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E
ur
J Cl
in
Pharm acol ( 1
99
1) 40: 437-438
003169709100108G
Eu
ropean Journ
al
of
CSIJO
@
DcsGJO
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©S
pringe
r-
Ve
rl
ag 1991
Magnesium-L-aspartate-HCI and magnesium-oxide:
bioavailability in healthy volunteers
B.
Miihlbauer1,
M.
Schwenk1,
W.
M.
Coram2, K.
H.
Antonin 1,
P.
Etienne2, P.R. Bieck 1,
and
F.
L.
Douglas2
1
Hum
an Pharmacology Institute. Ci
ba-Ge
igy G
mbH
. T
ii
bingen. FRG
' Pharmaceuticals Division. Ciba-
Ge
i
gy
Co
r
po
ra
ti
o
n.
S
ummit
J. USA
Received: January 28. 1990/Acccpt cd
in
revised form:
Octo
ber 19. 1990
Ke
y
words:
Magnesium de
fici
ency,
ora
l repl acement ther-
apy. bi
oava
il
abilit
y,
adverse e
ff
ects
Magnesium de
fi
ciency can occ
ur
in several
di
seases. such
as malabs
orpti
on
sy
ndrom
es, di abetes mellitus
and
renal
di
so
rder
s.
It
can be
tr
ea
ted with oral magnesium com-
po
und
s,
of
which several
pr
e
parati
ons are
curr
ently
ava
il-
able : va rious
co
mplex sa
lt
s, and the oxide or hyd rox
id
e of
magnesium [1 ]. In the
pr
esent s
tud
y,
two formulations of
magnesium-L-asp
ara
te HC I (MagnesiocardR ta
bl
ets and
Magnesioca
rdR
gra
nules, Ve
rl
a
-Phann
,
FR
G)
were com-
pared with
ma
gnesium-oxide (Magnetran
sR
fo
rte cap-
sules,
Fr
esenius,
FRG
) with respect to
bi
oava
ilability,
tol
era
bility, a
nd
st
oo
l
fr
e
qu
enc
y.
Th
e
thr
ee
magnesium
pr
ep
ara
tions were
ea
ch adminis-
tered in an open manner to 3
gro
ups
of
8 h
ea
lthy volun-
t
ee
rs according to a para
ll
el g
roup
desig
n.
Th
e gro
up
s
of
4 males and 4
fe
males
ea
ch were co
mparabl
e with regard
to age, heig
ht
and body weight. A
ft
er
a control and a
pl
acebo period of one
wee
k, 60
mEq
/d and 90
mEq
/d
magnesium were administered for 7 days
eac
h.
No
sp
ec
ial
di
et was given. Cumula
ti
ve urinary magnesium excretio n
was used to assess magnesium absorptio n [2. 3]. Plasma
and urine concentrations of magnesium. potassium and
calcium were measured by atome emissio n spectrome
tr
y
us
in
g a Spectraspan
SR
(
ARL
).
Urine
pH
was assessed
wi
th indicator strips (Sp
ez
ia
lindikator
pH
4.
0
-7.
0. Merck.
Darm
stadt). St
oo
l
fr
e
qu
ency was
eva
luated by the volun-
t
ee
rs, recording
th
e time and
numb
er of st
oo
ls. Mouth to
cae
cum
transit time was estimated us
in
g salazos
ul
fa
py-
ridine (
SASP
) as the test co
mp
o
und
[4]. measuring SP
in
sa
li
va by a specific
and
selective
HPL
C me
th
od [5
].
M
ea
ns and
SD
s of
th
e pa
ram
eters were calc
ul
ated and
tested by anal
ys
is of variance (AN
OY
A. randomized fac-
torial design) for diffe rences. 95% confidence intervals
were ca lculated
fo
r cumula
ti
ve urinary magnesium ex
cr
e-
tion. For statist
ic
al analysis of st
oo
l
fr
e
qu
en
cy
. the one
crite
ri
on variance anal
ys
is of Kruskal and Wallis was ap-
plied [6
].
Durin
g the
hi
gher magnesium dosage, st
oo
l
fr
e
qu
e
nc
y
was
in
cr
eased
1.
8-
fo
ld by magnesium-oxide, 3.2-
fo
ld by
gra
nules and 2.0-
fo
ld
by tablets of
ma
gnesium-L-aspa
r-
tate-HC
I.
Th
e differences between the
tr
ea
tment
gro
ups
did not r
eac
h sta
ti
stical significance. M
ea
n mouth-c
ae
cum
trans
it
time
of
ab
out 4 h was not affected by magnesium
tr
ea
tment, suggesting
th
at
th
e magnesium
pr
eparations
exerted
th
eir laxative e
ff
ect mainly in
th
e colo
n.
Minor
ad-
verse e
ff
ec
ts were reported in
ea
ch
gro
up
, such as
fl
a-
tule nce. diarrh
oea
, and gastric discomfor
t.
Th
ere were
complaints
of
an unpl
easa
nt taste of the granule
fo
rmula-
ti
on. which may influence patients compliance.
Urine
pH
was de
cr
eased ( -
0.
5) during
ma
gnesium-
L-aspartate
-H
Cl and
in
cr
ease
d ( + 0.5) during magne-
sium-oxide (P < 0.01) administration. indicating a s
li
g
ht
dis
turb
ance of the
ac
id
/base equilibrium.
