Magnesium EQL Pharma
Magnesium hydroxide 250 mg — Prescription mineral supplement for kidney stone prevention and magnesium deficiency
Magnesium EQL Pharma is a prescription magnesium hydroxide supplement providing 250 mg of elemental magnesium per tablet. It is primarily used for the prevention of recurrent kidney stones of unknown origin (idiopathic nephrolithiasis) and for the treatment of magnesium deficiency (hypomagnesemia). Magnesium plays a crucial role in over 300 enzymatic reactions in the body and is an essential mineral for neuromuscular function, bone health, and urinary stone prevention.
Quick Facts
Key Takeaways
- Magnesium EQL Pharma provides 250 mg of elemental magnesium per tablet as magnesium hydroxide, used for kidney stone prevention and magnesium deficiency treatment.
- The standard dose is one tablet twice daily, but your doctor may adjust the dose based on your blood test results and individual needs.
- Diarrhea is the most common side effect (1–2% of patients) and usually resolves when the dose is temporarily reduced for one week.
- This medicine should not be used in patients with severe kidney impairment, chronic urinary tract infections, or infected kidney stones.
- Safe during pregnancy with no known risks; consult your doctor for prolonged use during breastfeeding.
What Is Magnesium EQL Pharma and What Is It Used For?
Magnesium EQL Pharma is a prescription magnesium supplement containing magnesium hydroxide, used to prevent recurrent kidney stones of unknown origin and to treat clinically significant magnesium deficiency.
Magnesium EQL Pharma contains magnesium hydroxide as its active ingredient, providing 250 mg of elemental magnesium per tablet. Magnesium is the fourth most abundant mineral in the human body and the second most common intracellular cation after potassium. It serves as a cofactor in more than 300 enzymatic reactions, including those involved in energy metabolism, protein synthesis, DNA replication, and neuromuscular signal transmission.
The primary indication for Magnesium EQL Pharma is the prevention of recurrent kidney stones (nephrolithiasis) of unknown origin. Kidney stones are a common urological condition, affecting approximately 5–15% of the population worldwide, with recurrence rates as high as 50% within five years of a first episode. Magnesium acts as a natural inhibitor of calcium oxalate and calcium phosphate crystal formation in the urinary tract. By increasing the excretion of magnesium in urine, this medication reduces the supersaturation of stone-forming salts, thereby decreasing the likelihood of stone formation.
The second indication is the treatment of magnesium deficiency (hypomagnesemia). Magnesium deficiency can result from inadequate dietary intake, gastrointestinal malabsorption syndromes (such as Crohn’s disease or celiac disease), chronic alcoholism, certain medications (such as proton pump inhibitors or diuretics), or increased renal magnesium losses. Symptoms of magnesium deficiency include muscle cramps, tremors, fatigue, cardiac arrhythmias, and in severe cases, seizures and tetany.
Magnesium hydroxide, the active compound in this formulation, is a well-established inorganic magnesium salt that has been used in clinical medicine for decades. Compared to magnesium oxide, magnesium hydroxide has better bioavailability and is generally better tolerated by the gastrointestinal tract. The tablet formulation allows for convenient twice-daily dosing, and the scored tablet design enables easier swallowing for patients who have difficulty with larger tablets.
It is important to note that magnesium hydroxide may also be approved for other indications not covered in this patient information. Always consult your healthcare provider for guidance on its appropriate use in your specific clinical situation.
What Should You Know Before Taking Magnesium EQL Pharma?
Before starting Magnesium EQL Pharma, inform your doctor about any kidney problems, urinary tract infections, or other medications you are taking. This medicine is contraindicated in patients with severe kidney impairment or infected kidney stones.
Contraindications
You must not take Magnesium EQL Pharma if you have any of the following conditions:
- Allergy to magnesium hydroxide or any of the inactive ingredients listed in the composition section of this page (crospovidone, silicon dioxide, magnesium stearate, povidone).
- Chronic urinary tract infection — persistent or recurrent urinary tract infections can alter urine chemistry and promote the formation of struvite (magnesium ammonium phosphate) stones, which could be worsened by additional magnesium supplementation.
