MgSO4 Intravenous:

Preparation:

IV: Dilute in a compatible solution (eg, D5W, NS) to a usual concentration of 0.5 mEq/mL of elemental magnesium (ie, 60 mg/mL of magnesium sulfate); maximum concentration: 20% (ie, 200 mg/mL of magnesium sulfate or 1.6 mEq/mL of elemental magnesium).

Administration:

IV: Dilute in an appropriate fluid prior to administration. Rate of infusion dependent upon use:

Hypomagnesemia: Note: Rate should be slowed if patient experiences diaphoresis, flushing, or a warm sensation (Kliegman 2020).

Asymptomatic: In asymptomatic patients, a rate of ≤0.1 mEq/kg/hour of elemental magnesium (~12.5 mg/kg/hour magnesium sulfate) may be considered (in adults, the usual rate is ≤1,000 mg/hour of magnesium sulfate) (ASPEN [Corkins 2015]).

Urgent/emergent: Infuse slowly over 15 to 20 minutes (AAP [Shenoi 2020]).

Pulseless ventricular tachycardia (VT) associated with torsades: May administer as a bolus over several minutes (AAP [Shenoi 2020]; PALS [Kleinman 2010]).

VT with pulses associated with torsades: Infuse over 10 to 20 minutes; rapid infusion may cause hypotension (AAP [Shenoi 2020].

Asthma exacerbation (severe): Infuse over 15 to 60 minutes (AAP [Shenoi 2020]; GINA 2020).