evaluation of intravenous magnesium supplementation as prophylaxis for cisplatin-induced hypomagnesemia

background : we assessed the effects of cisplatin-based chemotherapy, magnesium supplementation, probable contributory factors such as cisplatin cumulative dose and dose per cycle on serum magnesium levels. methods : in this prospective randomized study, serum magnesium levels of 59 newly diagnosed adult patients receiving cisplatin-based chemotherapy were studied. the patients were randomly allocated to receive magnesium supplementation at a dose of 5 g iv per cycle (n=31) or to a control group (n=28). serum magnesium levels <1.8 mg/dl were considered to indicate hypomagnesemia. results : the decrease in mean magnesium levels with continuing chemotherapy courses was significant in both groups with a more prominent decrease in the control group. in courses 4 and 5, mean magnesium levels were significantly higher among those who received magnesium supplementation than in the control group. thirty patients (50.8%) had at least one incident of hypomagnesemia after beginning chemotherapy. all hypomagnesemia incidents were mild (mean 1.69, range; 1.52-1.79 mg/dl). hypomagnesemia was more frequent in the control group (38.7% vs. 60.7%, p=0.09). although age and sex had no significant effect on the incidence of hypomagnesemia, more hypomagnesemia incidents were observed in patients who received cisplatin in a single loading dose than in those who received the drug in divided doses for each cycle (71.4% % vs. 42.9%, p=0.056). conclusion : magnesium supplementation at a dose of 5 g per cycle partially compensated for cisplatin- induced magnesium loss. monitoring magnesium levels and magnesium supplementation is warranted, especially for those undergoing protracted courses of cisplatin-based chemotherapy. patients who receive the drug in a single loading dose might be more prone to magnesium loss.