- Infected kidney stones — also known as struvite or infection stones, these are composed partly of magnesium and would not benefit from additional magnesium intake.
- Severely impaired kidney function — the kidneys are the primary route of magnesium excretion. When kidney function is significantly reduced (estimated GFR below 30 mL/min), the body cannot adequately eliminate excess magnesium, leading to a dangerous buildup of magnesium in the blood (hypermagnesemia). Symptoms of hypermagnesemia include nausea, vomiting, muscle weakness, low blood pressure, respiratory depression, and in extreme cases, cardiac arrest.
Warnings and Precautions
Talk to your doctor before taking Magnesium EQL Pharma if you have mildly to moderately impaired kidney function (estimated GFR between 30–60 mL/min). In these patients, more frequent monitoring of serum magnesium levels is recommended to avoid accumulation. Your doctor may also need to adjust the dose or frequency of administration.
Patients with any degree of renal impairment should have their kidney function and serum magnesium levels checked regularly during treatment. This is particularly important during long-term use, as the risk of hypermagnesemia increases with the duration of therapy in patients with compromised renal function.
Drug Interactions
Inform your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines. Magnesium hydroxide can form insoluble complexes with certain drugs in the gastrointestinal tract, reducing their absorption and effectiveness. As a general rule, take other medications at least 2 hours before or after Magnesium EQL Pharma to minimize potential interactions.
Pregnancy and Breastfeeding
Magnesium EQL Pharma can be used during pregnancy. There are no known risks associated with the use of magnesium hydroxide during pregnancy. In fact, adequate magnesium intake during pregnancy is important for fetal development and maternal health, as magnesium plays a role in fetal bone formation, enzymatic function, and prevention of pre-eclampsia.
Magnesium hydroxide does pass into breast milk, but it is unlikely to affect the nursing infant at therapeutic doses. The amount of magnesium transferred to breast milk is generally small relative to the infant’s total dietary magnesium intake. However, your doctor should be consulted if you plan to use Magnesium EQL Pharma for more than occasional use during breastfeeding, particularly at higher doses.
Driving and Operating Machinery
Magnesium EQL Pharma has no known effect on the ability to drive or use machines. No dose adjustments or special precautions are needed for patients who drive or operate heavy machinery while taking this medication.
How Does Magnesium EQL Pharma Interact with Other Drugs?
Magnesium can reduce the absorption of several important medications, including certain antibiotics, bisphosphonates, and immunosuppressants. As a general rule, separate the intake of other medicines from Magnesium EQL Pharma by at least 2 hours.
Magnesium hydroxide, like other antacid-type minerals, can form poorly soluble chelation complexes with certain drugs in the gastrointestinal tract. This physical interaction reduces the absorption and bioavailability of the co-administered drug, potentially diminishing its therapeutic effect. The table below summarizes the most clinically relevant drug interactions.
| Drug or Drug Class | Type of Interaction | Clinical Significance | Recommendation |
|---|---|---|---|
| Tetracycline antibiotics (doxycycline, minocycline) | Reduced absorption via chelation | Major | Take antibiotic 2–3 hours before or 4–6 hours after magnesium |
| Quinolone antibiotics (ciprofloxacin, levofloxacin) | Reduced absorption via chelation | Major | Take antibiotic 2 hours before or 6 hours after magnesium |
| Bisphosphonates (alendronate, risedronate) | Reduced absorption via chelation | Major | Take bisphosphonate at least 30 min before; separate from magnesium by 2+ hours |
| Mycophenolate mofetil | Reduced absorption | Moderate | Separate doses by at least 2 hours |
| Eltrombopag (Revolade) | Reduced absorption via chelation | Major | Take eltrombopag 2 hours before or 4 hours after magnesium |
| Iron supplements | Mutual absorption reduction | Moderate | Separate doses by at least 2 hours |
| Levothyroxine (thyroid hormone) | Reduced absorption | Moderate | Take levothyroxine on empty stomach; separate by 4 hours |
Major Interactions
Tetracycline and quinolone antibiotics form particularly strong chelation complexes with divalent cations such as magnesium. The reduction in antibiotic absorption can be clinically significant, potentially leading to treatment failure. If you are prescribed any antibiotic while taking Magnesium EQL Pharma, inform your prescribing physician so appropriate dose timing can be arranged.
