Kühne S1, Sprenger J1, Erkenberg J1, Kisters K1,2

1Medizinische Klinik I & ESH Excellence Centre, St. Anna Hospital Herne & RUB Bochum, Germany

2Gesellschaft für Magnesiumforschung, Tutzing, Germany

 

Several drugs including especially diuretics and proton-pump inhibitors can cause a magnesium loss and hypomagnesemia.Some drugs and magnesium use the same transporters and metabolic pathways in the body for their intestinal absorption, metabolism, and elimination. Especially in multiple drug intake, there is often a potential risk of interaction in magnesium status. (1, 2)

In this context we report a 64 years old man with systemic sclerosis and normal renal function under an immunosuppressive therapy with 3 x 1,5 gr. cyclophosphamide showing a severe magnesium deficiency of 0.6 mg/dl (normal range: 1.7 – 2.55 mg/dl). Three days after magnesium therapy there was an increase and normalization of serum magnesium showing 2.56 mg/dl.

Concerning magnesium status and cyclophosphamide therapy only sparse data exist. Some authors described a magnesium depletion in patients receiving cisplatin-based chemotherapy in combination with cyclophosphamide. (3)

In animals simultaneous use of cyclophosphamide and low-magnesium diet an increased intensity of degenerative changes and necrotic lesions and reduced enzyme activities have already been described before. (4)

In conclusion under cyclophosphamide magnesium status has to be measured and corrected sufficiently.

 

References

1.Gröber U, Schmidt J, Kisters K. Magnesium in prevention and therapy. Nutrients. 2015; 7: 8199-8226.

2.Gröber U. Magnesium and drugs. Int J Mol Sci. 2019; 20(9): 2094-2113.

3.Hodgkinson E, Neville-Webbe HL, Coleman RE. Magnesium depletion in patients receiving cisplatin-based chemotherapy. Clin Oncol (R Coll Radiol). 2006; 18(9): 710-718.

4.Utzen J. Histological and histochemical examinations of the myocardium of rats kept on low-magnesium diet and treated with cyclophosphamide. Mater Med Pol. 1990; 22(3): 162-167.