Magnesium Evolan
Magnesium hydroxide 250 mg — Oral Tablet
Quick Facts About Magnesium Evolan
Key Takeaways About Magnesium Evolan
- Dual purpose: Used both for preventing recurrent kidney stones and for treating magnesium deficiency
- Prescription medication: Must be prescribed by a doctor who will determine the appropriate dosage for your condition
- Safe during pregnancy: No known risks during pregnancy; consult your doctor for regular use while breastfeeding
- Common side effect is diarrhea: Affects 1-2% of patients but usually resolves when the dose is temporarily halved
- Not for everyone: Do not use if you have severely impaired kidney function, chronic urinary tract infection, or infected kidney stones
What Is Magnesium Evolan and What Is It Used For?
Magnesium Evolan is a prescription medication containing magnesium hydroxide (250 mg elemental magnesium per tablet) used primarily to prevent recurrent kidney stones of unknown origin and to treat magnesium deficiency. It works by increasing urinary magnesium levels, which helps inhibit the formation of calcium oxalate kidney stones.
Magnesium is one of the most abundant minerals in the human body and serves as a cofactor in more than 300 enzymatic reactions. It plays crucial roles in energy production, protein synthesis, muscle and nerve function, blood glucose control, and blood pressure regulation. Despite its importance, magnesium deficiency is relatively common, particularly among older adults, individuals with gastrointestinal diseases, and those taking certain medications such as proton pump inhibitors or loop diuretics.
Magnesium Evolan delivers magnesium in the form of magnesium hydroxide, a well-established and highly bioavailable source of elemental magnesium. Each tablet provides 250 mg of elemental magnesium, which represents approximately 60-65% of the recommended daily allowance for most adults. The magnesium hydroxide formulation has a mild alkalinizing effect in the gastrointestinal tract, which can be beneficial for patients prone to acidic conditions.
Kidney Stone Prevention
One of the primary indications for Magnesium Evolan is the prevention of recurrent kidney stones of unknown origin (idiopathic nephrolithiasis). Kidney stones affect approximately 10-15% of the global population at some point in their lives, with calcium oxalate stones being the most common type, accounting for about 70-80% of all cases. Recurrence rates are high, with up to 50% of patients experiencing another stone within 5-10 years of their first episode.
Magnesium plays a key role in kidney stone prevention through several mechanisms. Increased urinary magnesium concentration directly inhibits calcium oxalate crystallization by forming soluble complexes with oxalate in the urine. This reduces the availability of free oxalate to bind with calcium, thereby decreasing the supersaturation of calcium oxalate — the primary driving force behind stone formation. Clinical studies have demonstrated that magnesium supplementation can reduce kidney stone recurrence rates by 50% or more in patients with idiopathic calcium oxalate stones.
Treatment of Magnesium Deficiency
Magnesium deficiency (hypomagnesemia) is the second primary indication for Magnesium Evolan. Hypomagnesemia is defined as a serum magnesium level below 0.7 mmol/L and is estimated to affect 2.5-15% of the general population. The condition can arise from inadequate dietary intake, gastrointestinal losses (chronic diarrhea, malabsorption syndromes), renal losses (diuretic use, certain kidney diseases), or increased requirements (pregnancy, lactation, intense physical activity).
Symptoms of magnesium deficiency can be subtle initially but may progress to more serious manifestations. Early signs include muscle cramps, fatigue, weakness, loss of appetite, nausea, and tingling or numbness in the extremities. Severe deficiency can lead to cardiac arrhythmias, seizures, personality changes, and tetany. Chronic magnesium deficiency has been associated with an increased risk of type 2 diabetes, cardiovascular disease, osteoporosis, and migraine headaches.
Magnesium hydroxide, the active ingredient in Magnesium Evolan, may also be approved for other conditions not described in this article. Always consult your doctor, pharmacist, or other healthcare professional for guidance and follow their instructions.
What Should You Know Before Taking Magnesium Evolan?
Before taking Magnesium Evolan, you must ensure you do not have any contraindications such as severely impaired kidney function, chronic urinary tract infection, or infected kidney stones. Inform your doctor about all medications you take, as magnesium can interact with several drugs including antibiotics and bisphosphonates.
As with any prescription medication, it is essential to understand the contraindications, warnings, and precautions before starting treatment with Magnesium Evolan. Your doctor will have assessed these factors before prescribing the medication, but being aware of them helps you use the medicine safely and effectively.
