
Formulary

4mmol/10mL 10% Injection

4mmol/2mL 50% Injection

10mmol/5ml 50% Injection                                                           

20mmol/10ml 50% Injection

Risk of incorrect dosing/administration of magnesium sulphate injection

We have been made aware of a serious clinical incident in another Trust involving magnesium sulphate 50% (20mmol in 10mL) ampoules, 50 pack size DEMO brand.

Labelling on the front of the box gives the strength as 50% and as 20.3mmol/10mL but the labelling on the ampoule only gives the strength as 50%w/v.

This issue also applies to the magnesium sulphate 10% (4mmol in 10mL) ampoules, 10 pack size DEMO brand. The labelling on the box gives the strength as 10% w/v and as 4.06mmol/10 mL but the labelling on the ampoule only gives the strength as 10%w/v.

Pharmacy is making every effort to source from other suppliers but this has been very difficult owing to ongoing drug shortages.

Before administration, check the ampoule against the label on the front of the box to confirm the strength. Please ensure all relevant staff are made aware of this.

Non formulary items

Magnesium Chelate

 
Non Formulary

Magnesium citrate

 
Non Formulary

Magnesium Hydroxide Mixture BP

 
Non Formulary
Classifications
May be initiated in any care setting
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.