The Basics

What is Magnesium Citrate?

Used as a laxative to treat occasional constipation.

Brand names for Magnesium Citrate

Nolvadex

How Magnesium Citrate is classified

Cathartics, Gastrointestinal Agents, Magnesium Compounds

Magnesium Citrate During Pregnancy

Magnesium Citrate pregnancy category

Category BNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Magnesium Citrate while pregnant

Can you take magnesium citrate while pregnant? Reproduction studies with PREPOPIK have been performed in pregnant rats at oral doses up to 2000 mg/kg/day (about 1.2 times the recommended human dose based on the body surface area), and did not reveal any evidence of impaired fertility or harm to the fetus due to PREPOPIK. The reproduction study in rabbits was not adequate, as treatment-related mortalities were observed at all doses. A pre and postnatal development study in rats showed no evidence of any adverse effect on pre and postnatal development at oral doses up to 2000 mg/kg twice daily (about 1.2 times the recommended human dose based on the body surface area). There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, PREPOPIK should be used during pregnancy only if clearly needed.

Taking Magnesium Citrate While Breastfeeding

What are recommendations for lactation if you're taking Magnesium Citrate?

No information is available on the impact of the clinical use of magnesium citrate while breastfeeding. However, other magnesium salts have been studied. Intravenous magnesium sulfate increases milk magnesium concentrations only slightly. Oral absorption of magnesium by the infant is poor, so maternal magnesium citrate is not expected to affect the breastfed infant’s serum magnesium. Magnesium citrate supplementation during pregnancy might delay the onset of lactation, but it can be taken during breastfeeding and no special precautions are required.

Maternal / infant drug levels

No information is available on the impact of the clinical use of magnesium citrate while breastfeeding. However, other magnesium salts have been studied. Intravenous magnesium sulfate increases milk magnesium concentrations only slightly. Oral absorption of magnesium by the infant is poor, so maternal magnesium citrate is not expected to affect the breastfed infant’s serum magnesium. Magnesium citrate supplementation during pregnancy might delay the onset of lactation, but it can be taken during breastfeeding and no special precautions are required.

Possible effects of Magnesium Citrate on milk supply

One mother who received intravenous magnesium sulfate for 3 days for pregnancy-induced hypertension had lactogenesis II delayed until day 10 postpartum. No other specific cause was found for the delay, although a complete work-up was not done.[3] A subsequent controlled clinical trial found no evidence of delayed lactation in mothers who received intravenous magnesium sulfate therapy.[4] Some, but not all, studies have found a trend toward increased time to the first feeding or decreased sucking in infants of mothers treated with intravenous magnesium sulfate during labor because of placental transfer of magnesium to the fetus.[4][5]A study in 40 pairs of matched healthy women with vaginally delivered singleton pregnancies, outcome endpoints were compared in those receiving continuous oral magnesium aspartate HCl supplementation mean dose of 459 mg daily (range 365 to 729 mg of magnesium daily) for at least 4 weeks before delivery versus non-supplemented controls. In the magnesium group, significantly fewer women could breastfeed their infants exclusively at discharge (63% vs 80%).[6]

Possible alternatives to Magnesium Citrate

(Laxative) Bisacodyl, Docusate, Magnesium Hydroxide, Psyllium, Sodium Picosulfate, Sodium Phosphate.

List of References

Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Cruikshank DP, Varner MW, Pitkin RM. Breast milk magnesium and calcium concentrations following magnesium sulfate treatment. Am J Obstet Gynecol. 1982;143:685-8. PMID: 7091241
2. Baldwin WF. Clinical study of senna administration to nursing mothers.:assessment of effects on infant bowel habits. Can Med Assoc J. 1963;89:566-7. PMID: 14045350
3. Haldeman W. Can magnesium sulfate therapy impact lactogenesis? J Hum Lact. 1993;9:249-52. PMID: 8260059
4. Riaz M, Porat R, Brodsky NL, Hurt H. The effects of maternal magnesium sulfate treatment on newborns: a prospective controlled study. J Perinatol. 1998;18:449-54. PMID: 9848759
5. Rasch DK, Huber PA, Richardson CJ et al. Neurobehavioral effects of neonatal hypermagnesemia. J Pediatr. 1982;100:272-6. PMID: 7199083
6. Meier B, Huch R, Zimmermann R et al. Does continuing oral magnesium supplementation until delivery affect labor and puerperium outcome? Eur J Obstet Gynecol Reprod Biol. 2005;123:157-61. PMID: 15899543

Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.

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