Bisphosphonates used for osteoporosis (such as alendronate or risedronate) must be taken on an empty stomach with plain water, and any mineral supplements including magnesium should be taken at least 2 hours after the bisphosphonate to avoid impaired absorption.
Minor Interactions
Some vitamin D supplements and calcium preparations may slightly influence magnesium absorption, but this interaction is generally not clinically significant at standard therapeutic doses. Patients taking multiple mineral supplements should discuss optimal timing with their pharmacist or physician to maximize the absorption of each supplement.
Potassium-sparing diuretics (such as spironolactone, amiloride, or triamterene) may reduce renal magnesium excretion, potentially increasing the risk of hypermagnesemia when combined with magnesium supplements. Your doctor should monitor your magnesium levels if you take these diuretics concurrently.
What Is the Correct Dosage of Magnesium EQL Pharma?
The standard dose for adults is one 250 mg tablet twice daily, but your doctor will determine the exact dose based on your individual needs and may adjust it following blood tests.
Always use this medicine exactly as your doctor or pharmacist has directed. Do not change the dose or stop taking it without consulting your prescribing physician. Dosage adjustments should be based on clinical response and laboratory monitoring of serum magnesium levels.
Adults
Standard Adult Dose
Kidney stone prevention: 250 mg (1 tablet) twice daily, morning and evening.
Magnesium deficiency: 250 mg (1 tablet) twice daily. Your doctor may increase the dose based on serum magnesium levels and clinical response. In severe deficiency, initial intravenous magnesium replacement may be needed before transitioning to oral supplementation.
The tablets have a score line to facilitate swallowing for patients who have difficulty swallowing the whole tablet. The score line is not intended for splitting the dose.
Children
Pediatric Use
The use of Magnesium EQL Pharma in children has not been specifically studied in controlled clinical trials. Any use in pediatric patients should be under direct physician supervision, with dosing determined by the child’s weight, age, and clinical condition. Pediatric dosing guidelines for magnesium supplementation typically recommend 5–10 mg/kg/day of elemental magnesium, divided into 2–3 doses.
Elderly
Elderly Patients
No specific dose adjustment is required for elderly patients with normal kidney function. However, since kidney function naturally declines with age, elderly patients should have their renal function assessed before starting therapy and monitored periodically. Dose reduction may be necessary if estimated GFR falls below 60 mL/min.
Patients with Kidney Impairment
Renal Impairment
Mild impairment (GFR 60–89 mL/min): Standard dose with periodic monitoring of serum magnesium.
Moderate impairment (GFR 30–59 mL/min): Dose reduction may be needed. Consult your doctor. More frequent monitoring of serum magnesium is required.
Severe impairment (GFR <30 mL/min): Contraindicated. Do not use Magnesium EQL Pharma.
Missed Dose
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a forgotten tablet. Missing occasional doses is unlikely to significantly affect your treatment outcomes, but consistent daily intake is important for optimal kidney stone prevention.
Overdose
In patients with normal kidney function, mild magnesium overdose is typically self-limiting, as the kidneys can efficiently excrete excess magnesium. The primary symptom is usually osmotic diarrhea. However, in patients with renal impairment, even modest overdoses can lead to significant hypermagnesemia requiring medical intervention, which may include intravenous calcium gluconate, fluid resuscitation, and in severe cases, hemodialysis.
Monitoring
Your doctor may need to follow up treatment with blood tests to ensure your magnesium levels are within the therapeutic range. For kidney stone prevention, periodic urine analysis and 24-hour urine collections may be ordered to assess urinary magnesium excretion, urine pH, and the levels of stone-promoting substances such as calcium, oxalate, and citrate.
What Are the Side Effects of Magnesium EQL Pharma?
The most common side effect is diarrhea, occurring in approximately 1–2% of patients. This usually resolves when the dose is temporarily halved for one week. Serious side effects are rare and primarily associated with impaired kidney function.
