Table 1.

Drug-induced magnesium loss and hypomagnesemia [10,27,28,33,34,39,41,42].

Drug Group (Drug, Substance)	Examples	Mechanism/Effect
Anti-diabetic medication	Insulin, insulin mimetic drugs	interference with Na+/Mg2+ exchanger SLC41A1, increased renal magnesium loss
Antimicrobials	Aminoglycoside antibiotics (e.g., gentamicin, tobramycin, amikacin)	reduced paracellular reabsorption of magnesium; increased renal magnesium loss, secondary hyperaldosteronism
	Antimicrobial medication (e.g., Pentamidine)	increased renal magnesium loss
	Antiviral medication (e.g., foscarnet)	magnesium chelating, nephrotoxicity, increased renal magnesium loss
	Polyene antifungals(e.g., amphotericin B)	nephrotoxicity, increased renal magnesium loss
Beta adrenergic agonists	Fenoterol, salbutamol, theophylline	increased renal magnesium excretion, metabolic abnormalities (magnesium shift into cells)
Bisphosphonates	Pamidronate	renal impairment, increased magnesium excretion
Cardiac glycoside	Digoxin	reduced renal tubular reabsorption of magnesium, increased magnesium excretion
Chemotherapeutic agents	Amsacrine, cisplatin	nephrotoxicity, cisplatin accumulates in renal cortex, increased renal magnesium loss, reduced TRPM6 expression (?)
Diuretics	Thiazide diuretics (e.g., HCT)	reduced TRPM6 expression (distal), increased renal magnesium loss, secondary hyperaldosteronism
	Loop diuretics (e.g,. furosemide)	reduced paracellular magnesium reabsorption (thick ascending limb), increased renal magnesium loss, secondary hyperaldosteronism
EGFR-Inhibitors	Cetuximab	increased renal magnesium loss, reduced TRPM6 activity
Immunosuppressants	mTOR-Kinase-Inhibitor (e.g., Rapamycin/Sirolimus)	reduced paracellular magnesium reabsorption
	Calcineurin inhibitors (e.g., cyclosporine, tacrolimus)	reduced TRPM6 expression (distal), increased renal magnesium loss
Proton-pump inhibitors	Omeprazole, pantoprazole	inhibition of active magnesium absorption by interfering with TRPM6 and TRPM7, increased renal magnesium loss (?)