administered intramuscularly into each buttock using undiluted 50% magnesium sulfate injection, usp. after the initial i.v. dose, some clinicians administer 1 to 2 g/hour by constant i.v. infusion. subsequent intramuscular doses of 4 to 5 g of magnesium sulfate may be injected into alternate buttocks every four hours, depending on the continuing presence of the patellar reflex, adequate respiratory function, and absence of signs of magnesium toxicity. therapy should continue until paroxysms cease. a serum magnesium level of 6 mg/100 ml is considered optimal for control of seizures. a total daily (24 hr) dose of 30 to 40 g magnesium sulfate should not be exceeded. in the presence of severe renal insufficiency, frequent serum magnesium concentrations must be obtained and the maximum dosage of magnesium sulfate is 20 g per 48 hours. parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. do not administer unless solution is clear. discard unused portion.

ause lowering of blood pressure. the central and peripheral effects of magnesium poisoning are antagonized to some extent by intravenous administration of calcium. with intravenous administration the onset of anticonvulsant action is immediate and lasts about 30 minutes. following intramuscular administration the onset of action occurs in about one hour and persists for three to four hours. effective anticonvulsant serum levels range from 2.5 to 7.5 meq/liter. pharmacokinetics: absorption: intravenously administered magnesium is immediately absorbed. distribution: approximately 1-2% of total body magnesium is located in the extracellular fluid space. magnesium is 30% bound to albumin. metabolism: magnesium is not metabolized. excretion: magnesium is excreted solely by the kidney at a rate proportional to the serum concentration and glomerular filtration. special populations: renal insufficiency: magnesium is excreted solely by the kidney. in patients with severe renal insufficiency, the dose should be lower and frequent serum magnesium levels must be obtained (see dosage and administration ). hepatic insufficiency: magnesium is excreted solely by the kidney. no dosing adjustments are necessary in hepatic insufficiency. drug-drug interactions: drug induced renal losses of magnesium occur with the following drugs or drug classes: aminoglycosides amphotericin b cyclosporine diuretics digitalis cisplatin alcohol

l) 40 g 325 meq 4% (40 mg/ml) 32.5 meq/100 ml 325 mosmol/liter ndc 0409-3164-12 case of 12 single-dose flexible plastic containers 40 g/1000 ml (40 mg/ml) 40 g 325 meq 4% (40 mg/ml) 32.5 meq/100 ml 325 mosmol/liter ndc 0409-6729-24 case of 24 single-dose flexible plastic containers 2 g/50 ml partial fill container 50 ml volume in 100 ml container. (40 mg/ml) 2 g 16.25 meq 4% (40 mg/ml) 16.25 meq/50 ml 325 mosmol/liter ndc 0409-5239-60 case of 60 single-dose flexible plastic containers 2 g/50 ml (40 mg/ml) 2 g 16.25 meq 4% (40 mg/ml) 16.25 meq/50 ml 325 mosmol/liter ndc 0409-6730-13 case of 24 single-dose flexible plastic containers 4 g/50 ml (80 mg/ml) 4 g 32.5 meq 8% (80 mg/ml) 32.5 meq/50 ml 649 mosmol/liter ndc 0409-6730-60 case of 60 single-dose flexible plastic containers 4 g/50 ml (80 mg/ml) 4 g 32.5 meq 8% (80 mg/ml) 32.5 meq/50 ml 649 mosmol/liter warning: do not use flexible container in series connections. store at 20 to 25°c (68 to 77°f). [see usp controlled room temperature.] protect from freezing.