Drug General Information (ID: DDIOUCKPR2)
Drug Name			Magnesium sulfate		Drug Info		Raltegravir		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Analgesics				Antiviral Agents
Structure

Mechanism of Magnesium sulfate-Raltegravir Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Magnesium sulfate				Raltegravir
Mechanism		Polyvalent cations				Binds to polyvalent cations
Key Mechanism Factor 1
		Factor Name		Chelation
		Factor Description		Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
Mechanism Description		Decreased absorption of Magnesium sulfate due to formation of complexes caused by Raltegravir

Recommended Action
Management		It is not known to what extent non-antacid aluminum and magnesium salts may interact with raltegravir. Until more information is available, it may be advisable to avoid taking raltegravir with any aluminum- and/or magnesium-containing product. According to the manufacturer, antacids containing calcium carbonate may be used without dose adjustment for raltegravir.

References
1	Canadian Pharmacists Association.
2	Cerner Multum, Inc. "Australian Product Information.".
3	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
4	Kiser JJ, Bumpass JB, Meditz AL, et al. "Effect of antacids on the pharmacokinetics of raltegravir in human immunodeficiency virus seronegative volunteers." Antimicrob Agents Chemother 54 (2010): 4999-5003. [PMID: 20921313]
5	Moss DM, Siccardi M, Murphy M, et al. "Divalent metals and pH alter raltegravir disposition in vitro." Antimicrob Agents Chemother 56 (2012): 3020-6. [PMID: 22450971]
6	Product Information. Isentress (raltegravir). Merck & Company Inc, West Point, PA.