Contraindications
Magnesium Evolan should not be used in the following situations:
- Allergy to magnesium hydroxide or any of the other excipients in the tablet (pregelatinized maize starch, povidone, hypromellose, crospovidone, colloidal anhydrous silicon dioxide, stearic acid)
- Chronic urinary tract infection: Magnesium supplementation may alter the urinary environment in ways that could worsen chronic urinary infections
- Infected kidney stones: Struvite stones (composed of magnesium ammonium phosphate) are associated with urinary tract infections, and additional magnesium could potentially contribute to their growth
- Severely impaired kidney function: The kidneys are the primary route for magnesium excretion. In patients with severely reduced kidney function (estimated GFR < 30 mL/min), magnesium cannot be adequately cleared from the body, leading to dangerous accumulation and potentially life-threatening hypermagnesemia
Warnings and Precautions
Consult your doctor before taking Magnesium Evolan if you have reduced kidney function (mild to moderate impairment). Your doctor may need to adjust the dosage and monitor your serum magnesium levels more frequently to prevent accumulation. Regular blood tests may be required to ensure that magnesium levels remain within the therapeutic range.
Patients with any degree of renal impairment should have their kidney function monitored periodically during treatment. If kidney function deteriorates during treatment, the dose may need to be reduced or the medication discontinued. Signs of magnesium accumulation include nausea, vomiting, facial flushing, drowsiness, hypotension, and in severe cases, respiratory depression and cardiac arrest.
If you develop symptoms such as persistent nausea, unusual drowsiness, muscle weakness, or low blood pressure while taking Magnesium Evolan, contact your doctor immediately. These may be signs of magnesium accumulation, especially if you have reduced kidney function.
Pregnancy and Breastfeeding
Magnesium Evolan can be taken during pregnancy. There are no known risks associated with its use during pregnancy. In fact, magnesium requirements increase during pregnancy, and adequate magnesium intake is important for both maternal health and fetal development. Magnesium deficiency during pregnancy has been associated with an increased risk of preeclampsia, gestational diabetes, preterm labor, and intrauterine growth restriction.
Magnesium hydroxide does pass into breast milk, but the amounts are unlikely to affect a nursing infant. Human milk naturally contains magnesium at concentrations of approximately 30-40 mg/L, and supplemental magnesium from maternal sources contributes minimally to this level. However, it is advisable to consult your doctor before using Magnesium Evolan regularly during breastfeeding, particularly for prolonged periods.
Driving and Operating Machinery
Magnesium Evolan has no known effect on the ability to drive or operate machinery. The medication does not cause drowsiness, dizziness, or other central nervous system effects that would impair your ability to safely operate vehicles or heavy equipment.
How Does Magnesium Evolan Interact with Other Drugs?
Magnesium can reduce the absorption of several medications when taken simultaneously, including tetracycline antibiotics, quinolone antibiotics, bisphosphonates, and levodopa. To avoid interactions, take these medications at least 2 hours before or after Magnesium Evolan. Always tell your doctor about all medicines you are taking.
Drug interactions with magnesium supplements are primarily related to the ability of magnesium ions to form insoluble chelation complexes with certain medications in the gastrointestinal tract. These complexes are poorly absorbed, leading to reduced bioavailability of both the magnesium and the interacting drug. Understanding these interactions is essential for ensuring that all of your medications work effectively.
It is important to inform your doctor or pharmacist about all medications you are currently taking, have recently taken, or plan to take. This includes prescription medicines, over-the-counter medications, vitamins, and herbal supplements. Your healthcare provider can advise you on the best way to schedule your medications to minimize interactions.
| Interacting Drug | Effect | Severity | Management |
|---|---|---|---|
| Tetracycline antibiotics (doxycycline, minocycline) | Magnesium chelates tetracyclines, reducing their absorption by up to 50-90% | Major | Take tetracycline 2-3 hours before or 4-6 hours after magnesium |
| Quinolone antibiotics (ciprofloxacin, levofloxacin) | Magnesium forms chelation complexes, reducing quinolone absorption by 30-50% | Major | Take quinolone 2 hours before or 6 hours after magnesium |
| Bisphosphonates (alendronate, risedronate) | Magnesium reduces bisphosphonate absorption significantly | Major | Take bisphosphonate at least 30 minutes before magnesium with plain water |
| Levodopa | Magnesium may reduce absorption of levodopa | Moderate | Separate doses by at least 2 hours |
| Mycophenolate mofetil | Magnesium-containing antacids reduce mycophenolate absorption | Moderate | Separate doses by at least 2 hours |
| Iron supplements | Magnesium and iron compete for absorption in the GI tract | Minor | Separate doses by at least 2 hours |
As a general rule, medications that may interact with magnesium should be taken at least 2 hours before or after Magnesium Evolan. If you are unsure about the timing, consult your pharmacist or doctor. Never stop taking a prescribed medication without consulting your healthcare provider.
