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Nottinghamshire Area Prescribing Committee
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 Formulary Chapter 9: Nutrition and blood - Full Chapter
09.05.01.03  Expand sub section  Magnesium
Magnesium Aspartate (Magnaspartate®)
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First Choice
Amber 3
Sachets
  • Amber 3 in line with SFH/NUH guidelines
  • Contain 10mmol magnesium per sachet
  • Link to SPC 
  • Magnesium citrate
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    Formulary
    Amber 2
    Tablet (unlicensed special)
  • Available at SFH, but magnaspartate now preferred as per SFH hypomagnesaemia guideline
  • Contains 6.2mmol magnesium per 150mg tablet (MagAsorb®)
  • No liquid available, but tablets disperse in water if needed. See here for general advice on dispersing tablets. Alternatively use magnesium hydroxide mixture.
  • May be available via retail chemists, but will need to be told it comes from "Lamberts Healthcare" and the cost can be extortionate. 
  •    
    Magnesium Glycerophosphate
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    Formulary
    Amber 2
    Chewable Tablet
  • For existing patients with short bowel or new patients who cannot tolerate magnesium aspartate. Gastro consultant recommended.
  • Contains 4mmol magnesium per tablet
  • Suspension (e.g. 4mmol/5ml) can be made in non-sterile manufacturing at NUH (unlicensed)
  • Tablets disperse in water if needed. See here for general advice on dispersing tablets.
  • See NUH hypomagnesaemia guideline below
     
  • Link  Link to reviews
    Link  NICE: Evidence Summary: Magnesium glycerophosphate
    Link  NUH: Guideline for the Treatment of Hypomagnesaemia in Adults
       
    Magnesium Hydroxide Mixture BP
    Restricted Drug Restricted
    Amber 2
    Liquid
  • Contains 14 mmol magnesium in 10ml
  • Restricted to use as an option if patients are unable to take tablets for magnesium replacement
  • Non-formulary for treatment of constipation 
  •    
    Magnesium Sulphate
    Formulary
    Red
    Injection 20% (1mL = approx 0.8mmol Mg)
    Injection 50% (1mL = approx 2mmol Mg)
  • See local hypomagnesaemia guidance below
     
  • Link  Hypomagnesaemia guidelines (NUH)
    Link  Hypomagnesaemia guidelines (SFH)
    Link  NUH: Guideline for the management of severe pre-eclampsia and eclampsia
    Link  SFH: Eclampsia and Pre-eclampsia guidance
    Link  SFH: ICCU Drugs Guidance
    Link  SFH: Magnesium for Asthma Guidance
    Link  UKMI Q&A: Can magnesium sulphate be given subcutaneously?
    Link  UKMI Q&A: Magnesium sulphate injection: converting between mM, mg and % w/v.
       
     ....
     Non Formulary Items
    Magnesium Chelate

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    Non Formulary
    Grey
    Tablet 150mg
     
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
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    Link to adult BNF
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    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Grey

    Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.
    Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting.
    Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
      

    Red

    Medicines which should normally be prescribed by specialists only. eg hospital only.
    For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
      

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
    Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
      

    Amber 2

    Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation.
    A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
    *Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
      

    Amber 3

    Primary care/ non specialist may initiate as per APC guideline.
    The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
      

    Green

    Medicines suitable for routine use within primary care.
    Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.   

    OTC

      

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