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Magnesium can decrease the absorption and effectiveness of numerous medications, including some common antibiotics such as tetracycline (Achromycin, Sumycin), demeclocycline (Declomycin), doxycycline (Vibramycin), minocycline (Minocin), ciprofloxacin (Cipro), levofloxacin (Levaquin), moxifloxacin (Avelox) and ofloxacin (Floxin) (NIH 2017; Cipro Prescribing Information 2016); certain statin drugs such as rosuvastatin (Crestor) and atorvastatin (Lipitor) (Martin, Curr Med Res Opin 2008); sotalol (Betapace, Sotylize, Sorine), a drug prescribed for atrial fibrillation (Betapace Prescribing Information 2010); gabapentin (Neurontin), a drug prescribed for seizures (Neurontin Prescribing Information 2017); and levothyroxine (Synthroid), a drug prescribed for thyroid disorders (Synthroid Prescribing Information 2017).

On the other hand, one form of magnesium may increase the absorption of certain anti-diabetes drugs such as glibenclamide (DiaBeta, Micronase, Glynase) and glimepiride (Amaryl), potentially affecting blood sugar control (Neuvonen, Br J Clin Pharmacol 1991; Kivisto, Clin Pharmacol Ther 1991). In some cases, magnesium can still be taken, but only several hours before or after taking these drugs.

Be aware that these interactions apply not only to magnesium in supplements but also in over-the-counter antacids and laxatives.

In addition, certain medications such as the immunosuppressant drug tacrolimus, oral contraceptives, estrogen replacement therapy, and loop and thiazide diuretics can deplete levels of magnesium in the body (Niederstadt, Transplant Proc 1997; Blum, Harefuah 1991; Kuller, Am J Epidemiol 1985), while antacid medications including H2 blockers such as cimetidine (Tagamet), famotidine (Pepcid AC) and ranitidine (Zantac), and proton pump inhibitors such as esomeprazole (Nexium) and lansoprazole (Prevacid), may interfere with magnesium's laxative effects (Kieboom, Pharmacoepidemiol Drug Saf 2018; Yamasaki, Eur Clin Pharmacol 2014).

For details, see the Cautions and Concerns section of the Magnesium Supplements Review.

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