What Is the Correct Dosage of Magnesium Evolan?
The standard dosage of Magnesium Evolan is one 250 mg tablet taken twice daily. Your doctor will determine the exact dose based on your individual condition and may adjust it over time. The tablet has a score line that allows it to be halved for easier swallowing, but the score line does not indicate half-dose use.
Always use Magnesium Evolan exactly as your doctor or pharmacist has instructed. If you are unsure about the correct dosage, consult your doctor or pharmacist. The dose is individualized based on your medical condition, the severity of any deficiency, your kidney function, and your response to treatment.
Adults
Standard Adult Dosage
Usual dose: 1 tablet (250 mg magnesium) twice daily
Administration: Take the tablets with a glass of water. The tablets can be taken with or without food, although taking them with meals may reduce the likelihood of gastrointestinal side effects.
Score line: The tablet has a score line (break line) to help you split the tablet if you have difficulty swallowing it whole. The score line is designed for ease of administration, not for dose division.
Your doctor may adjust the dosage based on your blood test results and clinical response. For kidney stone prevention, the goal is typically to achieve an adequate urinary magnesium concentration, which may require dose adjustments. For magnesium deficiency, the dose may be higher initially to replenish body stores and then reduced to a maintenance level.
Children
The use of Magnesium Evolan in children has not been extensively studied. If your doctor prescribes this medication for a child, they will determine the appropriate dose based on the child's weight, age, and clinical condition. Do not give this medication to a child unless specifically directed by a physician.
Elderly Patients
Elderly patients may require dose adjustments due to age-related decline in kidney function. Even if serum creatinine levels appear normal, the estimated glomerular filtration rate (eGFR) may be reduced in older adults. Your doctor will take your kidney function into account when prescribing the appropriate dose and will likely monitor your magnesium levels and kidney function more frequently.
Missed Dose
If you forget to take a dose of Magnesium Evolan, simply skip the missed dose and take your next dose at the regular scheduled time. Do not take a double dose to compensate for a forgotten tablet. Taking a double dose increases the risk of gastrointestinal side effects, particularly diarrhea.
Overdose
If you have taken too much Magnesium Evolan, or if a child has accidentally ingested the medication, contact your doctor, emergency department, or poison control center immediately for risk assessment and advice. Symptoms of magnesium overdose may include nausea, vomiting, facial flushing, low blood pressure, drowsiness, and in severe cases, respiratory depression, cardiac arrhythmias, and cardiac arrest. People with impaired kidney function are at the highest risk of overdose toxicity.
Your doctor may need to follow up your treatment with blood tests to monitor your serum magnesium levels, particularly if you have any degree of kidney impairment. Regular monitoring helps ensure the medication is working effectively and that magnesium levels remain within the safe therapeutic range (0.7-1.0 mmol/L).
What Are the Side Effects of Magnesium Evolan?
The most common side effect of Magnesium Evolan is diarrhea, which occurs in approximately 1-2% of patients. This typically resolves when the dose is halved for one week. Very rarely, prolonged use in patients with kidney impairment can cause hypermagnesemia (high blood magnesium). Abdominal pain has also been reported.
Like all medicines, Magnesium Evolan can cause side effects, although not everybody gets them. Most side effects are mild and related to the gastrointestinal tract, reflecting the osmotic properties of magnesium hydroxide. Understanding the potential side effects helps you recognize them early and take appropriate action.
The side effects are categorized below by frequency according to international medical convention. If you experience any side effects that concern you, or if side effects persist or worsen, contact your doctor or pharmacist for advice.
Common
May affect up to 1 in 10 patients
- Diarrhea — The most frequently reported side effect, occurring in approximately 1-2% of patients. Magnesium hydroxide has an osmotic effect in the intestines, drawing water into the bowel lumen. This side effect usually resolves if the dose is halved for approximately one week. Consult 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, vomiting, facial flushing, drowsiness, muscle weakness, low blood pressure, and in severe cases, respiratory depression and cardiac abnormalities. Patients with kidney impairment should be monitored regularly.
Frequency Not Known
Cannot be estimated from available data
- Abdominal pain — Stomach or abdominal discomfort has been reported. This is typically mild and transient, often associated with the osmotic effects of magnesium in the gastrointestinal tract.
If you experience any side effects, including any not listed above, talk to your doctor or pharmacist. You can also report side effects directly to your national medicines regulatory authority. By reporting side effects, you can help provide more information on the safety of this medicine.
