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A Double-Blind Placebo-Controlled Crossover Trial of Intravenous Magnesium Sulfate for Foscarnet-Induced Ionized Hypocalcemia and Hypomagnesemia in Patients with AIDS and Cytomegalovirus Infection
- Source :
- Antimicrobial Agents and Chemotherapy. 44:2143-2148
- Publication Year :
- 2000
- Publisher :
- American Society for Microbiology, 2000.
-
Abstract
- Foscarnet (trisodium phosphonoformate hexahydrate) is an antiviral agent used to treat cytomegalovirus disease in immunocompromised patients. One common side effect is acute ionized hypocalcemia and hypomagnesemia following intravenous administration. Foscarnet-induced ionized hypomagnesemia might contribute to ionized hypocalcemia by impairing excretion of preformed parathyroid hormone (PTH) or by producing target organ resistance. Prevention of ionized hypomagnesemia following foscarnet administration could blunt the development of ionized hypocalcemia. To determine whether intravenous magnesium ameliorates the decline in ionized calcium and/or magnesium following foscarnet infusions, MgSO 4 at doses of 1, 2, and 3 g was administered in a double-blind, placebo-controlled, randomized, crossover trial to 12 patients with AIDS and cytomegalovirus disease. Overall, increasing doses of MgSO 4 reduced or eliminated foscarnet-induced acute ionized hypomagnesemia. Supplementation, however, had no discernible effect on foscarnet-induced ionized hypocalcemia despite significant increases in serum PTH levels. No dose-related, clinically significant adverse events were found, suggesting that intravenous supplementation with up to 3 g of MgSO 4 was safe in this chronically ill population. Since parenteral MgSO 4 did not alter foscarnet-induced ionized hypocalcemia or symptoms associated with foscarnet, routine intravenous supplementation for patients with normal serum magnesium levels is not recommended during treatment with foscarnet.
- Subjects :
- Adult
Male
Foscarnet
endocrine system
medicine.medical_specialty
Side effect
Population
Pilot Projects
Antiviral Agents
Gastroenterology
Hypomagnesemia
Magnesium Sulfate
Double-Blind Method
Internal medicine
medicine
Humans
Magnesium
Pharmacology (medical)
Hypocalcaemia
Infusions, Intravenous
education
Pharmacology
Calcium metabolism
Acquired Immunodeficiency Syndrome
education.field_of_study
Cross-Over Studies
AIDS-Related Opportunistic Infections
Hypocalcemia
business.industry
virus diseases
biochemical phenomena, metabolism, and nutrition
medicine.disease
Crossover study
Infectious Diseases
Endocrinology
Parathyroid Hormone
Foscarnet Sodium
Cytomegalovirus Infections
Calcium
business
medicine.drug
Subjects
Details
- ISSN :
- 10986596 and 00664804
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- Antimicrobial Agents and Chemotherapy
- Accession number :
- edsair.doi.dedup.....22252589f366084352db2de076993bc0