Th
is
aspect may
be of clinical impor
ta
nce, pa rticula
rl
y in e
ld
erly patients
with multiple diseases. Calcium and po tassium l
eve
ls in
plasma and urine were not a
lt
ered by magnesium
tr
eat-
ment.
Pl
asma magnesium, rema
in
ed
unchan
ged too.
Th
e m
ea
n cumula
ti
ve urinary magensium ex
cr
etion
(Tab. 1) was similar during the placebo and control peri-
od
s.
rang
in
g
fr
om 77.5 to
93
.7
mEq/w
ee
k.
Th
ere
was a
significant increase during magnesium administra
ti
on,
more marked during
th
e Mg-L-asp
ar
tate-HCl
pha
se
(P < 0.0001).
Th
e maximum value
of
187.4 mEq/week was
Table 1. Total 7 day cumula
ti
ve urin ary magnesium excre
ti
on
(mEq/
24
h ··· 7d) during administra
ti
on
of
Mg-L-aspartatc-H
CI
(gra-
nules and tablets) and Mg-oxi
de
caps
ul
es in comparison with cont ro l
(no treatment) and placebo. Mean values (95% confidence inte
r-
vals) in 8 volunt
eers
are give
Pe
ri
ods days 0- 7 days
8-
14 days 1
5-2
1 days 22-28
Treatm ent /
dose
control pl
acebo
60 mEq/d 90 mEq/d
Mg-L-aspartatc- 78 84 146 1
81
HC I ta
bl
ets
(54-
101) (59- l I 0) (108- 184) ( 137-225)
Mg-L-aspartatc- 91 81 156 187
H C
l-
granules (61- 120)
(56-
106) (
11
3- 199) ( 15 1- 224)
Mg-ox ide
94
90 133 137
caps
ul
es
(76-
111
)
(74-
105) ( I I 1
-155)
(
11
5- 159)
438
reached
during
treatment
with magnesium-L-asparate-
HCI granules 90
mEq
/d.
Th
e differences
betwe
en
the
thr
ee
treatm
ent
groups
indicated
better
absorption
of
magnesium-L-asparate-HCI
than
of
magnesium-oxide.
On
e possible ex
planation
might
be
the
poor
solubility
of
magnesium-oxide, which
in
water
is 8.6 mg/di
[7]
.
In conclusion, all
three
formulations
of
magnesium
given
in
the trial
were
well
tolerated
,
but
they increased
the
number
of
stools. Magnesium-oxide
showed
signifi-
cantly lower
absorption
than
magnesium L-asparate-HCI.
As
there
were complaints
of
an
unpleasant
taste
of
the
re-
suspended
granules, tablets
of
magnesium-L-aspartate-
HCI
appear
to
be the first choice for
magne
sium substitu-
tion
among
the
formulations investigated.
References
1.
Mudge
GH
, Weine r IM (1990)
Agents
affecting volume
and
com-
position
of
body fluids. In: Gilman
AG
, Ra
ll
TW
, Nies AS, Taylor
P (eds)
The
pharmacological basis
of
th
erape
utics 8th ed
..
Perga-
mon, New York , pp 682-707
Announcements
International
Boerhaal
'e Course
on
Drug-Drug and Drug-Food
Interactions. Mechanisms, Study Design and Clinical Significance
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1991
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The
Netherlands
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"Third
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Locomoteur
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CHU
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Timone
F-13385 Marseille cedex 5
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The
7th International Conference on Pharmacoepidemiology
26-29 August,
1991
Basel, Switzerland
(E
urop
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Trade
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Co
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Center)
For
f11r1her
i11f
or
111a1i
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11
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1:
Dr. Stanley A.
Ed
lavitch
Conference
Chair
ISPE Office
Univers
it
y
of
Minnesota
B.
Muhlbauer
et al.: Bioavail
ab
ility
of
magnesium
2.
Drenick EJ,
Hunt
IF
, Swcndscid
ME
(
196
9) Magnesium depletion
during
prolonged
fasting
of
obese
males. J Cl
in
Endocrinol
Metab
29:
1341
-1348
3. Lim
P.
Jacob
E (1972) Magnesium status
of
a
lc
oholic patients. Me-
t
abo
lism 2 1: 1045-
1051
4.
Kennedy M, Chinwah P, Wade DN (1979) A pharmacological
me
thod
of
measuring
mouth
to caecum tran
si
t time
in
man.
Br
J
Cl
in
Pharmacol
8:
372-373
5.
Owerbach
J.
Johnson
NF,
Bates
TR
,
Pi
eniaszek HJ,
Jusko
WJ
( 1987) High
performance
liquid
chromatographic
assay
of
sulfa-
pyridinc and acetylsulfapyridine in biological fluids. J Pharm
Sci
67:250-253
6.
Kruska l
WH.
Wallis WA (I 952) Use
of
ranks
in
one-criterion vari-
ance anal
ys
i
s.
J
Am
Stat Assoc 47: 583-621
7.
Weast RC (1975)
Handb
oo
k of chemistry and physics, 55th ed.
Cleveland. CR C Press, B-106
B.
MOhlbaucr, M. D.
Human
Pharmacolo
gy
Institute
(HPI)
Ciba
-G
eigy
GmbH
Waldhornlestral3c
22
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FRG
Co
ll
ege
of
Pharmacy
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8
308
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Street
S.
E.
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USA
Tel.: (612) 624-4426/5931
Fax: (6 12) 624-2974
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of
Cellular and Molecular Biology
1- 7
September
, 1991
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des
Congres)
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ktor
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