Managing Diarrhea
Diarrhea is the most commonly reported side effect and is typically dose-related. The mechanism behind this is the osmotic action of magnesium hydroxide: unabsorbed magnesium in the intestinal lumen draws water into the bowel through osmosis, increasing stool water content and frequency. If you experience diarrhea while taking Magnesium Evolan, the following strategies may help:
- Dose reduction: Your doctor may recommend halving the dose for approximately one week, which usually resolves the symptom. Do not adjust your dose without consulting your doctor first.
- Take with food: Taking the tablet with meals may slow absorption and reduce the osmotic effect in the intestines.
- Adequate hydration: Drink sufficient fluids to compensate for any fluid losses from loose stools.
- Gradual dose increase: If starting treatment, your doctor may recommend beginning with a lower dose and gradually increasing to the target dose to allow your gastrointestinal system to adapt.
How Should You Store Magnesium Evolan?
Store Magnesium Evolan at room temperature, out of sight and reach of children. Do not use the medication after the expiry date printed on the packaging. Dispose of unused medication properly through your pharmacy — do not flush it down the drain or discard it in household waste.
Proper storage of medications is essential to maintain their effectiveness and safety. Magnesium Evolan should be stored under the following conditions:
- Keep out of sight and reach of children — Store the medication in a secure location where children cannot access it. Accidental ingestion by children can cause gastrointestinal symptoms and, in large amounts, potentially dangerous hypermagnesemia.
- Check the expiry date — Do not use the medication after the expiry date printed on the packaging (marked as "EXP" or similar). The expiry date refers to the last day of the indicated month. Expired medications may be less effective and should be properly disposed of.
- Storage conditions — No special storage conditions are required. Store at room temperature (below 25°C / 77°F) and protect from excessive moisture and direct sunlight. Keep the container tightly closed.
- Proper disposal — Do not dispose of medications via wastewater or household waste. Return unused or expired medication to your pharmacy for proper disposal. This helps protect the environment from pharmaceutical contamination of water sources and ecosystems.
Magnesium Evolan is available in the following package sizes: 90, 100, 105, 300 (3 × 100), and 500 (5 × 100) tablets in a plastic container. Not all pack sizes may be marketed in your country.
What Does Magnesium Evolan Contain?
Each Magnesium Evolan tablet contains magnesium hydroxide equivalent to 250 mg of elemental magnesium as the active ingredient. The tablet also contains several inactive ingredients (excipients) that serve as binders, disintegrants, and flow agents to ensure consistent tablet quality.
Active Ingredient
The active ingredient is magnesium hydroxide, providing the equivalent of 250 mg of elemental magnesium per tablet. Magnesium hydroxide [Mg(OH)₂] is an inorganic compound that dissociates in the stomach to release magnesium ions (Mg²⁺) and hydroxide ions (OH⁻). The magnesium ions are then absorbed primarily in the small intestine.
Inactive Ingredients (Excipients)
The following excipients are used in the manufacture of Magnesium Evolan tablets:
- Pregelatinized maize starch — Serves as a binder and disintegrant, helping the tablet maintain its shape during manufacturing and break apart properly in the stomach
- Povidone — A binding agent that helps hold the tablet ingredients together
- Hypromellose — Used as a binder and film-forming agent to improve tablet integrity
- Crospovidone — A super-disintegrant that promotes rapid breakdown of the tablet in gastrointestinal fluids
- Colloidal anhydrous silicon dioxide — A flow agent (glidant) that prevents ingredients from clumping during manufacturing
- Stearic acid — A lubricant that prevents the tablet from sticking to manufacturing equipment
Tablet Appearance
Magnesium Evolan tablets are white, round, and flat with a score line (break line) on one side. The score line is intended solely to facilitate breaking the tablet for patients who have difficulty swallowing it whole, and does not indicate that the tablet should be divided into equal half-doses.
Frequently Asked Questions About Magnesium Evolan
Magnesium Evolan is used for two main purposes: (1) prevention of recurrent kidney stones of unknown origin (idiopathic nephrolithiasis), and (2) treatment of magnesium deficiency (hypomagnesemia). The medication contains magnesium hydroxide, which provides 250 mg of elemental magnesium per tablet. By increasing urinary magnesium levels, it helps inhibit the formation of calcium oxalate kidney stones, which are the most common type. For magnesium deficiency, it replenishes the body's magnesium stores, helping to restore normal muscle and nerve function, energy production, and other magnesium-dependent physiological processes.
