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Table 2 Drugs associated with Mg deficiency and hypomagnesemia

From: Hypomagnesemia in critically ill patients

Drugs Mechanisms causing Mg deficiency Ref
  Renal loss  
Diuretics
 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]
Antimicrobial
 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]
Chemotherapy
 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]
Immunosuppressive
 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]
Epidermal growth factor receptor inhibitors
 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]
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