Like all medicines, Magnesium EQL Pharma can cause side effects, although not everyone experiences them. Most side effects are mild and related to the osmotic effect of magnesium in the gastrointestinal tract. Magnesium hydroxide attracts water into the intestinal lumen, which can soften stools and increase bowel frequency.
Common
May affect up to 1 in 10 patients
- Diarrhea — The most frequently reported side effect, occurring in approximately 1–2% of patients. Diarrhea is dose-dependent and typically mild. If you experience diarrhea, it usually resolves if the dose is halved for one week. Speak with your doctor before adjusting your dose.
Very Rare
May affect up to 1 in 10,000 patients
- Hypermagnesemia (elevated blood magnesium levels) — This has been observed after prolonged use in patients with impaired kidney function. Symptoms may include nausea, flushing, drowsiness, muscle weakness, diminished reflexes, hypotension, and in severe cases, respiratory depression or cardiac arrest. This is why the medication is contraindicated in severe renal impairment.
Frequency Not Known
Cannot be estimated from available data
- Abdominal pain — Some patients may experience cramping or discomfort in the abdomen, particularly when initiating therapy or taking the medication on an empty stomach.
Approximately 1–2% of patients experience diarrhea as a side effect of magnesium supplementation. This is related to the osmotic properties of unabsorbed magnesium in the intestinal tract. The diarrhea is usually mild to moderate in severity and self-limiting. If diarrhea occurs, your doctor may recommend temporarily halving the dose for one week, after which the full dose can usually be resumed without recurrence of symptoms.
Hypermagnesemia is a serious but very rare complication that is almost exclusively seen in patients with significantly impaired kidney function who take magnesium supplements over extended periods. In patients with normal renal function, the kidneys efficiently regulate serum magnesium levels, making clinically significant hypermagnesemia extremely unlikely. Early signs of hypermagnesemia include nausea, facial flushing, and drowsiness. If you experience any of these symptoms, especially in combination with muscle weakness or breathing difficulties, seek immediate medical attention.
When to Seek Medical Attention
Contact your doctor promptly if you experience persistent diarrhea lasting more than a few days, severe abdominal pain, signs of dehydration (excessive thirst, dark urine, dizziness), or any symptoms of hypermagnesemia described above. If you develop a rash, itching, swelling of the face or throat, or difficulty breathing, these could indicate an allergic reaction and you should seek emergency medical care immediately.
Reporting Side Effects
It is important to report suspected side effects after the medicine has been authorized. This makes it possible to continuously monitor the benefit-risk balance of the medicine. Healthcare professionals and patients are encouraged to report any suspected adverse reactions to their national pharmacovigilance authority.
How Should You Store Magnesium EQL Pharma?
Store at room temperature, out of the sight and reach of children. Do not use after the expiration date printed on the packaging.
Keep this medicine out of the sight and reach of children. Store at room temperature (below 25°C / 77°F) in the original container to protect from moisture. Do not store in the bathroom or other humid environments, as humidity can degrade the tablet integrity.
Do not use this medicine after the expiry date stated on the carton or label after “EXP.” The expiry date refers to the last day of that month. Once the container has been opened, the tablets should be used within the shelf life indicated and the container should be tightly closed after each use.
Do not throw away medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines you no longer use. These measures help to protect the environment and prevent accidental ingestion by children or pets.
What Does Magnesium EQL Pharma Contain?
Each tablet contains magnesium hydroxide equivalent to 250 mg of elemental magnesium, along with four inactive ingredients.
Active Ingredient
The active substance is magnesium hydroxide, equivalent to 250 mg of elemental magnesium per tablet. Magnesium hydroxide (Mg(OH)2) is an inorganic compound that dissociates in the acidic environment of the stomach to release magnesium ions, which are then absorbed primarily in the small intestine.
Inactive Ingredients (Excipients)
- Crospovidone — a cross-linked form of polyvinylpyrrolidone used as a tablet disintegrant, helping the tablet break apart quickly after ingestion for faster absorption.
- Silicon dioxide (colloidal) — used as a flow agent during tablet manufacturing to ensure uniform distribution of the active ingredient.
- Magnesium stearate — a lubricant that prevents the tablet from sticking to manufacturing equipment during the compression process.
