Citrate of Magnesia, Citroma, Citro-Nesia
Classifications: saline cathartic; Therapeutic: laxative
Prototype: Magnesium hydroxide
Pregnancy Category: B
1.75 g/30 mL solution
Hyperosmotic laxative. Promotes bowel evacuation by causing osmotic retention of fluid, which distends colon and stimulates
To evacuate bowel prior to certain surgical and diagnostic procedures and to help eliminate parasites and toxic materials
after treatment with a vermifuge.
Severe renal impairment, renal failure; nausea, vomiting, diarrhea, abdominal pain, acute surgical abdomen; intestinal impaction,
obstruction or perforation; rectal bleeding; use of solutions containing sodium bicarbonate in patients on sodium-restricted
diets; children <2 y.
Mild or moderate renal impairment; cardiac disease; older adults; pregnancy (category B).
Route & Dosage
Adult: PO 240 mL once
Child: PO 26 y, 412 mL; 612 y, 50100 mL
- Give on an empty stomach with a full (240 mL) glass of water. Time dosing so that it does not interfere with sleep. Drug
produces a watery or semifluid evacuation in 26 h.
- Chill solution by pouring it over ice or refrigerate it until ready to use to increase palatability.
- Be aware that once container is opened, effervescence will decrease. This does not effect the quality of preparation.
- Store at 2°30° C (36°86° F) in tightly covered containers.
Adverse Effects (≥1%) GI:
Abdominal cramps, nausea, fluid and electrolyte imbalance, hypermagnesemia (prolonged use).
May decrease effectiveness of digoxin, oral anticoagulants
; will decrease absorption of ciprofloxacin, tetracyclines
; sodium polystyrene sulfonate
will bind magnesium, decreasing its effectiveness.
Assessment & Drug Effects
- Monitor for dehydration, hypokalemia, and hyponatremia (see Appendix F) since drug may cause intense bowel evacuation.
Patient & Family Education
- Do not use for routine treatment of constipation (especially in older adult).
- Expect some degree of abdominal cramping.