Macs-K

Magnesium Citrate (1100mg) + Potassium Citrate (375mg)
Price: ₹220 - ₹270 for 15 tablets
Mfr: Macleods Pharmaceuticals Ltd. | Form: Tablet

📋 Clinical Overview

A fixed-dose combination of essential electrolytes, Magnesium Citrate and Potassium Citrate, primarily used for the prevention and treatment of hypomagnesemia and hypokalemia. It also serves as a urinary alkalinizer for conditions like renal tubular acidosis and hypocitraturic calcium oxalate nephrolithiasis. The citrate salts offer superior bioavailability compared to oxide or chloride salts and are generally better tolerated.

💊 Dosage & Administration

Adult: Typically 1 tablet/capsule containing Magnesium Citrate 1100mg (equivalent to ~160mg elemental Mg) + Potassium Citrate 375mg (equivalent to ~3mEq K+) once or twice daily after meals with a full glass of water. Dosage must be individualized based on serum levels and clinical response.

Note: Take with or immediately after food to minimize gastrointestinal irritation. Swallow whole with 200-250 mL of water. Do not crush or chew. Maintain adequate fluid intake (at least 2-2.5 L/day) to ensure proper dissolution and renal excretion, especially when used for stone prevention.

⚠️ Contraindications

  • Severe renal impairment (eGFR <30 mL/min/1.73m²) or anuria
  • Hyperkalemia (serum K+ >5.0 mEq/L)
  • Hypermagnesemia
  • Addison's disease (adrenal insufficiency)
  • Active peptic ulcer disease (citrate can be converted to bicarbonate, affecting gastric pH)

🔬 Mechanism of Action

Replenishes body stores of magnesium and potassium ions, which are critical cofactors for over 300 enzymatic reactions (Mg) and for maintaining resting membrane potential (K). The citrate moiety, upon metabolism, increases urinary pH and citrate excretion, inhibiting calcium oxalate and phosphate stone formation.

🤕 Side Effects

  • Diarrhea (due to magnesium's osmotic effect)
  • Nausea
  • Abdominal discomfort, cramping
  • Mild gastrointestinal irritation

🤰 Special Populations

Pregnancy: Category A (Indian FDA). Considered safe when used in recommended doses. Essential minerals are required in increased amounts during pregnancy. However, use should be for documented deficiency and under medical supervision.

Driving: Unlikely to affect driving ability. However, if symptoms of hypermagnesemia (drowsiness, dizziness) occur, driving should be avoided.

🔄 Drug Interactions

Potassium-Sparing Diuretics (Spironolactone, Amiloride)Increased risk of severe hyperkalemiaMajor
ACE Inhibitors (Ramipril, Enalapril) / ARBs (Losartan, Telmisartan)Increased risk of hyperkalemiaMajor
NSAIDs (Ibuprofen, Diclofenac)May reduce renal potassium excretion, increasing hyperkalemia riskModerate
Cardiac Glycosides (Digoxin)Hypomagnesemia and hypokalemia potentiate digoxin toxicity. Correction of deficits can alter digoxin requirements.Major
Tetracycline, Bisphosphonates (Alendronate), FluoroquinolonesMagnesium can chelate these drugs, severely reducing their absorption. Administer at least 2-4 hours apart.Major
Anticholinergic AgentsIncreased risk of GI mucosal injury due to delayed transit of tablet.Moderate

🔁 Alternatives to Macs-K

Same composition (Magnesium Citrate (1100mg) + Potassium Citrate (375mg)), different brands:

Uprise-MK Magnex-K Maga-K M-K Citra