- Povidone — a binder that helps hold the tablet together and maintain its shape and integrity.
Tablet Appearance and Pack Sizes
Magnesium EQL Pharma tablets are white, round, biconvex tablets with a score line, measuring 12 mm in diameter. The tablets are available in plastic containers of 90, 100, and 105 tablets. Not all pack sizes may be marketed in all countries.
How Does Magnesium Prevent Kidney Stones?
Magnesium inhibits kidney stone formation through multiple mechanisms: it binds to oxalate in the gut (reducing absorption), complexes with oxalate in the urine (preventing crystallization), and increases urinary citrate excretion (a natural stone inhibitor).
Kidney stones, or renal calculi, form when the concentration of stone-forming substances in urine exceeds their solubility threshold. The most common type of kidney stone is calcium oxalate, accounting for approximately 70–80% of all stones. Magnesium plays a multifaceted role in preventing stone formation through several complementary mechanisms.
In the gastrointestinal tract, magnesium ions bind to dietary oxalate, forming insoluble magnesium oxalate complexes. This reduces the amount of free oxalate available for intestinal absorption, which in turn lowers urinary oxalate excretion — a key risk factor for calcium oxalate stone formation. Studies published in the Journal of Urology and the European Urology journal have confirmed that oral magnesium supplementation significantly reduces urinary oxalate levels in stone-forming patients.
In the urinary tract, magnesium competes with calcium for binding to oxalate. When magnesium binds to oxalate in the urine, it forms a more soluble complex than calcium oxalate, effectively reducing the supersaturation of calcium oxalate and lowering the driving force for crystal nucleation and growth. This is the direct crystallization inhibition mechanism.
Additionally, magnesium appears to increase urinary citrate excretion. Citrate is one of the most important natural inhibitors of calcium stone formation, as it binds to calcium in the urine and prevents it from combining with oxalate or phosphate. A meta-analysis published in the BMC Nephrology journal found that magnesium supplementation was associated with a 30–50% reduction in kidney stone recurrence rates in randomized controlled trials.
The European Association of Urology (EAU) guidelines on urolithiasis recommend magnesium supplementation as part of the metabolic evaluation and prevention strategy for patients with recurrent calcium oxalate stones, particularly those with documented hypomagnesuria (low urinary magnesium). The American Urological Association (AUA) similarly recognizes the role of magnesium in comprehensive stone prevention programs.
Frequently Asked Questions
What is Magnesium EQL Pharma used for?
Magnesium EQL Pharma is a prescription medication used for two primary purposes: preventing recurrent kidney stones of unknown origin (idiopathic nephrolithiasis) and treating magnesium deficiency (hypomagnesemia). Each tablet provides 250 mg of elemental magnesium as magnesium hydroxide. It works by increasing urinary magnesium levels, which inhibits calcium oxalate crystal formation, and by correcting low magnesium levels in the body.
How should I take Magnesium EQL Pharma?
The standard dose is one 250 mg tablet taken twice daily, typically morning and evening. Always follow your doctor’s specific instructions, as the dose may be adjusted based on blood test results. The tablet has a score line to make it easier to swallow if needed, but this does not mean you should take half a tablet unless directed by your doctor. Take the tablet with a glass of water, and maintain adequate fluid intake throughout the day to support kidney stone prevention.
What are the main side effects?
The most common side effect is diarrhea, occurring in approximately 1–2% of patients. This is typically mild and often resolves if the dose is temporarily halved for one week. Very rarely, patients with impaired kidney function may develop elevated magnesium levels in the blood (hypermagnesemia) after prolonged use. Abdominal pain has also been reported but the frequency is not precisely known. If you experience persistent diarrhea, severe abdominal pain, or any symptoms of hypermagnesemia (muscle weakness, drowsiness, breathing difficulty), contact your doctor.
Can I take Magnesium EQL Pharma during pregnancy or breastfeeding?
