Table 2 Drugs associated with Mg deficiency and hypomagnesemia

Renal loss

 Loop

Increased renal Mg excretion by affecting the transepithelial voltage and inhibiting passive absorption.

[118]

 Thiazides

Enhance Mg entry into the cells in the distal convoluted tubule.

[118]

 Amphotericin B

 Aminoglycosides

 Capreomycin

 Pentamidine

Renal urinary Mg wasting caused by nephrotoxins may be part of tubular necrosis and acute renal failure. Notably, impairment in Mg reabsorption in the loop of Henle and distal tubules may occur before the onset and may persist after the resolution of renal damage.

[19, 47, 119]

 Cisplatin

Renal urinary Mg wasting caused by nephrotoxins may be part of tubular necrosis and acute renal failure. Cisplatin treatment is also associated with lowered intestinal absorption

[120]

 Calcineurin inhibitors

Urinary Mg wasting due to a downregulation of the Mg²⁺ transport proteins (TRPM6) in the loop of Henle and distal convoluted tubules.

[121]

 Cetuximab

 Panitumumab

 Matuzumab

Urinary Mg wasting due to a downregulation of the TRPM6 in the loop of Henle and distal convoluted tubules.

[122, 123]

Gastrointestinal loss

Proton-pump inhibitor

Impairing the intestinal Mg absorption by inhibiting Mg transporters (TRPM6 and TRPM7).

[124, 125]

Miscellaneous

Foscarnet

A general potent chelator of divalent cations which therefore has the potential to reduce ionized levels of Mg.

[126]

Cardiac glycosides

Mg deficiency is associated with cardiac glycosides. The exact mechanisms are not known.

[65]