Yes, Magnesium Evolan can be taken during pregnancy. There are no known risks associated with its use during pregnancy, and adequate magnesium intake is particularly important during this time. Magnesium hydroxide does pass into breast milk but is unlikely to affect a nursing infant, as the amounts are very small compared to the magnesium naturally present in human milk. However, if you plan to use the medication regularly during breastfeeding, it is advisable to consult your doctor first.
Diarrhea is the most common side effect of Magnesium Evolan, affecting approximately 1-2% of patients. It is caused by the osmotic effect of magnesium in the intestines. If you experience diarrhea, do not stop taking the medication without consulting your doctor. In most cases, reducing the dose by half for about one week allows the digestive system to adjust, and the diarrhea resolves. Your doctor can advise on the best approach. Taking the tablets with meals and ensuring adequate hydration can also help manage this side effect.
Magnesium can interact with several medications by reducing their absorption. This is particularly important for tetracycline antibiotics (doxycycline, minocycline), quinolone antibiotics (ciprofloxacin, levofloxacin), bisphosphonates (alendronate, risedronate), and levodopa. The general recommendation is to take these medications at least 2 hours before or after Magnesium Evolan to avoid interaction. Always inform your doctor about all medications you are taking so they can advise on proper timing and dosing.
Magnesium Evolan should not be taken by individuals who: (1) are allergic to magnesium hydroxide or any other ingredient in the tablet, (2) have a chronic urinary tract infection, (3) have infected kidney stones (struvite stones), or (4) have severely impaired kidney function. Additionally, patients with moderately reduced kidney function should only take Magnesium Evolan under close medical supervision, with regular monitoring of serum magnesium levels and kidney function tests. If you are unsure whether this medication is safe for you, discuss it with your doctor.
Magnesium Evolan prevents kidney stones by increasing the concentration of magnesium in the urine. Urinary magnesium binds to oxalate, forming soluble magnesium oxalate complexes. This reduces the amount of free oxalate available to combine with calcium, thereby decreasing the supersaturation of calcium oxalate in the urine — which is the primary driving force behind the formation of the most common type of kidney stones. Clinical studies have shown that magnesium supplementation can reduce the recurrence rate of calcium oxalate kidney stones by 50% or more.
References
This article is based on evidence from the following international sources. All medical claims adhere to Evidence Level 1A (systematic reviews and meta-analyses of randomized controlled trials) where available.
- World Health Organization (WHO). WHO Model List of Essential Medicines — 23rd List. Geneva: WHO; 2023. Available at: who.int
- European Medicines Agency (EMA). SmPC Guidelines for Magnesium-Containing Medicinal Products. Amsterdam: EMA; 2023.
- British National Formulary (BNF). Magnesium hydroxide: Drug monograph. NICE; 2024. Available at: bnf.nice.org.uk
- Moe OW. Kidney stones: pathophysiology and medical management. The Lancet. 2006;367(9507):333-344. doi:10.1016/S0140-6736(06)68071-9
- Johansson G, Backman U, Danielson BG, et al. Magnesium metabolism in renal stone formers. Effects of therapy with magnesium hydroxide. Scand J Urol Nephrol Suppl. 1980;53:125-130.
- Guerrera MP, Volpe SL, Mao JJ. Therapeutic uses of magnesium. Am Fam Physician. 2009;80(2):157-162.
- de Baaij JH, Hoenderop JG, Bindels RJ. Magnesium in man: implications for health and disease. Physiol Rev. 2015;95(1):1-46. doi:10.1152/physrev.00012.2014
- Ettinger B, Citron JT, Livermore B, Dolman LI. Chlorthalidone reduces calcium oxalate calculous recurrence but magnesium hydroxide does not. J Urol. 1988;139(4):679-684.
- Pak CY. Kidney stones. The Lancet. 1998;351(9118):1797-1801.
- National Institutes of Health (NIH). Magnesium: Fact Sheet for Health Professionals. Office of Dietary Supplements; 2024. Available at: ods.od.nih.gov
Editorial Team
This article has been written and reviewed by qualified medical professionals according to iMedic's rigorous editorial standards. All information is evidence-based and follows international guidelines from the WHO, EMA, FDA, and BNF.
iMedic Medical Editorial Team — Licensed physicians and pharmacologists with clinical experience in internal medicine, nephrology, and clinical pharmacology.
iMedic Medical Review Board — Independent panel of specialist physicians who review all content according to GRADE evidence framework and international medical guidelines.
Every article undergoes a multi-step review process: (1) Initial research and writing by qualified medical professionals, (2) Medical fact-checking against peer-reviewed sources and clinical guidelines, (3) Independent review by our Medical Review Board, (4) Regular updates to reflect the latest evidence. We follow the GRADE evidence framework and declare no conflicts of interest or commercial funding.