Yes, Magnesium EQL Pharma can be used during pregnancy. There are no known risks to the mother or fetus from taking magnesium hydroxide at recommended doses during pregnancy. In fact, adequate magnesium intake during pregnancy is beneficial for both maternal and fetal health. During breastfeeding, magnesium does pass into breast milk in small amounts but is unlikely to affect the nursing infant. However, consult your doctor if you plan to use it for more than occasional use while breastfeeding.
Can I take Magnesium EQL Pharma with other medications?
Magnesium can interact with several medications by reducing their absorption in the digestive tract. Important interactions include tetracycline and quinolone antibiotics, bisphosphonates (osteoporosis medications), mycophenolate (immunosuppressant), eltrombopag, iron supplements, and levothyroxine (thyroid hormone). As a general rule, take other medications at least 2 hours before or after Magnesium EQL Pharma. Always inform your doctor and pharmacist about all medications and supplements you are taking.
How does magnesium prevent kidney stones?
Magnesium prevents kidney stones through multiple mechanisms. In the gut, it binds to dietary oxalate, reducing the amount absorbed into the bloodstream and subsequently excreted in urine. In the urine, magnesium competes with calcium for oxalate binding, forming a more soluble complex and reducing calcium oxalate supersaturation. Magnesium also promotes citrate excretion, a natural stone inhibitor. Clinical studies have shown that magnesium supplementation can reduce stone recurrence by 30–50% in appropriate patient populations.
Who should not take Magnesium EQL Pharma?
Magnesium EQL Pharma should not be taken by patients with severe kidney impairment (estimated GFR below 30 mL/min), chronic urinary tract infections, infected kidney stones (struvite stones), or known allergy to magnesium hydroxide or any of the tablet’s inactive ingredients. Patients with moderate kidney impairment should use it only under medical supervision with regular blood monitoring. If you are unsure whether this medication is appropriate for you, consult your doctor.
References
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List, 2023. Geneva: WHO; 2023.
- European Association of Urology (EAU). EAU Guidelines on Urolithiasis. Arnhem: EAU Guidelines Office; 2024.
- Pearle MS, Goldfarb DS, Assimos DG, et al. Medical Management of Kidney Stones: AUA Guideline. Journal of Urology. 2014;192(2):316–324. doi:10.1016/j.juro.2014.05.006
- Schwartz BF, Bruce J, Leslie S, Stoller ML. Rethinking the role of urinary magnesium in calcium urolithiasis. Journal of Endourology. 2001;15(3):233–235.
- Jahnen-Dechent W, Ketteler M. Magnesium basics. Clinical Kidney Journal. 2012;5(Suppl 1):i3–i14. doi:10.1093/ndtplus/sfr163
- National Institute for Health and Care Excellence (NICE). Renal and ureteric stones: assessment and management. NICE guideline [NG118]. London: NICE; 2019 (updated 2024).
- Saigal CS, Joyce G, Timilsina AR. Direct and indirect costs of nephrolithiasis in an employed population: opportunity for disease management? Kidney International. 2005;68(4):1808–1814.
- Negri AL, Spivacow FR. Magnesium and calcium nephrolithiasis – an update. Archivos Españoles de Urología. 2019;72(10):1021–1029.
- British National Formulary (BNF). Magnesium hydroxide. London: BMJ Group and Pharmaceutical Press; 2025.
- Rude RK. Magnesium. In: Ross AC, Caballero B, Cousins RJ, et al., editors. Modern Nutrition in Health and Disease. 11th ed. Baltimore: Lippincott Williams & Wilkins; 2012. p. 159–175.
Medical Editorial Team
This article was written by the iMedic Medical Editorial Team, comprising licensed physicians specializing in nephrology, urology, and clinical pharmacology. All content is based on current international guidelines from the European Association of Urology (EAU), the American Urological Association (AUA), the National Institute for Health and Care Excellence (NICE), and the World Health Organization (WHO).
Our editorial process follows the GRADE evidence framework, ensuring that all medical claims are supported by the highest available level of evidence. Content is independently reviewed by our Medical Review Board and updated regularly to reflect the latest research and clinical guidelines.
Last medical review: January 14, 2026 | Next scheduled review: July 2026
iMedic receives no commercial funding and has no financial relationships with pharmaceutical companies. All content is produced independently for educational purposes only.